Doppelhertz Active Magnesium + B vitamins tablets No. 30

Magnesium Plus tablets spike No. 10

Compound

Active ingredients: magnesium lactate 200 mg, magnesium carbonate 100 mg, pyridoxine hydrochloride 2 mg, folic acid 0.2 mg, cyanocobalamin 0.1% 1 mg (which corresponds to the content of cyanocobalamin 0.001 mg).
Excipients: sodium bicarbonate - 800 mg, citric acid - 1300 mg, sodium saccharinate dihydrate - 10 mg, sorbitol - 966.8 mg, macrogol - 40 mg, lime flavor - 80 mg.

Pharmacokinetics

Absorption of magnesium in the gastrointestinal tract is no more than 50% of the dose taken. In the body, 99% of magnesium is found inside cells. Approximately 2/3 of intracellular magnesium is distributed in bone tissue, and 1/3 is in smooth and striated muscle tissue. Excreted in urine. Glomerular filtration is 70% of plasma filtration, tubular reabsorption is 95-97%. At least 1/3 of the administered dose of magnesium is excreted in the urine.

Pyridoxine hydrochloride is absorbed rapidly throughout the small intestine, with larger amounts absorbed in the jejunum. Metabolized in the liver to form pharmacologically active metabolites (pyridoxal phosphate and pyridoxaminophosphate). Pyridoxal phosphate is 90% bound to plasma proteins. Penetrates well into all tissues; accumulates mainly in the liver, less - in muscles and the central nervous system. Penetrates the placenta and is secreted into breast milk. T1/2 - 15-20 days. It is excreted by the kidneys (with intravenous administration - with bile 2%), as well as during hemodialysis. About 8-10% of the drug is excreted unchanged in the urine.

Folic acid is well and completely absorbed in the gastrointestinal tract, mainly in the upper parts of the duodenum. Intensively binds to plasma proteins. Penetrates through the blood-brain barrier, the placenta and into breast milk. The time to reach maximum concentration is 60 minutes. Deposited and metabolized in the liver to form tetrahydrofolic acid (in the presence of ascorbic acid under the action of dihydrofolate reductase). It is excreted by the kidneys, mainly in the form of metabolites.

Cyanocobalamin is absorbed in the small (partly large) intestine, combining with intrinsic factor and becoming protected from intestinal microflora. In the blood, cyanocobalamin combines with transcobalamins I and II, with which it is transported to tissues. Cyanocobalamin is deposited mainly in the liver and is excreted from the liver with bile into the intestine, from where it is reabsorbed. Eliminated from the body by the kidneys. After oral administration of up to 2 mg, 30-97% is absorbed; absorption of the drug (depending on the internal absorption factor) after administration at a dose of more than 2 mg is noticeably reduced. Communication with plasma proteins - 90%. Cmax after oral administration is achieved within 6-14 hours. T1/2 in the liver is 500 days. Excreted with normal renal function - 7-10% by the kidneys, about 50% - with feces; with reduced renal function - 0-7% by the kidneys, 70-100% - by feces. Penetrates through the placental barrier into breast milk.

Indications for use

Prevention of magnesium deficiency and related conditions:

• neuromuscular disorders (muscle weakness, tremors, spasms, convulsions);
• mental disorders (insomnia, irritability, anxiety);
• heart rhythm disturbances;
• disruption of the gastrointestinal tract (pain, cramps, bloating).

Contraindications

• severe renal failure (creatinine clearance<30 ml/min);
• children under 6 years of age;
• hypersensitivity to the components of the combination.

Carefully:

Moderate renal failure (since there is a risk of developing hypermagnesemia).

Directions for use and doses

Inside.

Adults and children over 12 years old: 1-2 tablets.

Children from 6 to 12 years: 1/2 tablet.

Take in the morning, after dissolving in a glass of water.

Storage conditions

At a temperature not higher than 25 °C.

Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date.

special instructions

In cases of concomitant calcium deficiency, magnesium deficiency must be corrected before supplemental calcium is administered.
With frequent use of laxatives, alcohol, increased physical and mental stress, the need for magnesium increases.

Description

A drug that replenishes magnesium deficiency in the body.

Dosage form

Effervescent tablets are round, flat-cylindrical, with a beveled edge, white or white with a slightly yellowish-greenish tint, with a dividing strip on one side, with a slight specific odor.

Use in children

Contraindicated for children under 6 years of age. Children from 6 to 12 years old - 1/2 tablet.

Action

Magnesium is a vital element. Plays an important role in the activity of the nervous system, participates in the regulation of the transmission of nerve impulses and in muscle contraction, in most metabolic reactions, promotes the production and consumption of energy, and plays an important physiological role in maintaining ion balance.

Read also:  17th week of pregnancy: your baby is experiencing a growth spurt and developing sucking and swallowing reflexes

Magnesium deficiency manifests itself in the form of neuromuscular disorders (insomnia, irritability, anxiety), heart rhythm disturbances (extrasystole, tachycardia) and gastrointestinal tract activity (pain, diarrhea, cramps, bloating).

Vitamin B6 plays an important role in metabolism, contributes to the normal functioning of the nervous system and complements the effect of magnesium.

Vitamin B12 and folic acid are involved in many enzymatic reactions.

Side effects

Possible: allergic reactions, dyspeptic disorders (diarrhea, abdominal pain).

When used in high doses: hypermagnesemia may develop.

Use during pregnancy and breastfeeding

During pregnancy and lactation, the drug can be used with caution and according to indications, since at this time the need for magnesium increases significantly. If its content is not balanced, it can lead to serious complications, including miscarriage.

Magnesium passes into breast milk, so use of the drug should be avoided during breastfeeding.

Interaction

Phosphates and calcium salts reduce the absorption of magnesium in the gastrointestinal tract.

Magnesium preparations reduce the absorption of tetracycline; It is recommended to wait 3 hours before using this combination.

Vitamin B6 inhibits the activity of levodopa.

Overdose

Symptoms of overdose: drop in blood pressure, nausea, vomiting, slowed reflexes, respiratory depression, coma, cardiac arrest and cardiac paralysis, anuria.

Treatment: rehydration, forced diuresis. In case of renal failure, hemodialysis or peritoneal dialysis is necessary.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive vehicles or operate potentially dangerous machinery.

Magnesium is the main anti-stress macronutrient!

Murzaeva Irina Yurievna

Endocrinologist, Preventive Medicine Doctor

March 13, 2018

Not so long ago, I began to get involved in the problems of violations of the most important micro (macro) elements in the human body , and it all started with a search for the causes of autoimmune thyroiditis and the reasons for its prevalence, with a textbook on micro element violations in AIT, then the topic began to expand in search of the causes of “massive hair loss ", including in children, searching for the causes of frequent acute respiratory viral infections in children... more to come. It turned out that the violation of the microelement composition of the human body is a huge science and more than one Russian scientist is engaged in this, but this topic is poorly covered and there is little literature where you can familiarize yourself with it:!: But whoever searches will always find.

Today we start talking about the most important microelements and macroelements for humans.

Magnesium is a mineral that is now actively discussed and advertised ... “magnesium for stress”, “magnesium for irritability”, “magnesium for arimagnesium for seizures” “magnesium for uterine hypertonicity during pregnancy”, etc. MagneB6 and Magnelis are perhaps the most famous magnesium preparations. But this is just the tip of the iceberg, magnesium is not so simple...)

Magnesium is involved in more than 300 enzymatic processes in the body; magnesium, along with sodium and potassium, is a vital macroelement (not even a microelement ).

