Denosumab-Induced Hypomagnesemia

Clinical Monitoring and Management

• The American Society of Clinical Oncology suggests that more frequent magnesium monitoring is warranted for patients receiving concurrent chemotherapy agents known to cause hypomagnesemia, such as cisplatin or cetuximab, in patients with cancer 1
• Intravenous magnesium sulfate replacement is recommended for symptomatic hypomagnesemia, with neurological symptoms including confusion, hallucinations, irritability, nystagmus, seizures, and severe pain, in patients treated with denosumab 1

Treatment Approach

• The European Society for Medical Oncology recommends intravenous magnesium sulfate replacement for symptomatic hypomagnesemia, in patients with solid malignancies and bone metastases treated with denosumab 1