Aluminum hydroxide, magnesium hydroxide, and simethicone: Drug information

(For additional information see "Aluminum hydroxide, magnesium hydroxide, and simethicone: Patient drug information" and see "Aluminum hydroxide, magnesium hydroxide, and simethicone: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

Brand Names: US

Almacone Double Strength [OTC];
Almacone [OTC] [DSC];
Alumina-Magnesia-Simethicone [OTC] [DSC];
Antacid Anti-Gas Max Strength [OTC];
Antacid Anti-Gas [OTC];
Antacid Extra Strength [OTC];
Antacid Fast Relief [OTC];
Antacid I [OTC];
Antacid III [OTC];
Antacid Plus Anti-Gas Relief [OTC] [DSC];
Antacid Regular Strength [OTC];
Antacid [OTC] [DSC];
Antacid/Anti-Gas [OTC] [DSC];
Antacid/Antigas [OTC];
FT Antacid & Antigas [OTC];
Gelusil [OTC];
Geri-Lanta Maximum Strength [OTC];
Geri-Lanta [OTC];
Geri-Mox [OTC];
GoodSense Advanced Antacid [OTC];
GoodSense Antacid & Gas Relief [OTC];
HyVee Advanced Antacid [OTC];
Maalox Max [OTC];
Maalox Multi Symptom Max St [OTC];
Mag-Al Plus XS [OTC];
Mag-Al Plus [OTC];
Mi-Acid Maximum Strength [OTC] [DSC];
Mi-Acid [OTC] [DSC];
Milantex Extra Strength [OTC] [DSC];
Milantex [OTC] [DSC];
Mintox Maximum Strength [OTC];
Mintox Plus [OTC];
Mintox Regular Strength [OTC] [DSC];
Mylanta Maximum Strength [OTC]

Pharmacologic Category

Antacid;
Antiflatulent

Dosing: Adult

Antacid/antigas

Antacid/antigas: Oral:

Products containing aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 25 mg per tablet: 1 to 4 tablets 4 times daily; may also take as needed, up to 12 to 16 tablets/24 hours.

Products containing aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL: 10 to 20 mL between meals, at bedtime, or as directed by health care provider; maximum: 120 mL/24 hours.

Products containing aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL: 10 to 20 mL between meals, at bedtime, or as directed by health care provider; maximum: 40 to 60 mL/24 hours.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; aluminum and/or magnesium may accumulate in renal impairment.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Aluminum hydroxide, magnesium hydroxide, and simethicone: Pediatric drug information")

Note: Chronic antacid therapy not recommended for management of gastroesophageal reflux disease (GERD) in pediatric patients (Ref). Multiple concentrations of liquid dosage forms exist; close attention must be paid to the concentration when ordering or administering. Approved ages and uses for products may vary; consult product labeling for specific information.

Heartburn/Indigestion

Heartburn/Indigestion:

Liquid: Children ≥12 years and Adolescents:

Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (eg, Mi-Acid, Mag Al Plus): Oral: 10 to 20 mL 4 times daily as needed between meals and at bedtime, or as directed by a health care provider; maximum daily dose: 120 mL per 24 hours.

Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (eg, Mi-Acid Maximum): Oral: 10 to 20 mL 4 times daily as needed between meals and at bedtime, or as directed by a health care provider; maximum daily dose: 60 mL per 24 hours.

Tablet, chewable: Children ≥12 years and Adolescents:

Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 25 mg per tablet (eg, Gelusil, Mintox Plus): Oral: 2 to 4 tablets; may repeat hourly as needed; maximum daily dose: 12 tablets per 24 hours.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; aluminum and/or magnesium may accumulate in renal impairment; avoid use due to risk of aluminum toxicity (Ref).

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Gastrointestinal: Constipation, decreased gastrointestinal motility, fecal impaction, hemorrhoids, stomach cramps, unpleasant taste (chalky)

1% to 10%: Gastrointestinal: Fecal discoloration (white speckles), nausea, vomiting

<1%, postmarketing, and/or case reports: Dehydration, fluid retention, hypomagnesemia, hypophosphatemia

Contraindications

OTC labeling: When used for self-medication, do not use if you have kidney disease; do not use more than the recommended dose for more than 2 weeks.

Warnings/Precautions

Concerns related to adverse effects:

• Hypophosphatemia: Prolonged antacid therapy may result in hypophosphatemia; aluminum in antacid may form insoluble complexes with phosphate leading to decreased phosphate absorption in the GI tract. Rarely, severe hypophosphatemia can lead to anorexia, muscle weakness, malaise, and osteomalacia.

Disease-related concerns:

• Renal impairment: Hypermagnesemia or aluminum intoxication may occur in patients with renal impairment, particularly with prolonged use. Aluminum intoxication may lead to osteomalacia or dialysis encephalopathy.

Dosage form specific issues:

• Phenylalanine: Some products may contain phenylalanine.

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated with hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP ["Inactive" 1997]; Zar 2007).

• Sodium: Some products may contain sodium.

Other warnings/precautions:

• Self-medication (OTC use): When used for self-medication, patients should be instructed to consult their health care prescriber prior to using if they are on a magnesium- and/or sodium-restricted diet. Do not take the maximum dose for >14 days.

Warnings: Additional Pediatric Considerations

Absorption of aluminum has been reported in infants receiving both short-term and long-term antacid therapy (Tsou 1991; Woodard-Knight 1992); use of aluminum antacids is not recommended in infants or in pediatric patients with kidney impairment (NASPGHAN/ESPGHAN [Rosen 2018]).

