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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Aluminum Hydroxide, Magnesium Hydroxide, Simethicone
Brand Name
Advanced Regular Strength Antacid
Generic Name
Aluminum Hydroxide, Magnesium Hydroxide, Simethicone
Active Ingredient
Aluminum HydroxideCategory
Other
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 200 mg/5mL | SUSPENSION | ORAL | 0363-1639 |
Detailed information about Advanced Regular Strength Antacid
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Advanced Regular Strength Antacid, you must consult a qualified healthcare professional.
Aluminum Hydroxide is an inorganic salt used primarily as an antacid to relieve heartburn and as a phosphate binder in patients with chronic kidney disease. It belongs to the antacid and phosphate binder drug classes.
Dosage for Aluminum Hydroxide must be individualized based on the condition being treated and the patient's response.
Aluminum Hydroxide should be used with extreme caution in children.
In patients with significant renal impairment (Stage 4 or 5 CKD), Aluminum Hydroxide must be used with extreme caution. While it is used to treat a complication of kidney disease, the kidneys are also the only way to remove absorbed aluminum. Prolonged use in these patients can lead to 'dialysis encephalopathy' or 'dialysis dementia.' Doses should be kept to the minimum effective amount for the shortest duration possible.
No specific dose adjustments are typically required for patients with liver disease, as the drug is not metabolized by the liver. However, patients with cirrhosis and associated fluid retention should monitor their intake if using combination products that contain high sodium levels.
Older adults are more prone to constipation and may have undiagnosed age-related declines in kidney function. Lower starting doses and increased fluid intake are often recommended to prevent bowel impaction.
If you miss a dose, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not double the dose to catch up. For those using it as a phosphate binder, if you finish a meal and forget the dose, take it immediately; however, if several hours have passed since the meal, the dose may no longer be effective for that specific meal.
Signs of an acute overdose may include severe constipation, stomach cramps, or a complete bowel obstruction. Chronic overdose (taking too much over a long period) can lead to aluminum toxicity, characterized by confusion, muscle weakness, and bone pain. In the event of a suspected overdose, contact a Poison Control Center or seek emergency medical care immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or use the medication for more than two weeks without medical guidance.
The most frequent side effect associated with Aluminum Hydroxide is constipation. Because aluminum salts have an astringent effect on the intestinal mucosa and slow down gastric emptying, the stool can become hard and difficult to pass. This effect is dose-dependent and is the primary reason many manufacturers combine Aluminum Hydroxide with Magnesium Hydroxide (which has a laxative effect). Patients may also experience a 'chalky' or unpleasant taste in the mouth immediately after administration, particularly with liquid or chewable forms.
> Warning: Stop taking Aluminum Hydroxide and call your doctor immediately if you experience any of the following serious symptoms:
Prolonged use of Aluminum Hydroxide (months to years) carries significant risks, particularly for the skeletal and neurological systems:
No FDA black box warnings currently exist for Aluminum Hydroxide. However, the clinical community maintains a high level of vigilance regarding its use in patients with renal failure due to the well-documented risk of systemic aluminum accumulation.
Report any unusual symptoms to your healthcare provider. Monitoring of blood mineral levels (calcium, phosphate, aluminum) is often required for long-term users.
Aluminum Hydroxide is generally safe for short-term use in healthy individuals, but it is not a benign substance. The most critical safety consideration is the duration of use. Patients should not use this medication for more than 2 weeks for acid symptoms without consulting a physician. Persistent heartburn can be a sign of more serious conditions, such as a peptic ulcer or esophageal cancer, which require a different diagnostic and treatment approach.
No FDA black box warnings for Aluminum Hydroxide.
For patients taking Aluminum Hydroxide long-term, especially for phosphate binding, the following laboratory tests are typically required every 1 to 3 months:
Aluminum Hydroxide does not typically cause drowsiness or impairment. However, if systemic toxicity occurs (aluminum encephalopathy), it can cause confusion and coordination issues. Until you know how you react to the medication, use caution when performing tasks requiring alertness.
Alcohol can irritate the stomach lining and increase acid production, potentially counteracting the benefits of the antacid. While there is no direct chemical interaction between alcohol and Aluminum Hydroxide, limiting alcohol intake is advised for anyone suffering from gastric hyperacidity.
There is no 'withdrawal syndrome' associated with stopping Aluminum Hydroxide. However, 'acid rebound' can occur if the medication was being used to mask significant acid reflux; symptoms may return once the buffering agent is removed. If using for phosphate binding, stopping the medication abruptly will lead to a rapid rise in serum phosphorus, which can be dangerous for heart health.
> Important: Discuss all your medical conditions, especially kidney disease or bowel issues, with your healthcare provider before starting Aluminum Hydroxide.
There are few absolute contraindications, but the use of Aluminum Hydroxide with Citrate salts (found in some calcium supplements like calcium citrate or in 'Alka-Seltzer' products) is highly discouraged. Citrate significantly increases the intestinal absorption of aluminum (by up to 50 times), which can lead to rapid-onset aluminum toxicity, especially in patients with kidney disease.
