Nutrient depletion·Magnesium·Reviewed June 9, 2026
What depletes magnesium?
22 medications in the NutriStack database are documented to lower Magnesium with ongoing use, most notably Cyclosporine, Esomeprazole, Furosemide, and Lansoprazole. The pattern spans 14 drug classes. Another 4 bind magnesium in the gut when taken at the same time, which is a timing problem rather than true depletion. Depletion builds slowly and is easy to miss; the table below shows how each medication drives it and which biomarker to check. Never start a replacement supplement without your prescriber's input.
Magnesium depletion at a glance.
A quick, data-grounded summary. The per-medication table is below.
22 medications in the NutriStack database are documented to lower Magnesium with ongoing use, most notably Cyclosporine, Esomeprazole, Furosemide, and Lansoprazole. The pattern spans 14 drug classes. Another 4 bind magnesium in the gut when taken at the same time, which is a timing problem rather than true depletion. Depletion builds slowly and is easy to miss; the table below shows how each medication drives it and which biomarker to check. Never start a replacement supplement without your prescriber's input.
What is documented to lower magnesium.
Worst documented severity first. Open any medication for its full interaction and depletion guide. Absence from this table means no documented record, not proven safety.
| Medication | Severity | How it lowers magnesium | Monitor |
|---|---|---|---|
| Cyclosporine Calcineurin inhibitor immunosuppressant | Significant | Calcineurin inhibitors can cause renal magnesium wasting and hypomagnesemia. | Serum magnesium |
| Esomeprazole Proton Pump Inhibitor | Significant | Chronic acid suppression impairs active intestinal magnesium transport, especially via TRPM6/7-mediated uptake. | Serum magnesium or RBC magnesium |
| Furosemide Loop Diuretic | Significant | Loop diuretics reduce paracellular magnesium reabsorption in the thick ascending limb, increasing renal losses. | Serum magnesium or RBC magnesium |
| Lansoprazole Proton Pump Inhibitor | Significant | Chronic acid suppression impairs active intestinal magnesium transport, especially via TRPM6/7-mediated uptake. | Serum magnesium or RBC magnesium |
| Omeprazole Proton Pump Inhibitor | Significant | Chronic acid suppression impairs active intestinal magnesium transport, especially via TRPM6/7-mediated uptake. | Serum magnesium or RBC magnesium |
| Pantoprazole Proton Pump Inhibitor | Significant | Chronic acid suppression impairs active intestinal magnesium transport, especially via TRPM6/7-mediated uptake. | Serum magnesium or RBC magnesium |
| Rabeprazole Proton pump inhibitor | Significant | Long-term PPI therapy can impair intestinal magnesium absorption and cause clinically significant hypomagnesemia. | Serum magnesium |
| Tacrolimus Calcineurin inhibitor immunosuppressant | Significant | Tacrolimus can cause renal magnesium wasting and clinically significant hypomagnesemia. | Serum magnesium |
| Chlorthalidone Thiazide-Like Diuretic | Moderate | Thiazides can increase urinary magnesium losses and contribute to low magnesium status. | Serum magnesium or RBC magnesium |
| Ciprofloxacin Fluoroquinolone Antibiotic | Moderate | Fluoroquinolones can increase renal magnesium wasting and can also bind supplemental magnesium in the gut during active treatment. | Serum magnesium or RBC magnesium |
| Dexamethasone Corticosteroid | Moderate | Chronic corticosteroid use can increase urinary magnesium losses and worsen low magnesium status. | Serum magnesium or RBC magnesium |
| Hydrochlorothiazide Thiazide Diuretic | Moderate | Thiazides can increase urinary magnesium losses and contribute to low magnesium status. | Serum magnesium or RBC magnesium |
| Levofloxacin Fluoroquinolone Antibiotic | Moderate | Fluoroquinolones can increase renal magnesium wasting and can also bind supplemental magnesium in the gut during active treatment. | Serum magnesium or RBC magnesium |
| Losartan/Hydrochlorothiazide Angiotensin II receptor blocker plus thiazide diuretic (fixed-dose combination) | Moderate | Thiazide diuretics can increase urinary magnesium loss. | Serum magnesium |