There is only 24 grams of magnesium in the body (this is not much), but without it, it is not possible to conduct a nerve impulse along nerve fibers, or contract the heart, or contract muscles, or regulate blood pressure; without it, blood coagulation is disrupted, appetite is disrupted, there can be nausea and vomiting and other disorders. A separate book has been written about magnesium; it is a serious scientific work, 800 pages long, entitled “Magnesium and the Diseases of Civilization.” In this article I will not cover all the most important “points of application” of magnesium in the body, sometime later, I’d rather talk about its practical application...

Magnesium is a mineral that is difficult to “accumulate” in the body, it is consumed extremely quickly, and the more stress, the more pronounced the magnesium deficiency... But not all magnesium preparations can successfully replenish its deficiency.... For its absorption and for the best effect in a given situation, it is important to understand what magnesium is “connected” with. I’ll explain in more detail... In order to enter the body, magnesium must be “in the composition” of salt or some organic compound, and the effect of magnesium and digestibility will depend on the nature of “this conductor - salt or organic matter”.

Now about magnesium absorption: Magnesium can exist in the following 15 forms −

magnesium citrate, magnesium malate, magnesium glycinate and bisglycinate, magnesium threonate, magnesium carbonate, magnesium lactate, magnesium taurate, magnesium chloride, magnesium orotate. magnesium sulfate, magnesium chelate, magnesium oxide, glutamate and magnesium aspartate.

And now I’ll decipher:

Magnesium citrate is a magnesium salt of citric acid, the most digestible form of magnesium, used in most well-known drugs - MagneB6 and Magnelis, magnesium citrate solgar, etc., is used more often as an antispasmodic, relieves spasms of the gastrointestinal tract, that is, relieves constipation and impaired bile secretion, good in gastroenterology.

Magnesium malate is a magnesium salt of malic acid that relieves hypomagnesium muscle cramps, relieves fatigue and aluminum intoxication in the body.

Magnesium threonate - in combination with threonic acid, in studies improves long-term and short-term memory, better than magnesium citrate

Magnesium taurate is a non-toxic form of magnesium, very bioavailable, good to use for insulin and leptin resistance, that is, it reduces cravings for overeating sweets and “night gluttons.”

Magnesium oxide - can only be used in cases of reducing high stomach acidity; in other cases it causes severe osmotic diarrhea. Therefore, it is good for constipation.

Magnesium chloride - used primarily as bath salts with a calming effect on the nervous system, but more on that later.

Magnesium orotate is a compound of magnesium with orotic acid, has a predominant effect on the heart muscle, is used for rhythm disturbances and congenital heart disease such as mitral valve prolapse.

Magnesium sulfate - combined with sulfuric acid, used in bath salts (in this form it is practically irreplaceable), in “famous” intravenous injections, mainly to relieve hypertensive crises.

Magnesium aspartate and glutamate - it is better not to use, they belong to the class of endotoxins.

Magnesium glycinate and bisglycinate are a good form of magnesium, mixed with glycine, good for chronic fatigue syndrome and pelvic pain, good because it does not cause a laxative effect.

Magnesium lactate is an artificially synthesized, inexpensive form of magnesium, has a general strengthening effect, as an excipient it is used in most magnesium preparations as an integral part.

Magnesium carbonate - also used for increased stomach acidity, neutralizes the effect of NSAIDs, good for GERD, not for phenylketonuria.

Magnesium chelate is a form of magnesium immersed in an amino acid, facilitating bioavailability. The absorption of the chelate and, accordingly, magnesium from it is 90% , it does not change the acidity of the stomach, unlike forms combined with acids - therefore it is suitable for everyone, but accordingly it is less effective for constipation and other gastrointestinal dyskinesias, but is rarely found in retail sales and is expensive form of magnesium.

Magnesium is in close relationship with calcium, vitamins K2 and D3. The balance of these four elements will help maintain health without complications.

Only for thyroid function, magnesium has a less significant effect than selenium, iodine and iron, for example.