Aluminum Hydroxide can significantly decrease the absorption of many important medications by binding to them in the gut (chelation) or by changing the stomach's pH.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A general rule is to take other medications at least 2 hours before or 4 hours after Aluminum Hydroxide to prevent absorption issues.
Aluminum Hydroxide must NEVER be used in the following circumstances:
Conditions requiring careful risk-benefit analysis by a physician include:
Patients who are sensitive to Aluminum Magnesium Hydroxide or Aluminum Carbonate will likely react to Aluminum Hydroxide as well. There is no known cross-sensitivity with non-aluminum antacids like Calcium Carbonate or Sodium Bicarbonate.
> Important: Your healthcare provider will evaluate your complete medical history, including kidney function and current mineral levels, before prescribing or recommending Aluminum Hydroxide.
Aluminum Hydroxide is generally considered safe for short-term use during pregnancy when taken at recommended OTC doses. It is often a second-line choice after calcium-based antacids for pregnancy-related heartburn. According to the FDA, it is not formally categorized under the old A-X system for most OTC labels, but clinical data suggests no increased risk of birth defects. However, long-term use or high doses should be avoided to prevent mineral imbalances in the mother and fetus. Always consult an OB/GYN before use.
Small amounts of aluminum may be excreted into breast milk, but because the mother absorbs so little of the drug, the amount passed to the infant is considered clinically insignificant. It is generally regarded as compatible with breastfeeding. However, nursing mothers should avoid taking it with citrate-containing products to prevent increased absorption.
As noted in the dosage section, use in children under 6 is generally discouraged. In older children, it should only be used for short-term relief. Chronic use in children is particularly dangerous because their developing bones and brains are more sensitive to the toxic effects of aluminum and the growth-stunting effects of phosphate depletion.
Elderly patients are at the highest risk for complications. They are more likely to have decreased renal clearance (even if serum creatinine appears normal) and are more prone to severe constipation. Furthermore, polypharmacy (taking many medications) is common in the elderly, making the risk of drug-drug interactions with Aluminum Hydroxide very high. Clinicians often recommend magnesium-aluminum combinations or H2 blockers for this population instead.
In patients with a GFR < 30 mL/min, the risk of aluminum accumulation is high. If used as a phosphate binder, it is typically reserved for short-term use (4-6 weeks) to bring very high phosphate levels down quickly before transitioning to an aluminum-free binder. Monitoring for 'dialysis encephalopathy' (speech disturbances, tremors, seizures) is mandatory for any renal patient on long-term therapy.
No specific adjustments are needed for liver disease, but patients with hepatic encephalopathy should be monitored closely, as any electrolyte disturbance or severe constipation can worsen their mental state.
> Important: Special populations, particularly the elderly and those with kidney disease, require individualized medical assessment and frequent lab monitoring.
Aluminum Hydroxide is an inorganic salt with the chemical formula Al(OH)3. Its primary pharmacologic effect is the chemical neutralization of hydrochloric acid (HCl) in the gastric lumen. The reaction is as follows:
This reaction results in the formation of aluminum chloride and water, effectively raising the pH of the stomach. By reducing the acidity, it also decreases the activity of pepsin. In the intestine, the aluminum chloride reacts with dietary phosphate to form insoluble aluminum phosphate (AlPO4), which is then excreted.
The onset of acid neutralization is relatively slow compared to sodium bicarbonate but provides a longer duration of effect. The buffering capacity of Aluminum Hydroxide is high, but it does not typically raise the gastric pH above 4 or 5, which is beneficial as it avoids the 'acid rebound' associated with making the stomach too alkaline. The duration of action is approximately 20-60 minutes if taken on an empty stomach and up to 3 hours if taken after a meal.
| Parameter | Value |
|---|---|
| Bioavailability | < 1% (Minimal) |
| Protein Binding | 90-95% (to Albumin/Transferrin) |
| Half-life | Hours (Normal) / Days (Renal Failure) |
| Tmax | 0.5 - 1 hour (for neutralization) |
| Metabolism | None (Inorganic Salt) |
| Excretion | Fecal (>99%), Renal (<1%) |
Aluminum Hydroxide is categorized as an Antacid and a Phosphate Binder. It is often grouped with other metal salts like Magnesium Hydroxide and Calcium Carbonate. Within the therapeutic area of nephrology, it is considered a 'metal-based phosphate binder.'
Common questions about Advanced Regular Strength Antacid
Aluminum Hydroxide is primarily used as an antacid to provide fast relief from heartburn, acid indigestion, and sour stomach by neutralizing excess gastric acid. Additionally, it is used in clinical settings as a phosphate binder for patients with chronic kidney disease to prevent high blood phosphorus levels. By binding to phosphorus in the food you eat, it allows the mineral to pass through your system without being absorbed. It is available both over-the-counter for digestive issues and as a prescription-strength treatment for kidney-related mineral imbalances. Always consult a healthcare provider to determine the appropriate use for your specific health needs.
