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Cancer Chemotherapy and Pharmacology

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01-04-2019 | Proton Pump Inhibitors | Original Article

Influence of oral magnesium-containing supplement and antacid administration on hypomagnesemia induced by panitumumab

Authors: Junya Sato, Hiroshi Ishikawa, Rei Tanaka, Michihiro Sino

Published in: Cancer Chemotherapy and Pharmacology | Issue 4/2019

Abstract

Purpose

Hypomagnesemia is a common side effect of panitumumab. The effect of magnesium-containing supplement as a laxative and concomitant antacid (proton pump inhibitor and histamine H₂ antagonist) administration on panitumumab-induced hypomagnesemia was retrospectively investigated.

Methods

Patients with advanced or recurrent colorectal cancer who received panitumumab were included in this study. Serum magnesium levels were extracted from the electronic medical records of 1753 administrations in 221 patients who received panitumumab. Serum magnesium levels in patients with or without oral magnesium-containing supplement and antacid treatment were compared using analysis of covariance as the number of panitumumab administration up to 16 times for covariates.

Results

The mean serum magnesium levels were significantly decreased with increasing number of panitumumab administrations (2.13 mg/dL at 1st vs. 1.55 mg/dL at 16th, p < 0.001). The use of oral magnesium-containing supplement significantly inhibited the decline in mean serum magnesium level (1.98 mg/dL vs. 1.78 mg/dL, p < 0.001). However, antacid use in patients receiving oral magnesium-containing supplement significantly decreased the effectiveness of the magnesium supplement on serum magnesium level (2.02 mg/dL vs. 1.93 mg/dL, p < 0.05).

Conclusion

The use of oral magnesium-containing supplement might function as magnesium supplement based on the finding that use of oral magnesium-containing supplement during panitumumab administration decreased hypomagnesemia. However, combination of antacid decreased the supplemental effect of oral magnesium on hypomagnesemia. These results suggest the possibility that use of antacids during anti-EGFR antibody administration may promote hypomagnesemia.

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Title: Influence of oral magnesium-containing supplement and antacid administration on hypomagnesemia induced by panitumumab
Authors: Junya Sato
Hiroshi Ishikawa
Rei Tanaka
Michihiro Sino
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Keywords: Proton Pump Inhibitors
Antacid
Panitumumab
Published in: Cancer Chemotherapy and Pharmacology / Issue 4/2019
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-019-03772-y

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Abstract

Purpose

Methods

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