Common Barriersīarriers to the effective use of magnesium sulfate in developing countries include complex dosing regimens, a lack of product harmonization, and low provider familiarity of the drug, all of which limit its impact. Women treated with magnesium sulfate had a 52% and 67% lower recurrence of convulsions (eclampsia) than those treated with diazepam and phenytoin, respectively.
These trials have found magnesium sulfate to reduce the occurrence of eclampsia by more than 50% and maternal deaths by 46%. Large clinical trials conducted between 19 found magnesium sulfate to be the most effective when compared with other treatments, including diazepam and phenytoin. Recent consultations among experts have led to the recommendation of one particular dosing: 5g in 10mL. The product is very stable at ambient temperatures and is unlikely to undergo any significant degradation as a result of heat if it is properly manufactured, packaged, sterilized and sealed.
Products are available in glass ampoules or vials sealed with a rubber or latex stopper and cap. Products AvailableĪround 35 manufacturers of generic magnesium sulfate solutions have been identified worldwide but there are likely to be other manufacturers around the world, especially in Asia and Latin America. A WHO survey related to the Global Reproductive Health Strategy (World Health Assembly Resolution 55.12) assessed the implementation of magnesium sulfate and found that in about 85% of the surveyed 58 countries, magnesium sulfate was available for use. Furthermore, a study by MCHIP states that most countries-except Rwanda and Ethiopia-reported that they have magnesium sulfate on their EMLs. ”Ĭase studies show magnesium sulfate is included in national protocols for maternal health service provision as well as EMLs and standard treatment guidelines in many countries (where national data was collected and reported), including Ghana, Mali, Malawi, Mongolia, and India. Magnesium sulfate has been placed on the World Health Organization (WHO) Essential Medicines List (EML) and is recommended as the most effective, safe and affordable treatment “for use in eclampsia and severe pre-eclampsia and not for other disorders. Calcium gluconate-a mineral supplement-is an antidote available in the rare event of magnesium sulfate overdose.
Magnesium sulfate is administered by injection into the woman’s vein or muscle. Magnesium sulfate costs approximately US $0.10 per ml (supplier median price), and is produced by a number of global manufacturers and many local manufacturers worldwide. Magnesium sulfate is the standard treatment for these conditions in the majority of developed countries, but less-effective and riskier medications, such as diazepam and phenytoin, still are widely used in developing countries. Magnesium sulfate (MgSO 4) is recognized by the WHO as the safest, most effective, and lowest-cost medication for treating PE/E. Source: Path/Evelyn Hockstein Commodity Introduction
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