Chronic renal impairment; CHF; oedema; cirrhosis and low Na diets; patients with recent GI haemorrhage. Administer 2-3 hrs before/after another medication to minimise drug interactions. Pregnancy and lactation.
Lactation: excretion in milk unknown
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Aluminum hydroxide: Neutralizes stomach hydrocloride to form AlCl3 salt plus water; increases gastric pH.
Magnesium hydroxide: Promotes bowel evacuation by causing osmotic retention of fluid, which causes the colon to distend with increased peristaltic activity; forms magnesium chloride when reacts with hydrochloric acid.
Simethicone: Disperses and prevents gas pockets in the GI system by decreasing surface tension of gas bubles.
Interaction
Aluminium Hydroxide: Enhanced absorption with citrates or ascorbic acid. Decreases absorption of allopurinol, tetracyclines, quinolones, cephalosporins, biphosphonate derivatives, corticosteroids, cyclosporin, delavirdine, Fe salts, imidazole antifungals, isoniazid, mycophenolate, penicillamine, phosphate supplements, phenytoin, phenothiazines, trientine.
Magnesium Hydroxide: Decreases absorption of tetracyclines and biphosphonates. Separate administration of these and other drugs by around 2 hr.
Simethicon: None well documented.
Pregnancy Category Note
Pregnancy Category: C
Lactation: excretion in milk unknown
Adult Dose
Adult: Dyspepsia, Abdominal Bloating
10-20 mL PO q4-6hr taken 1 hour before or 3 hours after meals, OR
Chew 2-4 tablets q4-6hr; not to exceed 12 tablets/24 hr
PO Antacid Up to 1 g/day.
Hyperphosphataemia in chronic renal failure Up to 10 g/day in divided doses w/ meals.
Child Dose
N/A
Renal Dose
N/A
Administration
Administration Should be taken on an empty stomach.
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