Some dosage forms may contain propylene glycol; in neonates, large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults, including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Liquid, Oral:

Mag-Al Plus: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (30 mL) [sugar free; contains butylparaben, propylene glycol, propylparaben, saccharin sodium; peppermint flavor]

Mag-Al Plus XS: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (30 mL) [sugar free; contains butylparaben, propylene glycol, propylparaben, saccharin sodium; cherry flavor]

Suspension, Oral:

Almacone: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC]) [gluten free, low sodium; contains butylparaben, propylparaben]

Almacone Double Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains alcohol, usp, benzyl alcohol, butylparaben, propylparaben, saccharin sodium; mint flavor]

Alumina-Magnesia-Simethicone: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (30 mL [DSC]) [contains butylparaben, propylparaben, saccharin sodium; lemon-mint flavor]

Antacid: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC]); Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL [DSC]) [sodium free; contains parabens, saccharin]

Antacid Anti-Gas: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains saccharin]

Antacid Anti-Gas Max Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains butylparaben, propylparaben, sorbitol; lemon flavor]

Antacid Extra Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains saccharin]

Antacid Fast Relief: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains parabens, saccharin]

Antacid I: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (360 mL)

Antacid III: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (360 mL)

Antacid Plus Anti-Gas Relief: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL [DSC]) [contains butylparaben, propylparaben]

Antacid Regular Strength: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains alcohol, usp, methylparaben, propylene glycol, propylparaben, saccharin sodium]

Antacid Regular Strength: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (30 mL) [contains parabens, saccharin]

Antacid/Anti-Gas: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL [DSC]) [contains alcohol, usp, benzyl alcohol, butylparaben, propylparaben, saccharin sodium]

Antacid/Antigas: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains butylparaben, propylparaben, saccharin sodium; cool mint flavor]

FT Antacid & Antigas: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL); Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains alcohol, usp, benzyl alcohol, butylparaben, propylparaben, saccharin sodium]

FT Antacid & Antigas: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL); Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains benzyl alcohol, butylparaben, propylparaben, saccharin sodium]

Geri-Lanta: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains benzyl alcohol, butylparaben, propylparaben, saccharin sodium]

Geri-Lanta Maximum Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains alcohol, usp, benzyl alcohol, butylparaben, propylparaben, saccharin sodium; lemon flavor]

Geri-Mox: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (769 mL [DSC]) [contains benzyl alcohol, butylparaben, propylparaben, saccharin sodium]

Geri-Mox: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains benzyl alcohol, butylparaben, propylparaben, saccharin sodium; mint flavor]

GoodSense Advanced Antacid: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains benzyl alcohol, butylparaben, propylparaben, saccharin sodium; cool mint flavor]

GoodSense Antacid & Gas Relief: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains alcohol, usp, benzyl alcohol, butylparaben, propylparaben, saccharin sodium; original flavor]

GoodSense Antacid & Gas Relief: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL) [contains alcohol, usp, butylparaben, propylparaben, saccharin sodium; original flavor]

GoodSense Antacid & Gas Relief: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains butylparaben, propylparaben, saccharin sodium; cherry flavor]

HyVee Advanced Antacid: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [gluten free; contains butylparaben, propylene glycol, propylparaben, saccharin sodium; cherry flavor]

Maalox Max: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains propylparaben, quinoline yellow (d&c yellow #10), saccharin sodium; lemon flavor]

Maalox Max: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains propylparaben, saccharin sodium; cherry flavor]

Maalox Max: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains propylparaben, saccharin sodium; wild berry flavor]

Maalox Multi Symptom Max St: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (769 mL) [contains butylparaben, propylene glycol, propylparaben, saccharin sodium; wild berry flavor]

Mi-Acid: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC]) [contains butylparaben, propylparaben, saccharin sodium]

Mi-Acid: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC]) [gluten free; contains alcohol, usp, butylparaben, propylparaben]

Mi-Acid Maximum Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL [DSC]) [gluten free; contains butylparaben, propylparaben]

Milantex: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC])

Milantex Extra Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL [DSC])

Mintox Maximum Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [contains butylparaben, propylparaben, quinoline yellow (d&c yellow #10), saccharin sodium]

Mintox Regular Strength: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (355 mL [DSC]) [contains butylparaben, propylparaben, saccharin sodium]

Mylanta Maximum Strength: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL) [paraben free; vanilla caramel flavor]

Generic: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 20 mg per 5 mL (30 mL); Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (30 mL)

Tablet Chewable, Oral:

Gelusil: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 25 mg

Mintox Plus: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, and simethicone 25 mg [lemon-mint flavor]

Generic Equivalent Available: US

May be product dependent

Pricing: US

Chewable (Gelusil Oral)

200-200-25 mg (per each): $0.04

Chewable (Mintox Plus Oral)

200-200-25 mg (per each): $0.05

Suspension (Almacone Double Strength Oral)

400-400-40 mg/5 mL (per mL): $0.01

Suspension (Maalox Max Oral)

400-400-40 mg/5 mL (per mL): $0.02

Suspension (Maalox Multi Symptom Max St Oral)

400-400-40 mg/5 mL (per mL): $0.01

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Administer 1 hour after meals or between meals.

Suspension: Shake well prior to use.

Administration: Pediatric

Oral: Administer between meals or at bedtime.

Suspension: Shake well prior to use.

