Aluminum Hydroxide: Antacid Uses, Dosage & Side Effects

Summary of Key Points

Aluminum hydroxide is a commonly used antacid that helps relieve symptoms of heartburn, indigestion, and acid reflux by neutralizing stomach acid. It is also used to manage high phosphate levels in individuals with kidney disease. Before starting or adjusting your dose, it’s important to consult a healthcare provider. Our telemedicine providers are available to assist with any questions or concerns you may have.

Names of Medication

Amphojel (Aluminum hydroxide)

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, the generic name is listed in parentheses.

Pharmacologic Category

Antacid

Phosphate binder

Dosing Information for Aluminum Hydroxide

Aluminum hydroxide is prescribed for various conditions, and the dosage and frequency depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your medication. If you have any questions, you can schedule a telemedicine appointment with one of our providers.

1. Gastroesophageal reflux disease (GERD): 500-1500 mg orally, 3-4 times daily, as needed for symptom relief. The duration of treatment varies based on symptom control.
2. Peptic ulcer disease: 500-1500 mg orally, 4-6 times daily, typically for 4-8 weeks. Consult your healthcare provider for the appropriate treatment duration.
3. Indigestion: 500-1500 mg orally, as needed, up to 4 times daily. This is generally used for short-term symptom relief.
4. Heartburn: 500-1500 mg orally, as needed, up to 4 times daily. The duration of treatment depends on the severity of symptoms.
5. Hyperphosphatemia (high phosphate levels): 500-1500 mg orally, 3-4 times daily, with meals. The treatment duration is based on phosphate levels and kidney function.
6. Duodenal ulcer: 500-1500 mg orally, 4-6 times daily, typically for 4-8 weeks. Consult your healthcare provider for the appropriate duration.
7. Gastritis: 500-1500 mg orally, 4-6 times daily, depending on symptom severity. The treatment duration varies.
8. Esophagitis: 500-1500 mg orally, 4-6 times daily, usually for 4-8 weeks. Consult your healthcare provider for the appropriate treatment duration.
9. Constipation (off-label use): 500-1500 mg orally, as needed, up to 4 times daily. This should be used for short-term relief only.
10. Acid reflux: 500-1500 mg orally, as needed, up to 4 times daily. The treatment duration depends on the severity of symptoms.

Dosage Forms and Strengths of Aluminum Hydroxide

Aluminum hydroxide is available in several forms and strengths:

1. Oral suspension: 320 mg/5 mL
2. Chewable tablets: 500 mg, 600 mg
3. Capsules: 500 mg

Administration Instructions for Aluminum Hydroxide

Aluminum hydroxide is taken orally, either as a liquid suspension, chewable tablet, or capsule. It is most effective when taken between meals or at bedtime. If you are using the liquid form, be sure to shake the bottle well before each dose. For chewable tablets, make sure to chew them thoroughly before swallowing. Always follow your healthcare provider’s dosing instructions. If you have any questions about how to take this medication, our telemedicine providers are available to assist you.

Adverse Reactions and Side Effects of Aluminum Hydroxide

As with any medication, aluminum hydroxide may cause side effects. These can range from common to rare:

1. Constipation (common): Aluminum hydroxide can cause constipation, especially with long-term use. Drinking plenty of water may help alleviate this side effect.
2. Low phosphate levels (uncommon): Prolonged use may lead to low phosphate levels, which can result in muscle weakness or bone pain.
3. Stomach cramps (rare): Some individuals may experience mild stomach cramps or discomfort.
4. Nausea (rare): Nausea may occur, particularly if the medication is taken on an empty stomach.
5. Aluminum toxicity (very rare): In patients with kidney disease, prolonged use can lead to aluminum buildup in the body, potentially causing serious side effects such as confusion or bone pain.

Contraindications for Aluminum Hydroxide

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. If you have any of the following conditions, avoid taking aluminum hydroxide or consult your healthcare provider before starting this medication:

1. Severe kidney disease: Aluminum hydroxide can accumulate in the body if your kidneys are not functioning properly, leading to toxicity. This can result in serious side effects, such as bone pain or muscle weakness.
2. Low phosphate levels (hypophosphatemia): Aluminum hydroxide can further lower phosphate levels, potentially worsening this condition and leading to bone problems or muscle weakness.
3. Allergy to aluminum compounds: If you are allergic to aluminum or any ingredients in aluminum hydroxide, taking this medication could trigger an allergic reaction, which may include rash, itching, swelling, or difficulty breathing.
4. Severe constipation: Aluminum hydroxide can exacerbate constipation, so it should be avoided if you already suffer from this condition or are prone to it.

