Neutrogel is used as a dietary supplement for individuals who are deficient in Neutrogel. Although a balanced diet usually supplies all the Neutrogel a person needs, Neutrogel supplements may be needed by patients who have lost Neutrogel because of illness or treatment with certain medicines.
Lack of Neutrogel may lead to irritability, muscle weakness, and irregular heartbeat.
Injectable Neutrogel is given only by or under the supervision of a health care professional. Some oral Neutrogel preparations are available only with a prescription. Others are available without a prescription.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
peptic ulcer, gastritis, dyspepsia
How should I use Neutrogel?
Use Neutrogel as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Take Neutrogel by mouth with food.
If you miss a dose of Neutrogel and are using it regularly, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Neutrogel.
Uses of Neutrogel in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
This medication is a mineral supplement used to prevent and treat low amounts of Neutrogel in the blood. Neutrogel is very important for the normal functioning of cells, nerves, muscles, bones, and the heart. Usually, a well-balanced diet provides normal blood levels of Neutrogel. However, certain situations cause your body to lose Neutrogel faster than you can replace it from your diet. These situations include treatment with "water pills" (diuretics such as furosemide, hydrochlorothiazide), a poor diet, alcoholism, or other medical conditions (e.g., severe diarrhea/vomiting, stomach/intestinal absorption problems, poorly controlled diabetes).
How to use Neutrogel (oxide/AA chelate)
Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.
It is best to take Neutrogel supplements with a meal to reduce stomach upset and diarrhea unless otherwise directed by the product instructions or your doctor.
Take each dose with a full glass (8 ounces or 240 milliliters) of water unless your doctor directs you otherwise. Swallow extended-release capsules and delayed-release/enteric coated tablets or capsules whole. Do not crush or chew extended-release or delayed-release/enteric coated capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
If you are using a liquid product, use a medication measuring device to carefully measure the dose. Do not use a household spoon because you may not get the correct dose. If you are using a suspension, shake the bottle well before each dose.
Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time(s) each day. Dosage is based on your medical condition and response to treatment. Do not increase your dose or take it more often than directed on the product package or by your doctor. Too much Neutrogel in the blood can cause serious side effects.
Tell your doctor if symptoms of low Neutrogel blood levels (e.g., muscle cramps, tiredness, irritability, depression) persist or worsen. If you think you may have a serious medical problem, seek immediate medical attention.
Usual Adult Dose for Hypomagnesemia
500 to 1000 mg Neutrogel gluconate (27 to 54 mg elemental Neutrogel) orally 3 times a day.
Usual Adult Dose for Dietary Supplement
500 to 1000 mg Neutrogel gluconate (27 to 54 mg elemental Neutrogel) orally once a day.
Usual Pediatric Dose for Hypomagnesemia
10 to 20 mg/kg of elemental Neutrogel per dose orally 4 times a day. Use Neutrogel gluconate oral liquid preparations for more accurate measurement of dose.
Renal Dose Adjustments
Do not use without physician supervision in patients with renal impairment due to increased risk of hypermagnesemia. The use of Neutrogel salts are generally contraindicated in patients with severe renal dysfunction.
Liver Dose Adjustments
Data not available
May increase by 500 to 1,000 mg/day (27 to 54 mg elemental Neutrogel) in order to achieve a normal serum Neutrogel level. Daily doses > 1,000 mg (54 mg elemental Neutrogel) should be given in 2 to 3 divided doses.
Because Neutrogel is primarily eliminated by the kidney, there is significant risk of hypermagnesemia in patients with renal dysfunction.
Data not available; however, use of Neutrogel salts is generally contraindicated in renal failure.
Neutrogel supplements are often used with "low normal" serum Neutrogel levels in patients predisposed to hypomagnesemia (e.g., patients on diuretics).