Now about my favorite form of magnesium...... If you don’t want to swallow pills, you don’t need a laxative effect, and your nerves are “on edge and you can’t sleep,” it wouldn’t be a bad idea to carry out an Anti-Stress or Detoxification program—your ideal option—English baths salt, or, simply put, baths with magnesium sulfate 0.5-1 kg of salt per 1 bath and within the first 15 minutes “you will start to fall asleep in the bath.”

Below are questionnaires by which you can determine magnesium deficiency in an adult and a child.

Magnesium preparations in cardiological practice

Despite the achievements of modern medicine, cardiovascular diseases (CVD) in the Russian Federation, as well as throughout the world, remain one of the most common diseases that practitioners have to deal with. First of all, this is, of course, arterial hypertension (AH), coronary heart disease (CHD) and chronic heart failure (CHF). These diseases are the main cause of death in both developed and developing countries [1]. This makes the problem of optimizing pharmacotherapy in order to reduce cardiovascular risk extremely important, and the search for an individual approach to the management of patients with various CVDs and a differentiated choice of drugs remains an urgent problem for the practicing physician. Today, a doctor has a wide selection of effective pharmacological agents for the treatment of various CVDs, which should be prescribed following the relevant Russian and international recommendations based on a large evidence base.

In recent years, the use of drugs that affect the balance of micro- and macroelements (sodium, potassium, calcium, magnesium, chlorine, phosphorus, sulfur, etc.), which are necessary for the normal functioning and performance of the body and which the human body is not able to synthesize on its own, has become promising. . Maintaining a normal level of these elements is only possible if an adequate amount of them is supplied with food. An optimally balanced diet helps maintain normal levels of macro- and microelements. But these are only ideal conditions, rarely achievable in modern life.

One of the most common types of mineral deficiency in many countries is magnesium deficiency, which occupies one of the leading places in human pathologies caused by disorders of mineral metabolism (manganese, iodine, zinc, copper, calcium), and, according to the International Classification of Diseases, 10th revision , is registered as a separate disease - E 61.2 [2, 3].

Data from a number of observations indicate that from 25% to 40% of the adult population are deficient in this important macronutrient.

Given the prevalence of magnesium deficiency, it is expected that a large number of patients with cardiovascular disease will have magnesium deficiency of varying severity.

Mechanism of action of magnesium

One of the macroelements important for the body is magnesium. From the point of view of biological function, magnesium is a cofactor and activator of a number of enzymes - enolase, alkaline phosphatase, carboxylase, hexokinase. Another role of magnesium ions is stabilizing. Magnesium ions stabilize the substrate molecules - they neutralize the negative charge of the substrate, the active center of the enzyme, help maintain the tertiary and quaternary structures of the enzyme protein molecule, facilitate the attachment of the substrate to the enzyme and thereby facilitate the chemical reaction, the magnesium-ATP complex, stabilizing the ATP molecule, facilitating its attachment and “correct” orientation in the active site of the enzyme, weakening the phosphoester bond and facilitating the transfer of phosphate to glucose. In some cases, magnesium ion can help attach the coenzyme, promoting the activation of metalloenzymes.

Magnesium contributes to the stability of the cell structure during growth and takes part in the process of regeneration of body cells.

Data have been obtained confirming the irreplaceable role of magnesium in the absorption of vitamins B1 (thiamine), B6 ​​(pyridoxine) and vitamin C [4, 5].

The participation of magnesium in phosphorus and carbohydrate metabolism, in protein synthesis, and in the transmission of neuromuscular impulses has been established [4].

Magnesium is involved in maintaining the electrical potential of membranes, promotes the penetration of calcium, sodium, and potassium ions through them, and takes part in the transmission of nerve impulses. It regulates the passage of the inhibition signal from the central parts of the nervous system to the peripheral nervous system. With a lack of magnesium, the nervous system remains in a state of overexcitation and, as a result, chronic stress is observed. Magnesium, in turn, is called an anti-stress element.