The most common side effect of Aluminum Hydroxide is constipation, which occurs because aluminum salts slow down the movement of the digestive tract. Some patients also report a chalky or unpleasant taste in the mouth, especially after using chewable tablets or liquid suspensions. Less frequently, users may experience nausea, vomiting, or stomach cramps. To manage constipation, doctors often recommend increasing fluid intake or using a product that combines aluminum with magnesium. If constipation becomes severe or you experience abdominal pain, you should stop use and contact a healthcare professional immediately.
While there is no direct chemical interaction between alcohol and Aluminum Hydroxide, drinking alcohol is generally discouraged when you have the symptoms that require an antacid. Alcohol can increase the production of stomach acid and irritate the esophageal lining, which may worsen heartburn or indigestion. Furthermore, heavy alcohol use can affect kidney function, potentially increasing the risk of aluminum accumulation over time. For the best results in managing acid reflux, it is recommended to avoid alcohol until your symptoms have fully resolved. Discuss your lifestyle habits with your doctor for personalized advice.
Aluminum Hydroxide is generally considered safe for short-term use during pregnancy to treat occasional heartburn, which is a common complaint among expectant mothers. Most clinical guidelines suggest it is a safe second-line option if calcium-based antacids do not provide enough relief. However, it should not be used in high doses or for long periods, as this could lead to mineral imbalances in both the mother and the developing fetus. It is also important to avoid taking it with citrate-containing supplements (like some prenatal vitamins) because they can increase aluminum absorption. Always speak with your obstetrician before starting any new medication during pregnancy.
When used as an antacid, Aluminum Hydroxide typically begins to neutralize stomach acid within 20 to 30 minutes of ingestion. The liquid suspension form usually works slightly faster than chewable tablets because it has a larger surface area to react with the acid immediately. The relief generally lasts for about 1 to 3 hours, especially if taken after a meal when the stomach is full. For its use as a phosphate binder, the effect occurs during the digestion of a meal, so it must be taken at the time of eating to be effective. If your symptoms do not improve after a few days of use, consult your doctor.
For occasional use as an antacid, you can stop taking Aluminum Hydroxide suddenly without any withdrawal symptoms. However, if you have been using it daily for a long time, you might experience a return of your original acid symptoms, sometimes referred to as 'acid rebound.' If you are taking Aluminum Hydroxide as a prescribed phosphate binder for kidney disease, you should NEVER stop taking it without your doctor's permission. Stopping the medication in this context can cause a dangerous and rapid spike in your blood phosphate levels, which can lead to heart problems and bone damage. Always follow the discontinuation plan provided by your medical team.
If you miss a dose of Aluminum Hydroxide, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, simply skip the missed dose and continue with your regular schedule; do not take two doses at once to make up for the one you missed. If you are using it as a phosphate binder with meals and you forget a dose until several hours after the meal, the dose may no longer be effective for that specific meal, and you should just wait for your next meal. Consistency is key, especially for kidney patients, so try to take your medication at the same time every day. Consult your pharmacist if you have frequent trouble remembering doses.
Aluminum Hydroxide is not known to cause weight gain directly, as it is not a hormone and does not contain significant calories. However, some patients may experience bloating or a feeling of fullness due to the constipation that the medication can cause, which might be mistaken for weight gain. In very rare cases of long-term toxicity, changes in bone density or muscle mass could occur, but these are not typical 'weight gain' scenarios. If you notice rapid or unexplained weight changes while taking this medication, it is more likely related to an underlying condition like heart or kidney issues. You should report any significant weight changes to your healthcare provider for evaluation.
Aluminum Hydroxide can interfere with the absorption of many other drugs, including certain antibiotics, heart medications, and bone-strengthening drugs. It works by binding to these medications in the stomach or by changing the acidity levels needed for them to dissolve properly. To avoid these interactions, a general rule is to take your other medications at least 2 hours before or 4 to 6 hours after taking Aluminum Hydroxide. It is especially important to avoid taking it with citrate supplements, which can dangerously increase aluminum levels in your blood. Always provide your doctor or pharmacist with a full list of all your current medications and supplements.
Yes, Aluminum Hydroxide is widely available as a generic medication and is also a common ingredient in many well-known brand-name antacid products. It is often sold as a stand-alone generic 'Aluminum Hydroxide Gel' or in combination with other ingredients like magnesium. Generic versions are required by the FDA to be just as safe and effective as the brand-name equivalents. Because it is an older, well-established medication, the generic forms are typically very affordable and available at most pharmacies and grocery stores. Whether you choose a brand-name or generic version, ensure you are following the specific dosing instructions on the package or provided by your doctor.
Other drugs with the same active ingredient (Aluminum Hydroxide)