The most usual intramuscular protocol is a 4 g intravenous loading dose, followed by 10 g intramuscularly and then 5 g intramuscularly every 4 hours in alternate buttocks. The intravenous regimen consists of a 4 g dose followed by a 1 to 2 g/h maintenance infusion via a controlled infusion pump. The goal is to achieve plasma levels of 15 to 25 mg/dL (1.5 to 3 mmol/L). If these levels are not reached after 30 minutes, another 4 g dose should be given. Magnesium sulfate can also be administered as an oral solution or gelatin capsule. The recommended initial dose is 6 grams for women who are less than 40 weeks pregnant or who weigh less than 100 pounds. The dose can be repeated after 30 minutes if necessary. Women who are more than 40 weeks pregnant or who weigh more than 100 pounds should receive 12 grams initially with subsequent doses of 6 grams each unless contraindicated. Oral magnesium sulfate solutions are usually administered twice daily with meals containing 320 milligrams per meal. Oral magnesium supplementation may cause diarrhea, so it is not recommended for women who require preeclampsia treatment during the first trimester. Magnesium deficiency has been associated with increased risk of developing preeclampsia. Therefore, it is important that women taking this medication maintain adequate dietary intake of magnesium.