• 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.

• 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.

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.

Contraindicated in:

• Severe abdominal pain of unknown cause.

Use Cautiously in:

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

GI: constipation.

F and E: hypophosphatemia.

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.

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.

• Antacids cause premature dissolution and absorption of enteric-coated tablets and may interfere with absorption of other oral medications. Separate administration of aluminum hydroxide and oral medications by at least 1–2 hr.
  • Tablets must be chewed thoroughly before swallowing to prevent their entering small intestine in undissolved form. Follow with a glass of water.
  • Shake liquid preparations well before pouring. Follow administration with water to ensure passage into stomach.
  • Liquid dosage forms are considered more effective than tablets.
• Hypophosphatemic: For phosphate lowering, follow dose with full glass of water or fruit juice.
• Antacid: May be given in conjunction with magnesium-containing antacids to minimize constipation, except in patients with renal failure. Administer 1 and 3 hr after meals and at bedtime for maximum antacid effect.
  • For treatment of peptic ulcer, aluminum hydroxide may be administered every 1–2 hr while the patient is awake or diluted with 2–3 parts water and administered intragastrically every 30 min for 12 or more hr per day. Physician may order NG tube clamped after administration.
  • For reflux esophagitis, administer 15 mL 20–40 min after meals and at bedtime.

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

Alugel

Therapeutic Classification: antiulcer agents, hypophosphatemics

Pharmacologic Classification: antacids, phosphate binders

(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].