MgS04 Capsule - FAQ

All answers relate to the magnesium sulfate capsules currently available in Australia which contain 950mg dried magnesium sulfate. If you are using other formulations of magnesium sulfate, you must check with the prescribing Doctor or Pharmacist to ensure that doses are equivalent to those described herein.

How do I take magnesium sulfate capsules?

These capsules should be taken in lots of five every 15 minutes until the dose is complete. Some people are able to swallow the five capsules as a simple handful; others need to take them one or two at a time. Whichever way they are taken, they do need to be accompanied by plenty of liquids to drink. About 250 ml of non-alcoholic liquids should be consumed for every five capsules taken. The fluid in the drinks replaces that which is drawn into the intestines as a result of the action of the magnesium sulfate. It also helps build up a large column of liquid inside the intestines which contributes to the wash-out effect associated with this agent.

It is undoubtedly better to take these capsules with plenty to drink both to counter any tendency to dehydration and to ensure optimum cleansing of the bowel. However, it is entirely reasonable to spread out the time over which this fluid is consumed to avoid excessive bloating and discomfort associated with having to drink a large amount of liquid in a short period of time.

Can I keep taking capsules every week?

In short – yes, you can. Magnesium sulfate is not a habit-forming laxative so you will not encounter a progressive increase over time in the number of capsules required to produce the desired effect as you would with the herbal and stimulant laxatives.

Just as importantly, magnesium sulfate is, in my opinion, the safest of the genuinely strong laxatives available and has been in use for this purpose for over 400 years! Provided you have normal kidney function and provided you drink adequate amounts of liquids with your capsules, you are unlikely to encounter any significant ill-effects from taking them.

So, once you find the correct dose of capsules for your own individual needs, you can continue to use them in the long term.

What do I do if the first 15 capsules taken over a half-an-hour hasn’t produced the desired effect?

I have found that not everyone will respond to the standard dose of 10 – 15 capsules. The same is true, of course, for almost every available laxative especially when your constipation is more severe. The central difference between my own approach to treating sluggish bowels, bloating and constipation and the strategies more widely employed revolves around the need to take enough laxative (capsules in this case) to provoke a powerful urge and to thoroughly empty the bowel. Taking the usual dose but then failing to experience the desired outcome is simply nowhere near as effective both in the short and the longer term.

When I advise my patients about the correct dose of capsules, I make an educated estimate of how many they are likely to need based upon the severity and duration of their constipation and upon the sort of laxatives they are already using. I try to estimate a dose that is likely to achieve the desired outcomes – strong urge and thorough cleanse – and then advise the patient to take 5 capsules every 15 minutes until that dose is complete.

Of course, you do need to ensure a satisfactory fluid intake when taking powerful saline laxatives like magnesium sulfate. This is no less important when you find that you need to take more than the standard dose of capsules. In my experience, it is safe to exceed the standard dose provided that you have normal kidney function and provided that you maintain good fluid intake. You should not consume so much fluid in a short time that you start to feel overly full and bloated. Rather, you should maintain a steady intake of fluid over the course of the day to ensure you maintain good hydration.

Why do I have to take so many capsules?

We are conditioned to regard medication as coming in tablets or capsules numbering no more than a few at a time. When confronted with a direction to take 15 magnesium sulfate capsules – or many more in certain circumstances – our first reaction is often one of disbelief. Of course, if we had to empty those capsules and gather the contents together on a spoon, we wouldn’t even flinch at the prospect of dissolving that amount of powder in some water and drinking it - if we could stand the taste!

The capsules are just a way of getting the necessary amount of magnesium sulfate into the stomach without having to experience its terrible taste.

Couldn’t I take a small amount every day rather than a whole lot just once or twice-a-week?

The vast majority of people believe, quite incorrectly, that their bowels must work every day. As a result, there is a widespread misconception that laxatives should also be taken every day. Yet many people taking their laxatives on a daily or twice-daily basis still only have their bowels opened every second or third day (or less often). People really do seem to be convinced – maybe even brainwashed - that the purpose of any laxative must be to instigate a regular, daily result. If this actually worked, if the current laxative strategies people prescribe regularly and reliably re-created this almost ideal bowel habit, then the problems of sluggish bowels, abdominal bloating, straining to evacuate the rectum and constipation would all have been sorted long ago.

The reality, however, is that existing laxative strategies rarely if ever achieve a daily, smooth and comfortable bowel action. For your bowels to be emptied properly, you will almost certainly need to provoke a very powerful urge to evacuate your rectum. And in order to achieve this, you simply must take a large enough dose of laxative. You must take enough capsules to provoke “the irresistible urge” and enough to completely empty the bowels. That might mean that you need to take a large number of capsules, but if that is what works for you then that is what you must do.

Cleaning your bowels out thoroughly just once-a-week often results in your bowels not working for a day or two afterwards. But the possibility of your bowels returning to spontaneous, sometimes even daily action thereafter is greatly enhanced. As it turns out, a thorough weekly cleanse with capsules can be the very best way of actually restoring a daily spontaneous bowel action.

My Doctor has suggested I take 5-7 capsules each night. Will this be OK to follow?

If your own Doctor has recommended this sort of regime, then you really should try it out and see how it works. I have no doubt that there will be people suffering from constipation and related complaints for whom a regular, daily dose of capsules works well. If that is the case, all credit to your Doctor for arriving at the schedule that works well for you.

My own recommendation - that you take capsules once-a-week (or, at most, twice-weekly) - stems from my own experience with a wide variety of laxatives used in as many different ways as I could imagine in thousands of patients over almost 20 years. If regular, low doses of capsules work well for you, that is excellent and you should continue. If this proves ineffective, however, please consider the strategies that I have outlined in this book.

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