Aluminium Hydroxide + Magnesium Hydroxide + Simethicon

Indications

Aluminium Hydroxide + Magnesium Hydroxide + Simethicon is used for: Dyspepsia, Flatulence

Adult Dose

Adult: Dyspepsia, Abdominal Bloating 10-20 mL PO q4-6hr taken 1 hour before or 3 hours after meals, OR Chew 2-4 tablets q4-6hr; not to exceed 12 tablets/24 hr PO Antacid Up to 1 g/day. Hyperphosphataemia in chronic renal failure Up to 10 g/day in divided doses w/ meals.

Child Dose

Renal Dose

Administration

Administration Should be taken on an empty stomach.

Contra Indications

Hypersensitivity to aluminium salts.

Precautions

Chronic renal impairment; CHF; oedema; cirrhosis and low Na diets; patients with recent GI haemorrhage. Administer 2-3 hrs before/after another medication to minimise drug interactions. Pregnancy and lactation. Lactation: excretion in milk unknown

Pregnancy-Lactation

Pregnancy Category: C Lactation: excretion in milk unknown

Interactions

Aluminium Hydroxide: Enhanced absorption with citrates or ascorbic acid. Decreases absorption of allopurinol, tetracyclines, quinolones, cephalosporins, biphosphonate derivatives, corticosteroids, cyclosporin, delavirdine, Fe salts, imidazole antifungals, isoniazid, mycophenolate, penicillamine, phosphate supplements, phenytoin, phenothiazines, trientine. Magnesium Hydroxide: Decreases absorption of tetracyclines and biphosphonates. Separate administration of these and other drugs by around 2 hr. Simethicon: None well documented.

Adverse Effects

Side effects of Aluminium Hydroxide + Magnesium Hydroxide + Simethicon : Aluminum hydroxide Chalky taste, Constipation, Fecal impaction, Stomach cramps, Nausea, Vomiting, Rebound hyperacidity, Aluminum intoxication, Hypophosphatemia, Milk-alkali syndrome, Osteomalacia Magnesium hydroxide Diarrhea, Hypermagnesemia Simethicone Loose stools

Mechanism of Action

Aluminum hydroxide: Neutralizes stomach hydrocloride to form AlCl3 salt plus water; increases gastric pH. Magnesium hydroxide: Promotes bowel evacuation by causing osmotic retention of fluid, which causes the colon to distend with increased peristaltic activity; forms magnesium chloride when reacts with hydrochloric acid. Simethicone: Disperses and prevents gas pockets in the GI system by decreasing surface tension of gas bubles.