Magnesium can affect calcium levels by influencing hormones that control calcium absorption and metabolism. In the regulation of vascular tone, magnesium and calcium ions act as antagonists: calcium plays a leading role in the contraction of smooth muscles of blood vessels, magnesium, on the contrary, in their expansion, promotes the elimination of excess cholesterol, the absorption of calcium and phosphorus.

Magnesium is able to increase insulin secretion and improve its penetration into cells. It is also necessary for the production of brain neuropeptides, stimulates intestinal motility, promotes the secretion of bile, and is involved in the production of catecholamines.

Lack of magnesium in the body

Since magnesium ranks 4th in content in the body, it is natural that with chronic magnesium deficiency, functional disorders occur in many organs and tissues.

Magnesium deficiency can be caused by changes in its distribution between blood serum and cells, decreased dietary intake, or excessive loss. Unlike primary magnesium deficiency, which is associated with a person’s constitutional characteristics, secondary magnesium deficiency is associated with living conditions or diseases.

Living conditions that cause magnesium deficiency:

• insufficient food intake (nutritional deficiency), intravenous therapeutic nutrition;
• hypocaloric diet, unbalanced diet (excessive levels of lipids, calcium, phosphates);
• stress, strenuous physical work;
• physical inactivity;
• exposure to high temperatures;
• increased consumption of magnesium during pregnancy, intensive growth, recovery, with excessive sweating, with excessive physical exertion, with chronic alcoholism;
• hormonal contraception.

Magnesium deficiency associated with diseases and their therapy:

• impaired absorption of macronutrients in the intestine (disease of the small intestine, reduction in the absorptive surface of the intestine after surgery or during radiotherapy, steatorrhea, dysbiosis in the large intestine); impaired insulin production;
• nephrotic syndrome;
• hypercortisolism;
• hypercatecholaminemia;
• hyperaldosteronism;
• hyperthyroidism;
• arterial hypertension;
• myocardial infarction;
• obesity;
• diuretic, cytostatic therapy;
• long-term use of antibiotics (gentamicin), diuretics, antitumor and other medications;
• poisoning with certain substances (aluminum, lead, cobalt, manganese, cadmium, beryllium, nickel).

Physiological effects of magnesium

Due to the combination of such properties inherent in this element, the physiological effects of magnesium are very diverse and are manifested in the fact that it has a beneficial effect on bone growth; helps slow heart rate, reduces high blood pressure; promotes bronchodilation; used as a prophylactic for muscle and joint pain, chronic fatigue syndrome, migraines, etc.

The effects of magnesium on the cardiovascular system are extremely important:

• hypotensive effect - has a hypotensive effect due to negative chrono- and inotropic effects, decreased vascular tone, inhibition of transmission in the autonomic ganglia, inhibition of the vasomotor center;
• anti-ischemic effect - due to the restoration of endothelium-dependent vasodilation, normalization of lipid spectrum indicators, improvement of rheological properties of blood, reduction of platelet aggregation activity, depressor effect on the inotropic function of the heart [6–8];
• antiarrhythmic effect - magnesium has a membrane-stabilizing effect, a depressor effect on the excitability and conductivity of the cell [9]. Depletion of magnesium stores causes significant adverse effects on the myocardium [10]. Violation of the content of potassium and magnesium ions and their ratio is a significant risk factor for the development of arrhythmias. In the Framingham Study, extrasystoles were detected in 5.5% of study participants (n = 3327, mean age 44 years). At the same time, long-term hypomagnesemia correlates with a high incidence of ventricular extrasystoles, tachycardia, and ventricular fibrillation (p = 0.01). This pattern remained significant even after taking into account adjustments for left ventricular mass, including in volunteers without clinically significant disease [11]. The PROMISE Study revealed a higher incidence of ventricular extrasystole and high mortality in the group of patients with hypomagnesemia compared to groups with normo- and hypermagnesemia [12];
• effect on connective tissue - magnesium affects collagen metabolism, reducing the severity of dysplastic changes in connective tissue [13, 14].