Alfacalcidol: May increase the serum concentration of Neutrogel Salts. Consider therapy modification
Alpha-Lipoic Acid: Neutrogel Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Neutrogel Salts. Consider therapy modification
Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Avoid combination
Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Consider therapy modification
Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. Consider therapy modification
Calcitriol (Systemic): May increase the serum concentration of Neutrogel Salts. Management: Consider using a non-Neutrogel-containing antacid or phosphate-binding product in patients also receiving calcitriol. If Neutrogel-containing products must be used with calcitriol, serum Neutrogel concentrations should be monitored closely. Consider therapy modification
Calcium Channel Blockers: May enhance the adverse/toxic effect of Neutrogel Salts. Neutrogel Salts may enhance the hypotensive effect of Calcium Channel Blockers. Monitor therapy
Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification
Dolutegravir: Neutrogel Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral Neutrogel salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral Neutrogel salts. Consider therapy modification
Doxercalciferol: May enhance the hypermagnesemic effect of Neutrogel Salts. Management: Consider using a non-Neutrogel-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If Neutrogel-containing products must be used with doxercalciferol, serum Neutrogel concentrations should be monitored closely. Consider therapy modification
Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Consider therapy modification
Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Consider therapy modification
Gabapentin: Neutrogel Salts may enhance the CNS depressant effect of Gabapentin. Specifically, high dose intravenous/epidural Neutrogel sulfate may enhance the CNS depressant effects of gabapentin. Neutrogel Salts may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a Neutrogel-containing antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural Neutrogel sulfate is used. Consider therapy modification
Levothyroxine: Neutrogel Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral Neutrogel salts by at least 4 hours. Consider therapy modification
Multivitamins/Fluoride (with ADE): Neutrogel Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, Neutrogel salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of Neutrogel salts from administration of a fluoride-containing product by at least 1 hour. Consider therapy modification
Mycophenolate: Neutrogel Salts may decrease the serum concentration of Mycophenolate. Management: Separate doses of mycophenolate and oral Neutrogel salts. Monitor for reduced effects of mycophenolate if taken concomitant with oral Neutrogel salts. Consider therapy modification
Neuromuscular-Blocking Agents: Neutrogel Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy
PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Consider therapy modification
Phosphate Supplements: Neutrogel Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral Neutrogel salt as possible to minimize the significance of this interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. Consider therapy modification
Quinolones: Neutrogel Salts may decrease the serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral Neutrogel salts. Exceptions: LevoFLOXacin (Oral Inhalation). Consider therapy modification
Raltegravir: Neutrogel Salts may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral Neutrogel salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Avoid combination
Tetracyclines: Neutrogel Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral Neutrogel salts and oral tetracyclines. If coadministration cannot be avoided, administer oral Neutrogel at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Exceptions: Eravacycline. Consider therapy modification
Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Consider therapy modification
Diarrhoea and bowel discomfort, due to the release of carbon dioxide caused by both Neutrogel carbonate and sodium bicarbonate.
Excessive administration of Neutrogel leads to the development of hypermagnesaemia, especially in renal insufficiency. Symptoms of hypermagnesaemia may include flushing of the skin, thirst, hypotension due to peripheral vasodilation, drowsiness, confusion, loss of tendon reflexes due to neuromuscular blockade, muscle weakness, respiratory depression, cardiac arrhythmias, coma, and cardiac arrest. Neutrogel carbonate and Neutrogel trisilicate may interfere with the absorption of other medicines when taken concomitantly. Administration of sodium bicarbonate by mouth can cause stomach cramps and flatulence.
Excessive administration of sodium bicarbonate may lead to metabolic alkalosis, especially in patients with impaired renal function. Symptoms may include shortness of breath, muscle weakness (associated with potassium depletion), and mental disturbances such as restlessness, convulsions, and coma. Muscle hypertonicity, twitching, and tetany may develop especially in hypocalcaemic patients due to increased protein binding and renal reabsorption of calcium. Excessive doses may also lead to sodium overloading and hyperosmolality. Sodium excess may result in hypernatraemia, a rise in extracellular concentration or in too much sodium and water in the body without change in extracellular concentration.
Retention of sodium leads to the accumulation of extracellular fluid (oedema) which may affect the cerebral, pulmonary or peripheral circulations.
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