Review Drug

Brand names:

Alu-Cap

Aludrox

Used in the following combined preparations Asilone, Gaviscon, Maalox, Mucaine, Mucogel, Topal, and others.

General Information

In use for over 50 years to neutralize stomach acid, aluminium hydroxide is the ingredient basic to many over-the- counter remedies for indigestion and heartburn. Because it is constipating (it is sometimes used for diarrhoea), this drug is usually combined with a magnesium-containing antacid that has a balancing laxative effect.

The prolonged action of the drug makes it useful in preventing the pain of stomach and duodenal ulcers or reflux oesophagitis. It can also promote the healing of ulcers.

In the intestine, aluminium hydroxide inactivates phosphate. This makes it helpful in treating high blood phosphate (hyperphosphataemia), a condition that occurs in some people with impaired kidney function. Prolonged heavy use can lead to
phosphate deficiency and a consequent weakening of the bones.

Some preparations include large amounts of sodium and should be used with caution by those on low-sodium diets.
Liquid preparations of the drug may be more effective as an antacid than tablets.

Quick Reference

Drug group Antacid

Overdose danger rating Low
Dependence rating Low
Prescription needed No
Available as generic Yes

Information For Users

Follow instructions on the label. Call your doctor if symptoms worsen.

How taken

Tablets,
capsules, liquid (gel suspension). The tablets should be well chewed.

Frequency and timing of doses

As antacid 4-6x daily as needed, or 1 hour before and after meals. Peptic ulcer 6-7 x daily.
Hyperphosphataemia 3-4 x daily with meals. Diarrhoea 2-6 x daily.

Dosage range

Adults Up to 70ml daily (liquid), 2-10g daily (tablets or capsules). Children over 6 years
Reduced dose according to age and weight.

Onset of effect

Within 15 minutes.

Duration of  action

2-4 hours.

Diet advice

For hyperphosphataemia, a low-phosphate diet may be advised in addition to aluminium hydroxide treatment.

Storage

Keep in a closed container in a cool, dry place out of the reach of children.

Missed dose

Do not take the missed dose. Take your next dose as usual.

Stopping the drug

Can be safely stopped as soon as you no longer need it (indigestion). When taken as ulcer treatment or for hyperphosphataemia resulting from kidney failure, do not stop without consulting your doctor.

Exceeding the dose

An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

Possible Adverse Effects

Constipation is common with aluminium hydroxide; nausea and vomiting may occur due to the granular, powdery nature of the drug. Bone pain occurs only when large doses have been taken regularly for months or years.

Interactions

General note .
Aluminium hydroxide may interfere with the absorption or excretion of oral anticoagulants, digoxin, tetracyclines and some other antibiotics, penicillamine, corticosteroids, antipsychotics, and Phenytoin.

Enteric-coated tablets. This drug may lead to the break-up of the enteric coating of tablets (such as bisacodyl, or enteric- coated prednisolone) before they leave the stomach, causing stomach irritation.

Special Precautions

Be sure to consult your doctor or pharmacist before taking this drug if:

▼         You have a
long-term kidney problem.

▼         You
have heart problems.

▼         You have
high blood pressure.

▼         You suffer
from constipation.

▼         You have a
bone disease.

▼         You are
taking other medications.

Pregnancy

▼ Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding

▼         No evidence of risk.

Infants and children

▼         Not recommended under 6 years except on the advice of a doctor.

Over 60

▼
Increased likelihood of adverse effects. Reduced dose may therefore be necessary.

Driving and hazardous work

▼         No known
problems.

Alcohol

▼         No known problems.

Prolonged Use

Aluminium hydroxide should not be used for longer than 4 weeks without consulting your doctor. Prolonged use in high doses may deplete blood phosphate and calcium levels, leading to weakening of the bones and fractures.