In recent years, among the possible pathogenetic mechanisms for the formation of mitral valve prolapse, some researchers point to a chronic deficiency of magnesium ions, which leads to disruption of the formation of connective tissue structures of the supporting trophic framework of the heart, which causes a chaotic arrangement of collagen fibers, disruption of its synthesis and biodegradation [15].

Magnesium ions are of great importance for the normal functioning of connective tissue. In a number of animal experiments, it was shown that magnesium deficiency leads to an increase in the activity of collagenases, in particular matrix metalloproteinases, while the metabolism of the structural components of the extracellular matrix, primarily collagen, was disrupted. Along with an increase in the activity of metalloproteinases, magnesium deficiency reduces the enzymatic activity of transglutaminases and lysyl oxidases involved in the formation of cross-links, resulting in a decrease in the mechanical strength of collagen fibers [15–17].

Symptoms of magnesium deficiency

Signs of magnesium deficiency are nonspecific. Clinically, magnesium deficiency can manifest itself in the form of endocrine-metabolic, mental and neurological disorders, in the form of disorders of various organs and systems, including the cardiovascular and musculoskeletal system.

The main complaints presented by patients: paresthesia in the form of impaired sensitivity, sensations of numbness, tingling, itching, crawling, etc., muscle cramps, increased neuromuscular excitability, fatigue, sudden dizziness accompanied by loss of balance, irritability, insomnia , nightmares, difficult awakening, deterioration in concentration, loss of appetite, constipation, nausea, diarrhea, vomiting, increased blood pressure, arrhythmias, angina pectoris, vasospasms, atrophic skin manifestations in the form of hair loss, increased brittleness of nails.

Examinations may reveal signs of dysfunction of the adrenal glands, the development of diabetes mellitus, urolithiasis and cholelithiasis, and immunodeficiency states. Such patients have an increased likelihood of developing tumor diseases.

Since the metabolism of magnesium and calcium is closely related, with magnesium deficiency the calcium level also decreases and osteoporosis develops. This is also facilitated by dysfunction of the parathyroid gland.

The cardiovascular system also responds to magnesium deficiency: patients experience accelerated progression of atherosclerosis, tachycardia, arrhythmias, mitral valve prolapse, and a decrease in the electrical stability of the myocardium, characterized by an increase in the dispersion and/or duration of the QT interval. In such patients, an increase in mortality from coronary artery disease was observed.

There is an opinion that cases of early myocardial infarction among people aged 30–40 years are associated with reduced magnesium content in the heart muscle.

Clinical experience with the use of magnesium preparations in cardiology

It is obvious that magnesium deficiency in diseases of the cardiovascular system cannot be compensated only by changing the diet; the use of magnesium preparations is necessary.

Inorganic magnesium preparations, such as magnesium sulfate, have extremely low bioavailability of magnesium and have a number of pronounced side effects [4, 18].

To compensate for magnesium deficiency, it is necessary to use magnesium preparations characterized by high bioavailability - organic magnesium preparations [19].

One of these drugs is Magnerot - a salt of magnesium and orotic acid. Orotic acid is one of the products of pyrimidine biosynthesis. In the human body, orotic acid is synthesized in the liver from aspartate and carbamoyl phosphate, subject to the physiological state of hepatocytes. Orotic acid salts are used as a mineral carrier, since orotic acid increases targeted transport into skeletal muscle myocytes and cardiomyocytes, and also has a number of additional advantages compared to inorganic salts.

To date, a large evidence base has been accumulated indicating the high effectiveness of magnesium orotate in various conditions accompanied by magnesium deficiency, including in patients undergoing coronary surgery [3, 7, 20–24].