Use: Labeled Indications

Antacid/antigas: Relief of acid indigestion, heartburn, sour stomach, or upset stomach and gas associated with these symptoms

Medication Safety Issues

Sound-alike/look-alike issues:

Maalox may be confused with Maox, Monodox

Maalox may be confused with other Maalox products (eg, calcium carbonate)

Mylanta may be confused with Mynatal

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acalabrutinib: Antacids may decrease the serum concentration of Acalabrutinib. Management: Separate administration of acalabrutinib capsules from the administration of any antacid by at least 2 hours in order to minimize the potential for a significant interaction. Acalabrutinib tablets are not expected to interact with antacids. Risk D: Consider therapy modification

Alfacalcidol: May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving alfacalcidol. If magnesium-containing products must be used with alfacalcidol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Allopurinol: Aluminum Hydroxide may decrease the serum concentration of Allopurinol. Management: Consider administering allopurinol 3 hours prior to aluminum hydroxide. Risk D: Consider therapy modification

Alpha-Lipoic Acid: Magnesium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Magnesium Salts. Management: Separate administration of alpha-lipoic acid from that of any magnesium-containing compounds by several hours. If alpha-lipoic acid is given 30 minutes before breakfast, then administer oral magnesium-containing products at lunch or dinner. Risk D: Consider therapy modification

Antipsychotic Agents (Phenothiazines): Antacids may decrease the absorption of Antipsychotic Agents (Phenothiazines). Risk C: Monitor therapy

Ascorbic Acid: May increase the absorption of Aluminum Hydroxide. Management: In patients with severe renal dysfunction, consider avoiding this combination. Administering agents at least 2 hours apart may help minimize effects. Monitor for toxic effects of aluminum (from antacid) if ascorbic acid is coadministered. Risk D: Consider therapy modification

Atazanavir: Antacids may decrease the absorption of Atazanavir. Management: Administer antacids 1 to 2 hours before or 2 hours after atazanavir to minimize the risk of a clinically significant interaction. Risk D: Consider therapy modification

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination

Belumosudil: Antacids may decrease the serum concentration of Belumosudil. Management: Consider separating administration of belumosudil and antacids by 2 hours and monitor for reduced belumosudil efficacy. Risk D: Consider therapy modification

Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Risk D: Consider therapy modification

Bisacodyl: Antacids may diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Management: Antacids should not be used within 1 hour before bisacodyl administration. Risk D: Consider therapy modification

Bismuth Subcitrate: Antacids may diminish the therapeutic effect of Bismuth Subcitrate. Management: Avoid administration of antacids within 30 minutes of bismuth subcitrate (tripotassium bismuth dicitrate) administration. Risk D: Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider therapy modification

Bosutinib: Antacids may decrease the serum concentration of Bosutinib. Management: Administer antacids more than 2 hours before or after bosutinib. Risk D: Consider therapy modification

Bromperidol: Antacids may decrease the absorption of Bromperidol. Risk C: Monitor therapy

Cabotegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider therapy modification

Calcitriol (Systemic): May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving calcitriol. If magnesium-containing products must be used with calcitriol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Calcium Polystyrene Sulfonate: Laxatives (Magnesium Containing) may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. More specifically, concomitant use of calcium polystyrene sulfonate with magnesium-containing laxatives may result in metabolic alkalosis or with sorbitol may result in intestinal necrosis. Management: Avoid concomitant use of calcium polystyrene sulfonate (rectal or oral) and magnesium-containing laxatives. Risk X: Avoid combination

Captopril: Antacids may decrease the serum concentration of Captopril. Risk C: Monitor therapy

Cefdinir: Antacids may decrease the absorption of Cefdinir. Management: Administer cefdinir 2 hours before or 2 hours after aluminum- or magnesium-containing antacids. Risk D: Consider therapy modification

Cefditoren: Antacids may decrease the serum concentration of Cefditoren. Risk X: Avoid combination

Cefpodoxime: Antacids may decrease the serum concentration of Cefpodoxime. Risk C: Monitor therapy

Cefuroxime: Antacids may decrease the serum concentration of Cefuroxime. Management: Administer cefuroxime axetil at least 1 hour before or 2 hours after the administration of short-acting antacids. Risk D: Consider therapy modification

Chenodiol: Aluminum Hydroxide may decrease the serum concentration of Chenodiol. Risk C: Monitor therapy

Chloroquine: Antacids may decrease the serum concentration of Chloroquine. Management: Separate the administration of antacids and chloroquine by at least 4 hours to minimize any potential negative impact of antacids on chloroquine bioavailability. Risk D: Consider therapy modification

Cholic Acid: Aluminum Hydroxide may decrease the absorption of Cholic Acid. Management: Administer cholic acid at least 1 hour before or 4 to 6 hours after administration of any aluminum hydroxide-containing products to minimize the potential for a significant interaction. Risk D: Consider therapy modification

Citric Acid Derivatives: May increase the absorption of Aluminum Hydroxide. Risk C: Monitor therapy

Corticosteroids (Oral): Antacids may decrease the bioavailability of Corticosteroids (Oral). Management: Consider separating doses by 2 or more hours. Budesonide enteric coated tablets could dissolve prematurely if given with drugs that lower gastric acid, with unknown impact on budesonide therapeutic effects. Risk D: Consider therapy modification

Cysteamine (Systemic): Antacids may diminish the therapeutic effect of Cysteamine (Systemic). Risk C: Monitor therapy

Dabigatran Etexilate: Antacids may decrease the serum concentration of Dabigatran Etexilate. Management: Dabigatran etexilate Canadian product labeling recommends avoiding concomitant use with antacids for 24 hours after surgery. In other situations, administer dabigatran etexilate 2 hours prior to antacids. Monitor clinical response to dabigatran therapy. Risk D: Consider therapy modification

Dasatinib: Antacids may decrease the serum concentration of Dasatinib. Management: Simultaneous administration of dasatinib and antacids should be avoided. Administer antacids 2 hours before or 2 hours after dasatinib. Risk D: Consider therapy modification

Deferasirox: Aluminum Hydroxide may diminish the therapeutic effect of Deferasirox. Risk X: Avoid combination

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification

Delavirdine: Antacids may decrease the serum concentration of Delavirdine. Management: Separate doses of delavirdine and antacids by at least 1 hour. Monitor for decreased delavirdine therapeutic effects with this combination. Risk D: Consider therapy modification

Diacerein: Antacids may decrease the absorption of Diacerein. Risk C: Monitor therapy

