aluminum hydroxide

REMS

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.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Severe abdominal pain of unknown cause.

Use Cautiously in:

Hypercalcemia;
Hypophosphatemia;

Adv. Reactions/Side Effects ⬆ ⬇

F and E: hypophosphatemia

GI: constipation

Interactions ⬆ ⬇

Drug-drug:

May ↓ absorption and effectiveness of tetracyclines, chlorpromazine, iron salts, isoniazid, digoxin, or fluoroquinolones.
May ↓ levels and effectiveness of salicylates.
May ↑ levels and risk of toxicity of quinidine, mexiletine, and amphetamine.

Availability ⬆ ⬇

(Generic available)

Suspension: 320 mg/5 mL^OTC
In combination with:
magnesium carbonate.

Route/Dosage ⬆ ⬇

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 concentrations.

Antacid

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

Action ⬆ ⬇

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

Therapeutic effects:

Lowering of serum phosphate concentrations.
Healing of ulcers and decreased pain associated with ulcers or gastric hyperacidity.
Frequently found in combination with magnesium-containing compounds.

Classifications ⬆ ⬇

Therapeutic Classification: antiulcer agents, hypophosphatemics

Pharmacologic Classification: antacids, phosphate binders

Pharmacokinetics ⬆ ⬇

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

Distribution: If absorbed, aluminum distributes widely; concentrates in the CNS with chronic use.

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

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO‡	hr–days	days–wk	days
PO‡	15–30 min	30 min	30 min–3 hr

‡Hypophosphatemic effect.

‡Antacid effect.

Patient/Family Teaching ⬆

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
- Advise patient not to take aluminum hydroxide within 1–2 hr of other medications without consulting health care professional.
- Advise patient to check label for sodium content if on sodium restriction; use low-sodium preparation.
- Inform patient of potential for constipation.
Hyperphosphatemia: Teach importance of a low-phosphate diet.
Antacid: Caution patient to consult health care professional before taking antacids for >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.

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Indications ⬇