Other Brands/Names

Acitral, Aludonna, Gastrucid, Maag-Gel Promag, Sanmag.

How It Works

Aluminum hydroxide lowers stomach acidity, which can help to relieve symptoms of gastrointestinal issues.

In the stomach, this compound releases hydroxide ions. These ions neutralize free protons to form water and insoluble aluminum salts. The neutralization raises overall gastric pH so the stomach becomes less acidic.

Indications

Aluminum hydroxide is used to relieve heartburn (a burning sensation in the chest), a symptom seen in gastroesophageal reflux disease (GERD) and dyspepsia. This condition occurs when stomach acid flows back into the esophagus.

Contraindication

Aluminum hydroxide should not be used in patients with a known allergy to this medicine. Prolonged use is not advised in people with kidney impairment or those on dialysis because adverse effects may be provoked. Since aluminum hydroxide binds phosphate, it should be avoided in patients with severe diarrhea, as it can worsen hypophosphatemia in individuals with electrolyte abnormalities.

Side Effects

Potential adverse effects of aluminum hydroxide include:

• Constipation (difficulty passing stool)
• Anemia
• Reduced appetite

Types

Chewable tablets and suspension.

Dosage

• Tablets: Chew 1–2 tablets four times daily and at bedtime, or as needed.
• Suspension: 1–2 sachets (7–14 mL) three to four times daily; children over 8 years: ½–1 sachet three to four times daily.

Safety

Kidney disease

Toxic effects have been reported in patients with kidney diseases, including:

• Seizures
• Osteomalacia, a skeletal condition that increases fracture risk
• Encephalopathy, an abnormality in brain structure or function

Screen for kidney disease before giving aluminum hydroxide, as its use as a phosphate binder in dialysis patients is strongly associated with these problems.

Pregnancy

In pregnancy, use this medicine only if the benefits outweigh potential fetal risks. The United States Food and Drug Administration (FDA) has not assigned an official pregnancy category. Some experts advise avoiding aluminum hydroxide during the first trimester and in women of childbearing potential who are not using contraception. For breastfeeding, some researchers consider use acceptable with close observation of the infant for any adverse effects.

Drug Interaction

Co-administration can reduce the effectiveness of the following medicines:

1. Fluoroquinolone antibiotics (ciprofloxacin), tetracycline, and antituberculosis agents (ethambutol, isoniazid).
2. H2-receptor antagonists to reduce stomach acid (cimetidine, famotidine).
3. Corticosteroids used for inflammation and immune overactivity (dexamethasone, hydrocortisone, methylprednisolone, prednisone).
4. Benzodiazepines used for seizure management (clonazepam, diazepam, lorazepam).
5. Anxiolytics (alprazolam).
6. Uric acid–lowering therapy (allopurinol).
7. Vitamins, and others.

These reductions can be minimized by giving the other medicines 1 hour before or 2 hours after aluminum hydroxide.

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