Gestational hypertension

Magnesium sulfate

This drug, often used in preeclampsia and eclampsia to control seizures, is being considered by some clinicians for use in gestational hypertension. However, prolonged use of magnesium sulfate is not recommended. The UK-based Medicines and Healthcare products Regulatory Agency (MHRA) recommends against any use of magnesium sulfate in pregnancy for longer than 5-7 days. If prolonged or repeated use occurs during pregnancy (for example, multiple courses or use for more than 24 hours), consider monitoring of neonates for abnormal calcium and magnesium levels and skeletal adverse effects. In 2013, the Food and Drug Administration (FDA) issued a similar recommendation relating to use of magnesium sulfate as a tocolytic.[50]Medicines and Healthcare products Regulatory Agency. Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy. May 2019 [internet publication]. https://www.gov.uk/drug-safety-update/magnesium-sulfate-risk-of-skeletal-adverse-effects-in-the-neonate-following-prolonged-or-repeated-use-in-pregnancy [51]US Food and Drug Administration. FDA drug safety communication: FDA recommends against prolonged use of magnesium sulfate to stop preterm labor due to bone changes in exposed babies. May 2013 [internet publication]. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-recommends-against-prolonged-use-magnesium-sulfate-stop-pre-term ​​ See Pre-eclampsia (Management approach).