aluminum hydroxide (OTC)

Frequency Not Defined

Nausea

Vomiting

Rebound hyperacidity

Aluminum-intoxication

Hypophosphatemia

Chalky taste

Constipation

Fecal impaction

Stomach cramps

Milk-alkali syndrome

Osteomalacia

Contraindications

Hypersensitivity to aluminum salts

Cautions

Aluminum toxicity may occur in renal failure patients

Hypophosphatemia may occur

Use caution in patients with heart failure, cirrhosis, edema, or renal failure

Will bind calcium if given at same time

Elderly may be predisposed to fecal impaction

Use caution in patients who have recently suffered massive gastrointestinal hemorrhage

Pregnancy Category: C

Lactation: Not known whether aluminum hydroxide is excreted in breast milk

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Antacid: Neutralizes HCl in the stomach to form soluble aluminum chloride

Phosphate binder: binds phosphate in the GI tract to form insoluble complexes and reduces phosphate absorption

Pharmacokinetics

Excretion

• Absorbed aluminum is eliminated in the urine (0.1-0.5 mg of Al in aluminum-containing antacid is absorbed from standard daily doses of antacid)
• Insoluble, poorly absorbed Al salts in the intestines: hydroxides, carbonates, phosphates and fatty acid derivatives, are excreted in feces

Oral Administration

Drink plenty of water following dose