Dichlorphenamide: Laxatives may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dolutegravir: Aluminum Hydroxide may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral aluminum hydroxide. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral aluminum hydroxide. Risk D: Consider therapy modification

Doxercalciferol: May enhance the hypermagnesemic effect of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If magnesium-containing products must be used with doxercalciferol, serum magnesium concentrations should be monitored closely. Risk D: Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification

Elvitegravir: Antacids may decrease the serum concentration of Elvitegravir. Management: Separate administration of aluminum and magnesium containing antacids and elvitegravir-containing products by at least 2 hours in order to minimize the risk for an interaction. Risk D: Consider therapy modification

Erdafitinib: Serum Phosphate Level-Altering Agents may diminish the therapeutic effect of Erdafitinib. Management: Avoid coadministration of serum phosphate level-altering agents with erdafitinib before initial dose increase period based on serum phosphate levels (Days 14 to 21). Risk D: Consider therapy modification

Erlotinib: Antacids may decrease the serum concentration of Erlotinib. Management: Separate the administration of erlotinib and any antacid by several hours in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification

Ethambutol: Aluminum Hydroxide may decrease the serum concentration of Ethambutol. Management: Avoid concurrent administration of ethambutol and aluminum hydroxide. If coadministration cannot be avoided administer ethambutol first and then wait at least 4 hours before administering aluminum hydroxide-containing products. Risk D: Consider therapy modification

Fexofenadine: Antacids may decrease the serum concentration of Fexofenadine. Management: Separate the administration of fexofenadine and aluminum- or magnesium-containing antacids. Risk D: Consider therapy modification

Fosinopril: Antacids may decrease the serum concentration of Fosinopril. Management: The US and Canadian fosinopril manufacturer labels recommend separating the doses of antacids and fosinopril by 2 hours. Risk D: Consider therapy modification

Gabapentin: Aluminum Hydroxide may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after administration of antacids containing aluminum hydroxide or magnesium hydroxide. Risk D: Consider therapy modification

Gefitinib: Antacids may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or 6 hours after administration of an antacid, and closely monitor clinical response to gefitinib. Risk D: Consider therapy modification

Hyoscyamine: Antacids may decrease the serum concentration of Hyoscyamine. Management: Administer immediate release and sublingual oral hyoscyamine before meals, and antacids after meals, when these agents are given in combination. Risk D: Consider therapy modification

Infigratinib: Antacids may decrease serum concentrations of the active metabolite(s) of Infigratinib. Antacids may decrease the serum concentration of Infigratinib. Management: Avoid coadministration of infigratinib with antacids or other gastric acid-lowering agents. If antacids cannot be avoided, administer infigratinib 2 hours before or after administration of antacids. Risk D: Consider therapy modification

Iron Preparations: Antacids may decrease the absorption of Iron Preparations. Management: No action is likely necessary for the majority of patients who only use antacids intermittently or occasionally. Consider separating doses of oral iron and antacids in patients who require chronic use of both agents and monitor for reduced iron efficacy. Risk D: Consider therapy modification

Isoniazid: Antacids may decrease the absorption of Isoniazid. Risk C: Monitor therapy

Itraconazole: Antacids may decrease the serum concentration of Itraconazole. Antacids may increase the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any antacids. Exposure to Tolsura brand itraconazole may be increased by antacids; consider itraconazole dose reduction. Risk D: Consider therapy modification

Ketoconazole (Systemic): Antacids may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer antacids at least 1 hour prior to, or 2 hours after, ketoconazole. Additionally, administer ketoconazole with an acidic beverage (eg, non-diet cola) and monitor patients closely for signs of inadequate clinical response to ketoconazole. Risk D: Consider therapy modification

Lanthanum: Antacids may diminish the therapeutic effect of Lanthanum. Management: Administer antacid products at least 2 hours before or after lanthanum. Risk D: Consider therapy modification

Ledipasvir: Antacids may decrease the serum concentration of Ledipasvir. Management: Separate the administration of ledipasvir and antacids by 4 hours. Risk D: Consider therapy modification

Levoketoconazole: Antacids may decrease the absorption of Levoketoconazole. Management: Advise patients to take antacids at least 2 hours after taking levoketoconazole. Risk D: Consider therapy modification

Levonadifloxacin: Magnesium Salts may decrease the serum concentration of Levonadifloxacin. Risk X: Avoid combination

Levonadifloxacin: Antacids may decrease the serum concentration of Levonadifloxacin. Risk X: Avoid combination

Levothyroxine: Magnesium Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral magnesium salts by at least 4 hours. Risk D: Consider therapy modification

Mequitazine: Aluminum Hydroxide may decrease the absorption of Mequitazine. Management: Administer mequitazine at least 2 hours before or 2 hours after administration of any aluminum hydroxide-containing products to minimize the potential for a significant interaction. Risk D: Consider therapy modification

Mesalamine: Antacids may diminish the therapeutic effect of Mesalamine. Antacid-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Avoid concurrent administration of antacids with the Apriso brand of mesalamine extended-release capsules. The optimal duration of dose separation is unknown. Other mesalamine products do not contain this interaction warning. Risk D: Consider therapy modification

Methenamine: Antacids may diminish the therapeutic effect of Methenamine. Management: Consider avoiding the concomitant use of medications that alkalinize the urine, such as antacids, and methenamine. Monitor for decreased therapeutic effects of methenamine if used concomitant with antacids. Risk D: Consider therapy modification

MiSOPROStol: Antacids may enhance the adverse/toxic effect of MiSOPROStol. More specifically, concomitant use with magnesium-containing antacids may increase the risk of diarrhea. Management: Avoid concomitant use of misoprostol and magnesium-containing antacids. In patients requiring antacid therapy, employ magnesium-free preparations. Monitor for increased adverse effects (e.g., diarrhea, dehydration). Risk X: Avoid combination

