• Lowering of phosphate levels in patients with chronic renal failure.
• Adjunctive therapy in the treatment of peptic, duodenal, and gastric ulcers.
• Hyperacidity, indigestion, reflux esophagitis.

Contraindicated in:

• Severe abdominal pain of unknown cause.

Use Cautiously in:

• Hypercalcemia
• Hypophosphatemia
• OB: Generally considered safe; chronic high-dose therapy should be avoided.

F and E: hypophosphatemia.

GI: constipation.

Drug-Drug:

• Absorption of tetracyclines, chlorpromazine, iron salts, isoniazid, digoxin, or fluoroquinolones may be decreased.
• Salicylate blood levels may be decreased.
• Quinidine, mexiletine, and amphetamine levels may be increased if enough antacid is ingested such that urine pH is increased.

(Generic available)

• Capsules: 475 mg^OTC; 500 mg^OTC;
• Tablets: 300 mg^OTC; 500 mg^OTC; 600 mg^OTC;
• Suspension: 320 mg/5 mL^OTC; 450 mg/5 mL^OTC; 600 mg/5 mL^OTC; 675 mg/5 mL^OTC;
• In combination with: magnesium carbonate, calcium carbonate, simethicone, and mineral oil. See Appendix [not included in this PDA edition].

Hypophosphatemia

• PO (Adults): 1.9–4.8 g (30–40 mL of regular suspension or 15–20 mL of concentrated suspension) 3–4 times daily.
• PO (Children): 50–150 mg/kg/24 hr in 4–6 divided doses; titrate to normal serum phosphate levels.

Antacid

• PO (Adults): 500–1500 mg (5–30 mL) 3–6 times daily.

AlternaGEL, Alu-Cap, Aluminet, Alu-Tab, Amphojel, Basalgel, Dialume

• Binds phosphate in the GI tract.
• Neutralizes gastric acid and inactivates pepsin.

• Lowering of serum phosphate levels.
• Healing of ulcers and decreased pain associated with ulcers or gastric hyperacidity.
• Constipation limits use alone in the treatment of ulcer disease.
• Frequently found in combination with magnesium-containing compounds.

Therapeutic Classification: antiulcer agents, hypophosphatemics

Pharmacologic Classification: antacids, phosphate binders

Absorption: With chronic use, small amounts of aluminum are systemically absorbed.

Distribution: If absorbed, aluminum distributes widely, crosses the placenta, and enters breast milk. Concentrates in the CNS with chronic use.

Metabolism/Excretion: Mostly excreted in feces. Small amounts absorbed are excreted by the kidneys.

Half-life: Unknown.

Alugel

†Hypophosphatemic effect.

†Antacid effect.

• Instruct patient to take aluminum hydroxide exactly as directed. If on a regular dosing schedule and a dose is missed, take as soon as remembered if not almost time for next dose; do not double doses.
  • Advise patient not to take aluminum hydroxide within 1–2 hr of other medications without consulting health care professional.
  • Advise patients to check label for sodium content. Patients with HF or hypertension, or those on sodium restriction, should use low-sodium preparations.
  • Inform patients of potential for constipation from aluminum hydroxide.
• Hypophosphatemia: Patients taking aluminum hydroxide for hyperphosphatemia should be taught the importance of a low-phosphate diet.
• Antacid: Caution patient to consult health care professional before taking antacids for more than 2 wk if problem is recurring, if taking other medications, if relief is not obtained, or if symptoms of gastric bleeding (black tarry stools, coffee-ground emesis) occur.