Drug-to-Drug Interactions with Aluminum Hydroxide

Aluminum hydroxide can interact with other medications, potentially reducing their effectiveness or increasing the risk of side effects. Be sure to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs, vitamins, and supplements. Some medications that may interact with aluminum hydroxide include:

1. Levothyroxine (Synthroid): Aluminum hydroxide can reduce the absorption of levothyroxine, making your thyroid medication less effective.
2. Digoxin (Lanoxin): Taking aluminum hydroxide with digoxin can decrease the effectiveness of digoxin, which is used to treat heart conditions.
3. Iron supplements (Ferrous sulfate): Aluminum hydroxide can interfere with iron absorption, potentially leading to low iron levels or worsening anemia.
4. Antibiotics (Tetracycline, Doxycycline): Aluminum hydroxide can bind to these antibiotics, reducing their effectiveness in treating infections.
5. Fluoroquinolone antibiotics (Ciprofloxacin, Levofloxacin): These antibiotics may not work as well when taken with aluminum hydroxide, as the medication can reduce their absorption.

Aluminum Hydroxide in Pregnancy

Is it safe to take aluminum hydroxide when pregnant?

Aluminum hydroxide is generally considered safe for short-term use during pregnancy, particularly for managing heartburn or indigestion. However, it’s important to use it only as directed and avoid prolonged use. Always consult your healthcare provider before taking any medication during pregnancy, including aluminum hydroxide. If you experience frequent heartburn or indigestion, one of our providers can help you find the safest treatment option through a telemedicine consultation.

Aluminum Hydroxide while Breastfeeding

Is it safe to take aluminum hydroxide while breastfeeding?

Aluminum hydroxide is typically considered safe while breastfeeding, as only minimal amounts are absorbed into the bloodstream and are unlikely to pass into breast milk in significant quantities. However, it’s still essential to consult your healthcare provider before using this medication while breastfeeding to ensure it’s the best option for both you and your baby. If you have any concerns, one of our providers can assist you through a telemedicine visit.

Estimated Cost of Aluminum Hydroxide Medication

The estimated cost of a 30-day supply of aluminum hydroxide without insurance, using a GoodRx coupon, ranges from $10 to $20, depending on the pharmacy and the specific formulation (liquid or tablet). Prices may vary, so it’s a good idea to check with your local pharmacy or use a GoodRx coupon to find the best deal.

Possible Alternatives to Aluminum Hydroxide

If aluminum hydroxide isn’t the right option for you, alternative treatments and lifestyle changes may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these options.

Gastroesophageal Reflux Disease (GERD)

Alternatives include proton pump inhibitors (PPIs) like omeprazole (Prilosec) or H2 blockers such as ranitidine (Zantac). Lifestyle modifications, such as avoiding trigger foods, eating smaller meals, and elevating the head of your bed, may also provide relief.

Peptic Ulcer Disease

Treatment options include PPIs like esomeprazole (Nexium) or H2 blockers like famotidine (Pepcid). Avoiding NSAIDs and managing stress can also help alleviate symptoms.

Indigestion

Over-the-counter antacids like calcium carbonate (Tums) or bismuth subsalicylate (Pepto-Bismol) may be suitable alternatives. Eating smaller, more frequent meals and avoiding fatty or spicy foods can also help manage indigestion.

Heartburn

H2 blockers like cimetidine (Tagamet) or PPIs like lansoprazole (Prevacid) may be effective. Additionally, lifestyle changes, such as avoiding large meals and not lying down immediately after eating, can help reduce symptoms.

Hyperphosphatemia

Alternatives include phosphate binders like sevelamer (Renvela) or calcium acetate (PhosLo). Dietary adjustments, such as reducing phosphate intake, may also be beneficial.

Duodenal Ulcer

PPIs like pantoprazole (Protonix) or H2 blockers like nizatidine (Axid) are commonly prescribed. Reducing alcohol consumption and avoiding smoking can also support healing.

Gastritis

PPIs like rabeprazole (Aciphex) or H2 blockers like ranitidine (Zantac) may be recommended. Avoiding irritants such as alcohol, caffeine, and spicy foods can also help manage symptoms.

Esophagitis

PPIs like omeprazole (Prilosec) or H2 blockers like famotidine (Pepcid) are often prescribed. Dietary changes, such as avoiding acidic foods, can also help reduce inflammation.

Constipation

Alternatives include stool softeners like docusate (Colace) or fiber supplements like psyllium (Metamucil). Increasing water intake and fiber consumption can also help relieve constipation.

Acid Reflux

H2 blockers like ranitidine (Zantac) or PPIs like omeprazole (Prilosec) may be effective. Lifestyle changes, such as avoiding trigger foods and eating smaller meals, can also help reduce symptoms.

Recent Updates on Aluminum Hydroxide Research

Recent studies have focused on the long-term safety of aluminum hydroxide, particularly in patients with chronic kidney disease (CKD). Research suggests that prolonged use of aluminum-based antacids in CKD patients may lead to aluminum accumulation, which can cause bone and neurological issues. As a result, healthcare providers are increasingly cautious about recommending aluminum hydroxide for long-term use in these patients. Ongoing studies are also exploring the potential benefits of combining aluminum hydroxide with other medications to enhance its effectiveness in treating hyperphosphatemia.

If you have concerns about the long-term use of aluminum hydroxide or are interested in learning more about recent research, our telemedicine providers are available to discuss your treatment options and answer any questions you may have.

James Kingsley

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