Drug & supplement interaction

Magnesium + Amikacin

Amikacin brand names: Amikin, Arikayce.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Magnesium has a moderate interaction with Amikacin. Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Magnesium and Amikacin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

AMINOGLYCOSIDE ANTIBIOTICS

Why this applies to Amikacin

Amikacin falls under AMINOGLYCOSIDE ANTIBIOTICS — the group Magnesium interacts with.

Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's what's going on with this pairing. Amikacin is a powerful injectable antibiotic, and both it and magnesium can quietly turn down the signal nerves use to tell muscles to contract (they lower the release of a messenger called acetylcholine). Stack the two together and that effect can add up, which may lead to unusual muscle weakness, and in rare cases trouble with breathing muscles.

The good news: this is mostly a concern with high-dose intravenous magnesium, like the kind given in a hospital setting, not the everyday magnesium tablet you might take for constipation or a deficiency. The evidence here is anecdotal, so it's a possibility rather than something that happens often. Still, if you're receiving both, mention it to your care team so they can watch you closely. Don't change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. L'Hommedieu CS, Nicholas D, Armes DA, et al. Potentiation of magnesium sulfate--induced neuromuscular weakness by gentamicin, tobramycin, and amikacin. J Pediatr 1983;102:629-31..

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Magnesium Also Interacts With Other Medications

Magnesium has 6 major, 174 moderate, 114 minor known drug interactions in our database — the Amikacin one above is one of them. If you take anything else, check it against the full list below.

Major 6 Moderate 174 Minor 114 No known interaction 2,536 (incl. Amikacin)
Taking anything else?

Check Another of Your Medications Against Magnesium

Covers the 2,830 medications we’ve checked against Magnesium. Pick one to open its full report.

From our Q&A

Questions About Magnesium or Amikacin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Magnesium or Amikacin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Amikacin

This page covers Magnesium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amikacin page lists 52 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Bacillus Coagulans (moderate).

By severity: 3 major · 38 moderate · 11 minor.

From our pharmacist’s overview on the Amikacin page

“The supplements that deserve genuine wariness with amikacin (Amikin, Arikayce) are the ones that touch the kidneys. Amikacin is a potent antibiotic that can strain kidney function on its own, so herbs like Siberian cocklebur and asarabacca (often contaminated with aristolochic acid, a known kidney toxin) should stay off the table durin…”

Reviewed by 2 · Jul 18, 2026

Open the Amikacin interaction page

One more smart check

Taking Magnesium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 29,717 real supplement products containing Magnesium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Magnesium. Your product may carry other ingredients that interact with Amikacin too, on top of Magnesium — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Magnesium and Amikacin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Magnesium
Top 10

#5 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amikacin
Steady interest

#1,457 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Magnesium

What is Magnesium?

Magnesium
  • Preventing or treating magnesium deficiency
  • Constipation
  • Muscle cramps
  • Sleep support
  • Anxiety and stress
  • Migraine prevention

Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some other uses, like easing constipation or preventing migraines, have reasonable support, while uses for sleep and anxiety are less proven. It is generally safe for most healthy people at recommended amounts, but talk to your pharmacist or doctor before starting, especially if you have kidney problems.

Read the full Magnesium monograph & all interactions
Medication

About Amikacin Oral Inhalation

What Is Amikacin Oral Inhalation Used For?

Brand names: Amikin, Arikayce

Arikayce is approved for adults with refractory Mycobacterium avium complex (MAC) lung disease — a serious bacterial lung infection that has not responded to at least 6 consecutive months of a standard multidrug antibiotic regimen. It is used as part of a combination treatment plan, not on its own.

This approval is limited: Arikayce is intended only for adults who have few or no other treatment options. It is not recommended for patients whose MAC lung disease has not yet failed standard therapy.

See full Amikacin Oral Inhalation drug information
Keep checking

Other Drugs & Magnesium

Browse every other medication we’ve checked against Magnesium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

6Major
174Moderate
114Minor
2,535No known interaction
6 Major 174 Moderate 114 Minor 2,535 No interaction
Major

6 interactions

Moderate

174 interactions

Showing 60 of 174 moderate interactions — see all 174 on the Magnesium page.

Minor

114 interactions

Showing 60 of 114 minor interactions — see all 114 on the Magnesium page.

No interaction 2,535 drugs checked — show the list

We also checked Magnesium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,535 medications checked with no known interaction — see the full Magnesium list.

See the full Magnesium interactions page
See every supplement checked against Amikacin, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Magnesium monograph › Uses, safety, and every drug interaction in one place Amikacin supplement interactions › Every supplement checked against Amikacin, ranked by severity Amikacin Oral Inhalation drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Magnesium and Amikacin Together: Common Questions

Can you take Magnesium with Amikacin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Magnesium and Amikacin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Amikacin and Magnesium?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.