The greatest experience in the use of magnesium orotate is in patients with mitral valve prolapse (MVP) as pathogenetic therapy. A long-term, over 15 years, observation of patients who took the drug at a dose of 1500 mg/day twice a year for 3 months showed that this leads to an improvement in clinical condition and is accompanied by a decrease in heart rate, number of episodes of tachycardia, duration QTc interval, frequency of paroxysmal supraventricular tachycardia, supraventricular and ventricular extrasystole [25]. The use of magnesium orotate in patients with mitral valve prolapse also improves quality of life and echocardiography indicators (reducing the depth of mitral valve prolapse, reducing the degree of mitral regurgitation) [26]. These effects are realized due to the fact that the drug causes changes in the architectonics of loose fibrous connective tissue, manifested in the orderliness of the relative arrangement of fibers, an increase in the content of amorphous substance of loose fibrous connective tissue involved in the metabolic processes of the myocardium, improved diffusion capacity and architectonics of connective tissue, which determines improved elasticity and extensibility [27].

The anti-ischemic effect of magnesium is manifested due to a positive effect on endothelium-dependent vasodilation [6], as well as normalization of metabolism in ischemic tissues, and a depressor effect on the inotropic function of the heart [8]. These same effects also explain the positive dynamics in patients with severe CHF when magnesium is included in complex therapy [7].

The drug is also effective in the prevention of supraventricular tachyarrhythmias during surgical interventions in patients with combined cardiac and urological pathologies. If the drug is prescribed before surgery, the likelihood of arrhythmia decreases by 16% [9].

An important positive aspect of magnesium preparations in cardiological practice is also that they can be used for the correction and prevention of hyperkalemia associated with long-term courses of potassium-sparing diuretics, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, as well as associated with the presence of metabolic syndrome. With the use of magnesium orotate, the well-being of patients improves and laboratory parameters are normalized [28].

Thus, magnesium deficiency is one of the most common types of mineral deficiency, occurring in 25–40% of the adult population. Literature data and more than 20 years of experience in the clinical use of magnesium preparations indicate their good effectiveness and high safety profile in patients with various cardiac pathologies.

