Generic
Aluminium Hydroxide + Magnesium Hydroxide + Simethicone
43 brands available in the market
At a glance
Aluminium Hydroxide + Magnesium Hydroxide + Simethicone is a combination antacid and antiflatulent used to neutralize excess stomach acid and relieve flatulence. It is used for heartburn, indigestion, gastritis and peptic ulcer.
Description
Aluminium Hydroxide + Magnesium Hydroxide + Simethicone is a combination of non-systemic acid neutralizing substances and an antiflatulent. Aluminium Hydroxide and Magnesium Hydroxide relieve ulcer by neutralizing gastric acid secreted from parietal cells. Simethicone works by its antifoam properties, spreading on the surface of aqueous liquids, forming a film of low surface tension and causing collapse of foam bubbles. It allows gas bubbles in the GI tract to coalesce and be expelled. This combination rapidly relieves acid pain, disperses gastric foam and facilitates eructation of gas and air.
Indications
Hyperacidity, peptic ulcer, gastritis, peptic oesophagitis, heartburn, sour stomach, hiatus hernia, prevention of stress ulceration and GI bleeding, flatulence, dyspepsia, abdominal bloating, post-operative gas pain.
Therapeutic class
Antacid & Antiflatulent
Pharmacological class
Aluminium-Magnesium based Antacid + Simethicone
Pharmacology
Aluminium hydroxide neutralizes gastric hydrochloric acid to form aluminium chloride salt and water, increasing gastric pH. Magnesium hydroxide reacts with hydrochloric acid to form magnesium chloride and increases peristaltic activity to promote bowel evacuation. Simethicone disperses and prevents gas pockets in the GI system by decreasing the surface tension of gas bubbles.
Mechanism of action
Aluminium hydroxide and Magnesium hydroxide neutralize stomach acid to relieve pain and heartburn. Simethicone reduces the surface tension of gas bubbles to relieve flatulence and gas-related discomfort.
Dosage
Tablet: Chew 1-2 tablets 1-3 hours after meals and at bedtime, or as directed by the physician. (Max 12 tablets/24 hours)
Suspension: 10-20 mL (2-4 teaspoonfuls) 1 hour before or 3 hours after meals every 4-6 hours, or as directed by the physician.
Antacid (Hyperacidity/Heartburn): Up to 1 g/day.
Hyperphosphataemia in Chronic Renal Failure: Up to 10 g/day in divided doses with meals.
Administration
Should be taken on an empty stomach (1 hour before or 3 hours after meals).
Chew tablets thoroughly for rapid action.
Administer 2-3 hours before or after other medications to minimize drug interactions.
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Side effects
Aluminium Hydroxide side effects: Chalky taste, constipation, fecal impaction, stomach cramps, nausea, vomiting, rebound hyperacidity, aluminium intoxication (in chronic renal failure), hypophosphataemia, milk-alkali syndrome, osteomalacia.
Magnesium Hydroxide side effects: Diarrhea, hypermagnesaemia (in renal disease).
Simethicone side effects: Rarely, loose stools.
With long-term use: Alkaluria (may predispose to nephrolithiasis by forming calcium phosphate precipitation).
Precautions & warnings
- Caution in chronic renal impairment (risk of aluminium accumulation, encephalopathy, and osteomalacia)
- Caution in congestive heart failure, oedema, cirrhosis, and low sodium diets
- Caution in patients with recent gastrointestinal haemorrhage
- Maintain 2 hour gap with other medications (to avoid absorption interference)
- Avoid use in the first trimester of pregnancy
- Caution during lactation
Contraindications
- Renal failure
- Hypophosphataemia
- Severely debilitated patients
- Alkalosis
- Hypermagnesaemia (where abdominal distention may be due to partial or complete intestinal obstruction)
- Hypersensitivity to aluminium or magnesium salts
Drug interactions
- Aluminium Hydroxide: Enhanced absorption with citrates or ascorbic acid; decreases absorption of allopurinol, tetracyclines, quinolones, cephalosporins, bisphosphonates, corticosteroids, cyclosporine, delavirdine, iron salts, imidazole antifungals, isoniazid, mycophenolate, penicillamine, phosphate supplements, phenytoin, phenothiazines, trientine
- Magnesium Hydroxide: Decreases absorption of tetracyclines and bisphosphonates
- Antacids generally: Decrease bioavailability of theophylline, tetracycline, quinolone antibiotics, isoniazid, ketoconazole, ethambutol, antimuscarinic drugs, benzodiazepines, phenothiazines, ranitidine, indomethacin, nitrofurantoin, fluoride, phosphate, propranolol, atenolol, digoxin, vitamins; increase bioavailability of sulphonamides, levodopa, valproic acid, enteric-coated aspirin
Food interactions
Calcium-rich foods (e.g., milk) may increase aluminium absorption. Citrus fruits increase aluminium absorption.
Use in pregnancy
It is advised to avoid antacid preparations in the first trimester of pregnancy.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
There is insufficient information on the use of this combination during lactation. Use with caution.
Pediatric use
Use in children as directed by a physician.
Geriatric use
No dose adjustment needed for elderly patients; however, constipation and electrolyte imbalance risks are higher.
Renal / hepatic impairment
Renal impairment: Caution in chronic renal impairment (risk of aluminium accumulation, encephalopathy, and osteomalacia). Hypermagnesaemia may occur.
Hepatic impairment: Caution in cirrhosis patients (may be on a low sodium diet).
Overdose effects
Overdose symptoms: severe constipation, intestinal obstruction, diarrhea, electrolyte imbalance. Treatment: drug discontinuation and symptomatic measures.
Storage conditions
Store below 30°C, protected from light and moisture. Keep out of reach of children.
Chemical structure
Aluminium Hydroxide + Magnesium Hydroxide + Simethicone