Moxifloxacin (Systemic): Aluminum Hydroxide may decrease the absorption of Moxifloxacin (Systemic). Management: Administer moxifloxacin at least 4 hours before or 8 hours after aluminum hydroxide. Risk D: Consider therapy modification

Multivitamins/Fluoride (with ADE): May increase the serum concentration of Aluminum Hydroxide. Aluminum Hydroxide may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, aluminum hydroxide may impair fluoride absorption. Management: Avoid administration of aluminum hydroxide within at least 1-2 hours of fluoride administration. In patients with severe renal dysfunction, consider avoiding this combination altogether. Risk D: Consider therapy modification

Multivitamins/Minerals (with ADEK, Folate, Iron): May increase the serum concentration of Aluminum Hydroxide. Management: In patients with severe renal dysfunction, consider avoiding this combination of agents. Administering agents at least 2 hours apart may help minimize the interaction(s). If combined, monitor for toxic effects of aluminum. Risk D: Consider therapy modification

Multivitamins/Minerals (with AE, No Iron): May increase the serum concentration of Aluminum Hydroxide. Specifically, vitamin C may enhance aluminum absorption. Management: In patients with severe renal dysfunction, consider avoiding this combination of agents. Administering agents at least 2 hours apart may help minimize the interaction(s). If coadministered, monitor for toxic effects of aluminum. Risk D: Consider therapy modification

Mycophenolate: Magnesium Hydroxide may decrease the serum concentration of Mycophenolate. Management: Simultaneous administration of magnesium hydroxide antacids with the Myfortic brand of mycophenolic acid is specifically not recommended. Administer magnesium hydroxide at least 2 hours after a dose of the Cellcept brand of mycophenolate mofetil. Risk D: Consider therapy modification

Mycophenolate: Aluminum Hydroxide may decrease the serum concentration of Mycophenolate. Management: Simultaneous administration of aluminum hydroxide antacids with the Myfortic brand of mycophenolic acid is not recommended. Administrater aluminum hydroxide at least 2 hours after a dose of the Cellcept brand of mycophenolate mofetil. Risk D: Consider therapy modification

Neratinib: Antacids may decrease the serum concentration of Neratinib. Specifically, antacids may reduce neratinib absorption. Management: Separate the administration of neratinib and antacids by giving neratinib at least 3 hours after the antacid. Risk D: Consider therapy modification

Neuromuscular-Blocking Agents: Magnesium Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy

Nilotinib: Antacids may decrease the serum concentration of Nilotinib. Management: Separate the administration of nilotinib and any antacid by at least 2 hours whenever possible in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification

Nirogacestat: Antacids may decrease the serum concentration of Nirogacestat. Management: If acid-reducing therapy is required, separate nirogacestat administration from antacids by 2 hours. Risk D: Consider therapy modification

Octreotide: Antacids may decrease the serum concentration of Octreotide. Risk C: Monitor therapy

PAZOPanib: Antacids may decrease the serum concentration of PAZOPanib. Management: Avoid the use of antacids in combination with pazopanib whenever possible. Separate doses by several hours if antacid treatment is considered necessary. The impact of dose separation has not been investigated. Risk D: Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification

Pexidartinib: Antacids may decrease the serum concentration of Pexidartinib. Management: Administer pexidartinib at least 2 hours before or 2 hours after antacids. Risk D: Consider therapy modification

Phosphate Supplements: Antacids may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate administration. Separating administration of oral phosphate supplements from antacid administration by as long as possible may minimize the interaction. Risk D: Consider therapy modification

Phosphate Supplements: Magnesium Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral magnesium salt as possible to minimize the significance of this interaction. Risk D: Consider therapy modification

Potassium Phosphate: Antacids may decrease the serum concentration of Potassium Phosphate. Management: Consider separating administration of antacids and oral potassium phosphate by at least 2 hours to decrease risk of a significant interaction. Risk D: Consider therapy modification

QuiNINE: Antacids may decrease the serum concentration of QuiNINE. Risk X: Avoid combination

Quinolones: Antacids may decrease the absorption of Quinolones. Of concern only with oral administration of quinolones. Management: Avoid concurrent administration of quinolones and antacids to minimize the impact of this interaction. Recommendations for optimal dose separation vary by specific quinolone; see full monograph for details. Risk D: Consider therapy modification

Quinolones: Magnesium Salts may decrease the serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar/enox-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe/enox-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral magnesium salts. Risk D: Consider therapy modification

Raltegravir: Aluminum Hydroxide may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral aluminum hydroxide with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Risk X: Avoid combination

Rilpivirine: Antacids may decrease the serum concentration of Rilpivirine. Management: Administer antacids at least 2 hours before or 4 hours after oral rilpivirine when used with most rilpivirine products. However, administer antacids at least 6 hours before or 4 hours after the rilpivirine/dolutegravir combination product. Risk D: Consider therapy modification

Riociguat: Antacids may decrease the serum concentration of Riociguat. Management: Separate the administration of antacids and riociguat by at least 1 hour in order to minimize any potential interaction. Monitor clinical response to riociguat more closely in patients using this combination. Risk D: Consider therapy modification

Rosuvastatin: Antacids may decrease the serum concentration of Rosuvastatin. Risk C: Monitor therapy

Roxadustat: Polyvalent Cation Containing Products may decrease the serum concentration of Roxadustat. Management: Administer roxadustat at least 1 hour after the administration of oral polyvalent cation containing products. Risk D: Consider therapy modification

Selpercatinib: Antacids may decrease the serum concentration of Selpercatinib. Management: Coadministration of selpercatinib and antacids should be avoided. If coadministration cannot be avoided, selpercatinib should be administered 2 hours before or 2 hours after antacids. Risk D: Consider therapy modification