| Methylprednisolone Corticosteroid | Moderate | Chronic corticosteroid use can increase urinary magnesium losses and worsen low magnesium status. | Serum magnesium or RBC magnesium |
| Prednisolone Corticosteroid | Moderate | Chronic corticosteroid use can increase urinary magnesium losses and worsen low magnesium status. | Serum magnesium or RBC magnesium |
| Prednisone Corticosteroid | Moderate | Chronic corticosteroid use can increase urinary magnesium losses and worsen low magnesium status. | Serum magnesium or RBC magnesium |
| Torsemide Loop diuretic | Moderate | Loop diuretics increase urinary magnesium excretion. | Serum magnesium |
| Combined Oral Contraceptive Hormonal Contraceptive | Mild | Oral contraceptives are associated with lower magnesium status in some users, likely through altered renal handling and demand. | RBC magnesium |
| Valganciclovir Antiviral (nucleoside analogue prodrug) | Mild | Ganciclovir/valganciclovir can cause renal tubular dysfunction and is frequently co-administered in transplant recipients receiving calcineurin... | Serum magnesium |
| Vancomycin Glycopeptide antibiotic | Mild | Vancomycin nephrotoxicity, particularly with intravenous use, elevated trough concentrations, or concurrent aminoglycosides, can cause acute kidney... | Serum magnesium (alongside serum creatinine and vancomycin trough levels) |
| Voriconazole Triazole antifungal | Mild | Hypomagnesemia is reported during voriconazole therapy, often co-occurring with hypokalemia and frequently driven by concurrent therapies such as... | Serum magnesium |
Binds magnesium, not depletion.
These medications form poorly absorbed complexes with magnesium in the gut when doses overlap. That blunts absorption of the medication, the mineral, or both at that dose, but it does not drain the body's stores. The fix is separating doses by the window on each medication's page, not supplementing more.
| Medication | Severity | What happens when taken together | Monitor |
|---|---|---|---|
| Doxycycline Tetracycline Antibiotic | Mild | Tetracyclines chelate magnesium in the gut, functionally reducing magnesium availability when co-administered. | Serum magnesium or RBC magnesium |
| Minocycline Tetracycline antibiotic | Mild | Magnesium ions chelate minocycline in the gastrointestinal tract, and magnesium-containing antacids or supplements reduce absorption of the... | Serum magnesium (rarely required) |
| Moxifloxacin Fluoroquinolone antibiotic | Mild | Moxifloxacin forms insoluble chelate complexes with divalent magnesium cations in the gastrointestinal tract. This is primarily a bidirectional... | Serum magnesium (routine monitoring not generally required for healthy patients on short courses) |
| Tetracycline Tetracycline antibiotic | Mild | As a divalent cation, magnesium forms insoluble chelates with tetracycline in the gut, reducing absorption of both agents. Antacids and supplements... | Serum magnesium |
If you need to restore magnesium.
Repletion is not automatic: dose, form, and timing depend on the medication involved, and some pairings need separation from the very drug causing the depletion. Confirm with your prescriber before adding magnesium.
Common magnesium depletion questions.
Quick answers drawn from the table above.
Which medications deplete magnesium?
22 medications in the NutriStack database are documented to lower magnesium, including Cyclosporine, Esomeprazole, Furosemide, Lansoprazole, and Omeprazole. Severity differs by drug; the full table with mechanisms and monitoring biomarkers is on this page.
How do I know if my magnesium is low?
The biomarkers used to track magnesium status in this context include Serum magnesium, Serum magnesium or RBC magnesium, and RBC magnesium. If you take one of the medications above long term, ask your prescriber whether checking is worthwhile; depletion develops gradually.
Should I take a magnesium supplement with these medications?
Not automatically. Documented depletion makes repletion worth discussing, but the right answer depends on your labs, dose, and the specific drug, and some pairings need magnesium doses separated from the medication itself. Bring it up with your prescriber or pharmacist.
Check your whole stack
See what your medications deplete.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.