NutriStack
Chlorthalidone and Magnesium Malate, a synergy.
Chlorthalidone has documented potential to lower magnesium during chronic treatment. Magnesium malate is a magnesium-containing supplement that can support replacement when depletion is present. This is most important when low magnesium accompanies low potassium, muscle symptoms, or arrhythmia risk.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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From the interaction database
What the row says.
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At a glance
- Substances
- Chlorthalidone and Magnesium Malate
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Chlorthalidone has documented potential to lower magnesium during chronic treatment. Magnesium malate is a magnesium-containing supplement that can support replacement when depletion is present. This is most important when low magnesium accompanies low potassium, muscle symptoms, or arrhythmia risk.
Mechanism. Chlorthalidone blocks NCC in the distal convoluted tubule and can increase renal magnesium wasting. Magnesium malate provides supplemental magnesium to offset this loss.
Recommendation. Ask your prescriber about checking magnesium if you use chlorthalidone long term. Use magnesium malate at a consistent replacement dose and avoid high-dose use without kidney-function monitoring.
Sources (2)
- Cocco G, Iselin HU, Strozzi C, Cesana B, Baumeler HR. Magnesium depletion in patients on long-term chlorthalidone therapy for essential hypertension. Eur J Clin Pharmacol. 1987;32(4):335-338. PMID 2886340
- Mohn ES, Kern HJ, Saltzman E, Mitmesser SH, McKay DL. Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update. Pharmaceutics. 2018;10(1):36. PMID 29558445
Stack Score
How this pair moves the number.
Effect on the composite score
If both Chlorthalidone and Magnesium Malate are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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