Sodium Polystyrene Sulfonate: Laxatives (Magnesium Containing) may enhance the adverse/toxic effect of Sodium Polystyrene Sulfonate. More specifically, concomitant use of sodium polystyrene sulfonate with magnesium-containing laxatives may result in metabolic alkalosis or with sorbitol may result in intestinal necrosis. Management: Avoid concomitant use of sodium polystyrene sulfonate (rectal or oral) and magnesium-containing laxatives. Risk X: Avoid combination

Sotalol: Antacids may decrease the serum concentration of Sotalol. Management: Avoid simultaneous administration of sotalol and antacids. Administer antacids 2 hours after sotalol. Risk D: Consider therapy modification

Sotorasib: Antacids may decrease the serum concentration of Sotorasib. Management: Avoid coadministration of sotorasib and antacids. If use of a gastric acid suppressing medication cannot be avoided, administer sotorasib 4 hours before or 10 hours after oral antacid administration. Risk D: Consider therapy modification

Sparsentan: Antacids may decrease the serum concentration of Sparsentan. Management: Administer sparsentan 2 hours before or 2 hours after antacids. Risk D: Consider therapy modification

Strontium Ranelate: Aluminum Hydroxide may decrease the serum concentration of Strontium Ranelate. Management: Separate administration of strontium ranelate and aluminum hydroxide by at least 2 hours when possible, in order to minimize this interaction. Risk D: Consider therapy modification

Strontium Ranelate: Magnesium Hydroxide may decrease the serum concentration of Strontium Ranelate. Management: Separate administration of strontium ranelate and magnesium hydroxide by at least 2 hours when possible, in order to minimize this interaction. Risk D: Consider therapy modification

Sucralfate: Antacids may diminish the therapeutic effect of Sucralfate. Management: Consider separating the administration of antacids and sucralfate by at least 30 minutes. Risk D: Consider therapy modification

Sulpiride: Antacids may decrease the serum concentration of Sulpiride. Management: Separate administration of antacids and sulpiride by at least 2 hours in order to minimize the impact of antacids on sulpiride absorption. Risk D: Consider therapy modification

Tacrolimus (Systemic): Aluminum Hydroxide may decrease the serum concentration of Tacrolimus (Systemic). Particularly, maximum concentration may decrease. Aluminum Hydroxide may increase the serum concentration of Tacrolimus (Systemic). Risk C: Monitor therapy

Tacrolimus (Systemic): Magnesium Hydroxide may increase the serum concentration of Tacrolimus (Systemic). Magnesium Hydroxide may decrease the serum concentration of Tacrolimus (Systemic). Specifically, maximum concentration may decrease. Risk C: Monitor therapy

Taurursodiol: Aluminum Hydroxide may decrease the absorption of Taurursodiol. Risk X: Avoid combination

Tetracyclines: Antacids may decrease the absorption of Tetracyclines. Management: Separate administration of antacids and oral tetracycline derivatives by several hours when possible to minimize the extent of this potential interaction. Monitor for decreased therapeutic effects of tetracyclines. Risk D: Consider therapy modification

Tetracyclines: Magnesium Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral magnesium salts and oral tetracyclines. If coadministration cannot be avoided, administer oral magnesium at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Risk D: Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant use of trientine and polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. For other oral polyvalent cations, give trientine 1 hour before, or 1 to 2 hours after the polyvalent cation. Risk D: Consider therapy modification

Unithiol: May diminish the therapeutic effect of Polyvalent Cation Containing Products. Risk X: Avoid combination

Ursodiol: Aluminum Hydroxide may decrease the serum concentration of Ursodiol. Management: Separate administration of ursodiol and aluminum-containing antacid products to prevent adsorption in the gastrointestinal tract. Risk D: Consider therapy modification

Velpatasvir: Antacids may decrease the serum concentration of Velpatasvir. Management: Separate administration of velpatasvir and antacids by at least 4 hours. Risk D: Consider therapy modification

Vitamin D Analogs: May increase the serum concentration of Aluminum Hydroxide. Specifically, the absorption of aluminum may be increased, leading to increased serum aluminum concentrations. Management: Consider avoiding chronic use of aluminum and aluminum-containing products in patients who are also taking active vitamin D analogs. If coadministered, monitor aluminum status and for signs and symptoms of aluminum-related toxicities. Risk D: Consider therapy modification

Pregnancy Considerations

Refer to individual monographs.

Breastfeeding Considerations

Refer to individual monographs.

Dietary Considerations

Almacone Double Strength suspension contains magnesium 165 mg and sodium 1 mg per 5 mL.

Alamag Plus contains phenylalanine 2.6 mg and magnesium 83 mg per tablet

Gelusil contains magnesium 85 mg per tablet.

Maalox Advanced Maximum Strength suspension contains magnesium 145 mg and sodium 5 mg per 5 mL.

Mi-Acid suspension contains magnesium 85 mg and sodium 1 mg per 5 mL.

Mintox Plus contains magnesium 83.4 mg per tablet.

Rulox suspension contains magnesium 85 mg per 5 mL.

