Adult Dosing

Relief of symptoms associated with upset stomach

• Maalox Advanced Maximum Strength Liquid, Mylanta Maximum Strength
• 2-4 teaspoonfuls (10-20 mL) PO bid
• Max: 8 teaspoonfuls (40 mL)/day x 2 wks

• Maalox Advanced Regular Strength, Mylanta Regular Strength
• 2-4 teaspoonfuls (10-20 mL) PO qid
• Max: 16 teaspoonfuls (80 mL)/day x 2 wks

• Gelusil
• 2-4 tabs PO q1h prn
• Max: 12 tabs/24 h

Pediatric Dosing

Relief of symptoms associated with upset stomach (>12 yrs)

• Maalox Advanced Maximum Strength Liquid, Mylanta Maximum Strength
• 2-4 teaspoonfuls (10-20 mL) PO bid
• Max: 8 teaspoonfuls (40 mL)/day x 2 wks

• Maalox Advanced Regular Strength, Mylanta Regular Strength
• 2-4 teaspoonfuls (10-20 mL) PO qid
• Max: 16 teaspoonfuls (80 mL)/day x 2 wks

[Outline]

• Adult Dosing
• Pediatric Dosing

• Relief of symptoms associated with upset stomach such as heartburn, acid indigestion, sour stomach, pressure, gas and bloating

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Aluminum hydroxide/magnesium hydroxide
• Renal impairment: Caution advised; dose adjustments not defined

• Simethicone
• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Aluminum hydroxide/magnesium hydroxide/simethicone
• Hepatic impairment: Dose adjustments not defined

• Antacids may interfere with the absorption of concomitantly administered oral drugs by changing GI transit time or by binding the drug
• Do not use more than the maximum recommended dose and for more than 2 weeks. If symptoms last for more than 2 wks, discontinue the treatment and further evaluate the patient

Cautions: Use cautiously in

• Renal impairment
• Magnesium-restricted diet

Pregnancy Category:NR (aluminum hydroxide); C (simethicone); B (magnesium hydroxide)

Breastfeeding: No published information available on use of aluminum, antacid therapy in nursing mother. Additional intake of this mineral by mother is unlikely to surpass that found in other infant foods; also oral absorption of aluminum is poor. Hence, antacid use during breastfeeding is acceptable and no special precautions are required. Simethicone is not absorbed orally, hence cannot be transferred to breastmilk. It is also used safely in breastfed infants. No special precautions are required. Use of Magnesium hydroxide is acceptable during breastfeeding. This information is based upon Lactmed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/ht mlgen?LACT last accessed 11 May 2011).

• GI: Constipation, diarrhea
• METABOLIC: Hypophosphatemia
• DERM: Flushing, sweating

Aluminum hydroxide

• Antacid; neutralizes hydrochloric acid in gastric secretions, also inhibits the action of pepsin by increasing the pH and via adsorption
• 17-30% systemic absorption
• Not metabolized
• Excreted in feces and urine
• Half-life: Unknown

Magnesium hydroxide

• Laxative; Neutralizes gastric acid, attracts/retains water in intestinal lumen and causes peristalsis
• Poorly absorbed
• Metabolism: Unknown
• Mainly excreted in urine
• Half-life: Unknown

Simethicone

• Antiflatulent; relieves flatulence by dispersing and preventing formation of mucus-surrounded gas pockets in GI tract
• Metabolism: Unknown
• Excreted unchanged in feces
• Half-life: Unknown

US Trade Name(s)

• Maalox Advanced Maximum Strength Liquid
• Maalox Advanced Regular Strength
• Mylanta Regular Strength
• Mylanta Maximum Strength
• Gelusil

US Availability

Maalox Advanced Maximum Strength Liquid, Mylanta Maximum Strength (aluminum hydroxide/magnesium hydroxide/simethicone)

• OTC SUSP: [400 mg/400 mg/40 mg]/5 mL

Maalox Advanced Regular Strength, Mylanta Regular Strength (aluminum hydroxide/magnesium hydroxide/simethicone)

• OTC SUSP: [200 mg/200 mg/20 mg]/5 mL

Gelusil (aluminum hydroxide/magnesium hydroxide/simethicone)

• OTC CHEW TABS: 200 mg/200 mg/25 mg

Canadian Trade Name(s)

• Antacid Plus Extra Strength
• Antacid Regular With Anti-Gas
• Antacid With Alumina
• Magnesia Plus Simethicone Oral Suspension
• Diovol Plus
• Maalox Antacid With Anti-Gas
• Maalox Antacid With Anti-Gas Extra Strength

Canadian Availability

Antacid Plus Extra Strength, Maalox Antacid With Anti-Gas Extra Strength (aluminum hydroxide/magnesium hydroxide/simethicone)

• LIQ: [400 mg/400 mg/40 mg]/5 mL

Antacid Regular With Anti-Gas, Maalox Antacid With Anti-Gas (aluminum hydroxide/magnesium hydroxide/simethicone)

• LIQ: [200 mg/200 mg/20 mg]/5 mL

Antacid With Alumina, Magnesia Plus Simethicone Oral Suspension (aluminum hydroxide/magnesium hydroxide/simethicone)

• SUSP: [228 mg/200 mg/25 mg]/5 mL

Diovol Plus (aluminum hydroxide/magnesium hydroxide/simethicone)

• SUSP: [165 mg/200 mg/25 mg]/5 mL
• TABS: 300 mg/100 mg/25 mg

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Mylanta Double Strength
• Mylanta P
• Mylanta Original

Australian Availability

Mylanta Double Strength (aluminum hydroxide/magnesium hydroxide/simethicone)

• SUSP: [800 mg/800 mg/60 mg]/10 mL
• TABS: 400 mg/400 mg/40 mg

Mylanta P (aluminum hydroxide/magnesium hydroxide/simethicone)

• SUSP: [400 mg/400 mg/40 mg]/10 mL

Mylanta Original (aluminum hydroxide/magnesium hydroxide/simethicone)

• TABS: 200 mg/200 mg/20 mg

[Outline]

Gastrointestinal

GI Combination Agents