aluminum hydroxide (Alternagel, Amphojel, Alu-Cap, Dialume, AlH3OH)

Introduction

Tradename: Alternagel, Amphojel, Alu-Cap, Dialume. Al(OH)3

Indications

• symptomatic treatment of dyspepsia, peptic ulcer, GERD, hiatal hernia
• hyperphosphatemia in non-renal impaired patients
• skin irritation, including diaper rash
• stress ulcer prophylaxis

Contraindications

pregnancy-category :value +, ? 1st trimester

safety-in-lactation :value ?

Dosage

• 500-1500 mg PO up to 6 times daily
• 1-3 capsules 1-3 hours after meals & QHS PRN

Tabs: 300(?), 475, 500, 600(?) mg.

Suspension:

• 320 mg/5 mL, 450 mg/5 mL, 600 mg/5 mL, 675 mg/5 mL.
• 5-30 mL 1 & 3 hours after meals & QHS PRN

Pharmacokinetics

• elimination :route kidney
• usual duration of action is 20-60 minutes if taken after meals
• effects may persist for up to 3 hours

Adverse effects

• common (> 10%)
  • constipation
  • chalky taste
  • stomach cramps
  • fecal impactation
• less common (1-10%)
  • nausea/vomiting, discoloration of feces (white speckles)
• uncommon (< 1%)
  • hypophosphatemia, hypomagnesemia
• other
  • decrease in GI motility
  • long term use in patients with renal failure may result in aluminum toxicity

• drug adverse effects of antacid(s)

Drug interactions

• decreased absorption of many medications including:
  • tetracyclines, digoxin, iron salts, isoniazid, allopurinol, corticosteroids, penicillamine, phenothiazines, H2 receptor antagonists

• drug interaction(s) of iron supplements in combination with antacids
• drug interaction(s) of beta-adrenergic receptor antagonists with aluminum hydroxide

Mechanism of action

• increased pH of gastric secretions
• aluminum binds phosphate in food within the intestine

More general terms

• antacid
• phosphate binder

Additional terms

• Al+3 (aluminum ion)

Component of

• aluminum hydroxide/magnesium hydroxide/ribonuclease/angiogenin inhibitor/simethicone
• aluminum hydroxide/diphenhydramine/lidocaine/magnesium hydroxide/simethicone
• aluminum hydroxide/dimethicone/magnesium hydroxide
• aluminum hydroxide/magnesium trisilicate
• aluminum hydroxide/magnesium carbonate (Gaviscon)
• aluminum hydroxide/magnesium hydroxide/simethicone (Mylanta II, Maalox Plus)
• aluminum hydroxide/magnesium hydroxide (Maalox, Mylanta)
• aluminum hydroxide/aspirin/magnesium hydroxide (Ascriptin)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3026338