Literature

1. Ezzati M., Lopez A., Rodgers A., Vander Hoorn S., Murray CJL eds. Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Geneva: World Health Organization; 2004.
2. Bourre JM Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients // J. Nutr. Health Aging. 2006; 10 (5): 377–385.
3. Classen HG Magnesium orotate-experimental and clinical evidence // Rom. J. Intern. Med. 2004; 42(3):491–501.
4. Gromova O. A. Magnesium and pyridoxine. Basic knowledge. M.: ProtoTip, 2006. 234 p.
5. Torshin I. Yu., Gromova O. A., Gusev E. I. Mechanisms of anti-stress and antidepressant action of magnesium and pyridoxine // Journal of Neurology and Psychiatry. 2009, No. 11, p. 107–111.
6. Kirichenko A. A., Flegentova O. N., Novichkova Yu. N., Vinogradova I. V., Ryazantsev A. A., Yurchenko K. V. Effect of therapy with Magnerot on cardialgia in postmenopausal women // Attending Physician. 2005. No. 5. P. 76 –77.
7. Stepura OB, Martynow AI Magnesium orotat in severe congestive heart failure (MACH) // Int J Cardiol. 2009, May 1; 134(1):145–147.
8. Ezhov A.V., Pimenov L.T., Zamostyanov M.V. Clinical effectiveness of Magnerot in the treatment of stable angina pectoris in combination with arterial hypertension in the elderly // Ros. honey. lead. 2001. No. 1. P. 71–74.
9. Davydova S., Yarovoy S. Magnesium preparations in the treatment and prevention of supraventricular tachyarrhythmias in urological patients // Doctor. 2011. No. 9. pp. 44–49.
10. Chakraborti S., Chakraborti T., Mandal M. et al. Protective role of magnesium in the cardiovascular diseases: A review // Mol Cell Biochem. 2002; 238:163–179.
11. Tsuji H., Venditti FJ Jr., Evans JC et al. The associations of levels of serum potassium and magnesium with ventricular premature complexes (the Framingham Heart Study) // Am J Cardiol. 1994; 74:232–235.
12. Eichhorn EJ, Tandon PK, Dibianco R. et al. The Study Group Clinical and prognostic significance of serum magnesium concentration in patients with severe chronic congestive heart failure: The Promise Study // J Am Coll Cardiol. 1993; 21(3):634–640.
13. Libova L. T., Dobrynina V. A., Kalenik S. A., Brovkina E. G. Use of the drug MAGNEROT® for mitral valve prolapse and stage I hypertension // New Millennium Medicine. 2011. No. 4. P. 3–4.
14. Martynov A.I., Akatova E.V., Nikolin O.P. Clinical effectiveness of magnesium orotate in patients with rhythm disturbances and arterial hypertension with mitral valve prolapse // Cardiovasc. therapy and prevention. 2009; 8:8–12.
15. Baker P., Bansal G., Boudoulas H. et al. Floppy mitral valve chordae tendineae: histopathologic alterations // Hum Pathology. 1998; 19(5):507–512.
16. Kitlinski M., Konduracka E., Piwowarska. Evaluation of magnesium cation levels in serum of patients with mitrale valve prolapse syndrome // Folia Med Cracov. 2000; 41 (3–4): 17–24.
17. Disse S., Abergei E., Derrebi A. et al. Mapping of the first locus for autosomal dominant myxomatous mitral valve prolapse to chromosome 16 p11.2–p.12.1 // Am J Hum Genet. 1999; 65(5):1242–1251.
18. Lazebnik L. B., Drozdova S. L. Correction of magnesium deficiency in cardiovascular pathology // Cardiology. 1997; 5: 103–104.
19. Tokimasa T., Akasu T. Cyclic AMP regulates an inward rectifying sodiumpotassium current in dissociated bull-frog sympathetic neurons // J Physiol. 1990; 420:409–429.
20. Jellinek H., Takacs E. Morphological aspects of the effects of orotic acid and magnesium orotate on hypercholesterolaemia in rabbits // Arzneimittelforschung. 1995. Vol. 45. No. 8. P. 836–884.
21. Geiss KR, Stergiou N., Neuenfeld HU, Jester HG Effects of magnesium orotate on exercise tolerance in patients with coronary heart disease // Cardiovasc Drugs Ther. 1998; 12: 153–156.
22. Ezhov AV, Pimenov LT Effect of adjuvant magnesium therapy on the quality of life and emotional status of elderly patients with stable angina // Adv Gerontol. 2002; 10: 95–98.
23. Salerno C., Crifo C. Diagnostic value of urinary orotic acid levels: applicable separation methods // J Chromatogr B Analyt Technol Biomed Life Sci. 2002; 781:57–71.
24. Motyl T., Krzeminski J., Podgurniak M. et al. Variability of orotic acid concentration in cow's milk // Endocr Regul. 1991; 25: 79–82.
25. Akatova E.V., Martynov A.I., Nikolin O.P. Results of long-term therapy with magnesium orotate in patients with mitral valve prolapse // Cardiovascular Therapy and Prevention. 2012; 3:30–35.
26. Akatova E.V., Martynov A.I. 15-year experience of using magnesium in patients with MVP // Cardiology. 2011.
27. Avtandilov A. G., Dzeranova K. M., Borovaya T. G., Didenko L. V. Effect of magnesium orotate on the connective tissue framework and inotropic function of the heart in patients with mitral valve prolapse. Clinical and morphological study // Rational pharmacotherapy in cardiology. 2013; 9 (4): 390–397.
28. Limanova O. A., Fedotova L. E., Kalacheva A. G., Torshin I. Yu., Gromova O. A. Management of patients with hyperpotassium conditions (cases from practice) // Zemsky Vrach. 2013; 4 (21), 24–32.

T. E. Morozova1, Doctor of Medical Sciences, Professor O. S. Durnetsova

GBOU VPO First Moscow State Medical University named after. I. M. Sechenova Ministry of Health of the Russian Federation, Moscow

1 Contact information