Mechanism of Action

Aluminum hydroxide and magnesium hydroxide are antacids; simethicone is used to relieve symptoms of gas

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Actonorm | Carelox plus | Maalox plus | Moxal plus | Mylanta ii | Neogastro plus | Simeco;
(AR) Argentina: Aludrox | Aludrox ii | Faboacid | Factor ag antiacido | Gastroge | Mucalan a-g | Mylanta ii | Mylanta max | Mylanta plus | Pepsamar duo | Simecon antiacido | Simecon antiacido bebile | Suspension antiacida c/simeticona df;
(AU) Australia: Mylanta | Mylanta original;
(BD) Bangladesh: Antanil-plus | Avlocid | Biocid plus | Entacyd plus | Flatameal | Gastrona | Magadrox plus | Neutral s | Peptacid | Pharmacid-plus | Seemacid plus;
(BE) Belgium: Mylanta;
(BF) Burkina Faso: Gestid;
(BG) Bulgaria: Almalox;
(BR) Brazil: Alca luftal | Alcalone plus | Digeflex | Gastran | Gastrival composto | Gastrobem | Gastrobion | Gastrogel | Gastrogel fresh | Gastrol tc | Gelmax dim | Geltrat | Kolantyl dmp | Maalox | Magnazia | Mylanta plus | Pepsogel | Prodigest | Simeco plus | Stomaliv;
(CI) Côte d'Ivoire: Gastrigel | Polygel | Viscid;
(CL) Chile: Ditopax | Gasopax | Maalox plus | Mylanta | Simeco plus;
(CO) Colombia: Aced full | Acilax | Anforal | Antiacido | Calymag | Digel | Ditopax | Galac | Gastrigel | Gastritan | Gastrobutina | Gastrolife | Gastrosal | Gel ii mk | Hidropep | Hidrosin | Hidroxido de aluminio + hidroxido de magnesio + simeticona | Hidroxido de aluminio + magnesio + simeticona | Maalox plus | Magnelum compuesto | Magnemox | Metromag | Metromag ii | Mk doss | Multigel | Mylanta | Mylanta ct | Mylanta dos | Mylanta ii | Neutracid | Neutrogel | Pepsamar plus | Re hidroflux | Reflugax | Simetil | Sinacid | Vongel d.t.;
(DE) Germany: Paractol;
(DO) Dominican Republic: Acifar | Antalox | Carbomag | Cymagel | Digel | Diomal | Diomal plus | Ditopax | Fenacid | Gelnacid sm | Maalox plus | Mylanta | Troxin;
(EC) Ecuador: Alukron | Flatlive | Mylanta;
(EG) Egypt: Acidipan | Alucon | Alumatrend | Loburna;
(ES) Spain: Gelosim;
(ET) Ethiopia: Aluminium hydroxide/magnesium hydroxide/simethicone | Corasil | Peptica | Viscid;
(FI) Finland: Mylanta;
(GB) United Kingdom: Maalox plus | Mylanta | Novasil plus;
(GR) Greece: Maalox plus | Simeco;
(HK) Hong Kong: Alumag-s | Antad | Axcel eviline forte | Bf Maschew | Bio Gastal | Dimegel | Diovol Forte | Diovol plus | Eurogel | Eviline | Gelusil plus | Hydrosil | Lantacid | M A S | Maalox plus | Magal | Mylanta | Mylanta rs | S M A | Siloxogene | Simeco | Sinwell | Sma | Triloxane V | U Lanta | Vickmans Mas | Vida Meco | Walotab S | Welmagel | Zigatab;
(ID) Indonesia: Acitral | Aludonna d | Andrew actal plus | Anflat | Berlosid | Bufantacid | Carsida | Dexanta | Di-gel | Farmacrol forte | Formag | Gelusil mps | Gestabil | Gestamag | Hufamag plus | Indomag | Lagesil | Lambucid | Lexacrol | Maalox plus | Madrox | Magnidicon | Magtral | Mylacid | Mylanta | Neosanmag | Novamag | Plantacid | Polyanta | Polycrol | Riomag | Samtacid | Simeco | Tomaag | Trianta | Trofax | Ulcid | Ultilox;
(IE) Ireland: Maalox plus;
(IL) Israel: Maalox plus;
(IN) India: Acidin mps | Acigel | Aciguard | Acinil | Almagel | Alucinol | Aluprogel | Anacid | Antacid | Antagit ds | Camagel mps | Capcid | Cardiocid | Centacid | Coolpep mps | Dab | Digiflux | Digusil mps | Diovol Forte | Disilox mps | Entasid MPS | Exocid | Gasmag | Gastromax | Gelona | Gelusil plus | Intacid mps | Klarcid | Lenocarb | Litacid | Logascid | Mac mps | Methicocid | Nucid | Nutracid | Peptica | Polycid | Polycrol Xpress Relief | Rabemac mps | Riogel s | Savocid | Siloxogene | Simeco | Ud alusil | Viscid | Zocid;
(IQ) Iraq: Acilox plus | Gasteredain plus | Gelocid plus;
(IT) Italy: Maalox plus;
(JO) Jordan: Maalox plus | Moxal plus | Novagel plus;
(KE) Kenya: Antagit ds | Beta cool | Centacid | Flatameal ds | Maalox plus | Nilacid | Pepgel | Peptica | Peptigo | Polycid plus | Siam | Siloxogene | Viscid;
(KR) Korea, Republic of: Geron-g | Green-g | Jowigel | Maalox s | Mylanta | Mylanta ii | Rogel | Simeco | Varogel | Varomagel | Yudigel 2;
(KW) Kuwait: Carelox plus | Maalox plus | Medacid Plus | Moxal plus;
(LB) Lebanon: Actonorm | Diovol plus | Maalox plus;
(LT) Lithuania: Almagel neo | Manti | Protab;
(LU) Luxembourg: Mylanta;
(LV) Latvia: Almagel neo | Maalox plus | Protab;
(MX) Mexico: Alka-gel complex | Alkagel complex | Ditopax | Espagel compuesto | Melbin | Mylanll | Neutraforte | Neutralin comp | Noax 3;
(MY) Malaysia: Almaxane | Almecon | Belcid forte | Dyna u | Eviline | Gastotac | Gastrorelief | Gelusil forte | Gelusil plus | Gestid | Hydrosil | Maalox plus | Mylanta | Mylanta ii | Povil | Zellox II;
(NG) Nigeria: Alumina, magnesium & simethicone | Antabon | Belcid | Esilox | Gestid | Locid | Maalox plus | Neogastro plus | Pepsid | Riwod | Rulox plus;
(NZ) New Zealand: Mylanta | Mylanta 11 | Mylanta heartburn relief | Mylanta p;
(PE) Peru: Acidor | Acidor extra rapid | Andrews sabor a menta | Calmacid | Hidrox. alum. + hidrox. mage. + simeti. | Hidrox. alum. + Hidrox. magne. + Simeti. | Maalox plus | Moxal plus | Mylanta ct | Mylanta dos | Mylanta ii | Neutracid | Peptinal | Phillips;
(PH) Philippines: Alsium | Kremil s | Kremil S Extra Str | Maalox plus | Monnax | Mylanta | Mylanta rolltabs;
(PK) Pakistan: Alkagex | Almagel | Alucid mp | Alucone | Amgecon | Anacid | Antasil | Deacid | Demox | Dijex mp | Dijex mp mf | Filmacid | Gelusil plus | Geocone | Hosgel | Kemycone | Lecid | Lemagel | Lifcid | Magnicon | Manacid | Mylanta | Polycrol | Polysim plus | Rejex mp | Semosil | Siam | Sigel | Silocrol | Simeco | Simecrol | Stargel | Trisil plus;
(PL) Poland: Manti;
(PR) Puerto Rico: Antacid I | Gelusil | Maalox | Maalox multi symptom | Maalox plus | Maglox | Mylanta | Mylanta childrens | Simaal | Stratuscare antacid & antigas;
(PT) Portugal: Maalox plus;
(PY) Paraguay: Antiacid | Banflax antiacido | Emetan antiacido | Factor ag antiacido | Maalox plus | Mylanta | Salcedol;
(QA) Qatar: Actonorm Gel | Maalox Plus | Medacid Plus;
(RU) Russian Federation: Almagel neo | Almolox "york" | Alprogel | Nasigel cherry | Protab;
(SA) Saudi Arabia: Medacid Plus | Moxal plus | Mylanta ii | Novagel plus | Rialox plus;
(SG) Singapore: Allumag MPS | Eviline | Gelusil | Hydrosil | Zellox II;
(SL) Sierra Leone: Antacid | Bgacid | Ezycid | Magacol | Miracid | Roxacid;
(TH) Thailand: Admag | Almaxane | Alugas | Alutop | Amico-l | Amogin Otc | Antacia-sm | Antacil | Belcid | Bowa | Brygel-s | Burajel | Cophargel | Deacid plus | Diovol Forte | Droxyl | Estacid | Gasitone | Gaspec S | Gastrona | Gasxid | Gelusil mps | Herogel | Kenya | L-dacin | Maalox plus | Maccrol | Macsil | Mag 77 | Magnum | Magsenum d | Manosimet | Mar | Mylanta ii | Newgel DS | Silomed | Simagel | Simcomag | Stomac | Stomox | T.o.gel | Ulcegel | Ulco | V day milk | Welin | Ziga;
(TR) Turkey: Alujel | Asidal | Simeco;
(TW) Taiwan: A.m.d. | Ams | Antagel | Antagel ii | Gastracin | Gelgel | Hosgel | Lederscon | Macgel | Mylanta | Mylanta ii | Simelium | Sinwell | Ulwycon | Wecon | Weicon;
(UA) Ukraine: Almagel neo | Manti;
(UG) Uganda: Antagit ds | Axcel eviline forte | Centacid | Maalox | Minto | Moxal plus;
(UY) Uruguay: Maalox plus | Mylanta plus | Pepsamar duo | Simeco plus;
(VE) Venezuela, Bolivarian Republic of: Acifar | Ditosil | Flati cona | Maaloxil | Magnum | Mylanta | Mylantados | Mylantamil | Valmecon;
(VN) Viet Nam: Almasane | Extra strength antigas | Hamigel s | Mylenfa | Phagelpagel;
(ZA) South Africa: Gelusil s | Lo-acid | Maalox plus;
(ZM) Zambia: Antagit ds | Digusil mps | Lo-acid | Nutrigel | Peptica | Polygel | Zellox II;
(ZW) Zimbabwe: Neutragel

"Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics (AAP) Committee on Drugs. Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
Gelusil (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Sarasota, FL: WellSpring; December 2021.
Lightdale JR, Gremse DA; Section on Gastroenterology, Hepatology, and Nutrition. Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics. 2013;131(5):e1684-1695. doi:10.1542/peds.2013-0421 [PubMed 23629618]
Mag-AL Plus (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Greenville, SC: Pharmaceutical Associates Inc; received April 2019.
Mag-AL Plus (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Greenville, SC: Pharmaceutical Associates Inc; January 2022.
Mi-Acid Maximum Strength (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Livonia, MI: Major Pharmaceuticals; April 2018.
Mi-Acid Regular Strength (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Livonia, MI: Major Pharmaceuticals; November 2018.
Mintox Plus Tabs (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Livonia, MI: Major Pharmaceuticals; December 2017.
Mylanta (aluminum hydroxide/magnesium hydroxide/simethicone) [prescribing information]. Westport, CT: Infirst Healthcare Inc; received February 2018.
Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2018;66(3):516-554. doi:10.1097/MPG.0000000000001889 [PubMed 29470322]
Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
Tsou VM, Young RM, Hart MH, Vanderhoof JA. Elevated plasma aluminum levels in normal infants receiving antacids containing aluminum. Pediatrics. 1991;87(2):148-151. [PubMed 1987526]
Woodard-Knight L, Fudge A, Teubner J, Simmer K. Aluminium absorption and antacid therapy in infancy. J Paediatr Child Health. 1992;28(3):257-259. [PubMed 1605980]
Zar T, Graeber C, Perazella MA. Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial. 2007;20(3):217-219. [PubMed 17555487]

Topic 8616 Version 388.0

خرید پکیج

Aluminum hydroxide, magnesium hydroxide, and simethicone: Drug information