Intravenous Magnesium Sulfate Administration Guidelines

Dosing by Clinical Indication

• For severe refractory asthma exacerbations, administer 2 g IV magnesium sulfate over 20 minutes, as recommended by the American Heart Association, for patients with the most severe exacerbations, particularly those with severe respiratory distress who have failed to respond to initial bronchodilator therapy 1, 3
• For torsades de pointes, administer 2 g IV magnesium sulfate as first-line therapy regardless of serum magnesium level, as recommended by the American Heart Association 2
• If episodes of torsades persist, repeat infusions of 2 g may be necessary, according to the American Heart Association guidelines 2
• The American Thoracic Society recommends that IV magnesium sulfate is not used for mild or moderate asthma exacerbations as it shows no benefit in these populations 1, 3