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Aluminum Hydroxide

    DEA Class; OTC

    Common Brand Names; AlternaGEL, Amphojel, Nephrox

    • Antacids

    Antacid; some use for hyperphosphatemia; there is concern regarding Al++ toxicity with long-term use as a phosphate ‘binder’, thus use is limited to patients with high serum phosphate (7mg/dL). Not a primary treatment for PUD.

    Indicated for use as an antacid to counteract the hyperacidity associated with gastritis, peptic ulcer disease including duodenal ulcer and possibly gastric ulcer, reflux esophagitis, and hiatal hernia.

    For the management of hyperphosphatemia secondary to renal osteodystrophy in patients with end stage renal disease.
    For stress gastritis prophylaxis.

    Hypersensitivity to aluminum salts

    • Nausea
    • Vomiting
    • Rebound hyperacidity
    • Aluminum-intoxication
    • Hypophosphatemia
    • Chalky taste
    • Constipation
    • Fecal impaction
    • Stomach cramps
    • Milk-alkali syndrome
    • Osteomalacia

    Aluminum toxicity may occur in renal failure patients

    Hypophosphatemia may occur

    Use caution in patients with heart failure, cirrhosis, edema, or renal failure

    Will bind calcium if given at same time

    Elderly may be predisposed to fecal impaction/constipation

    Use caution in patients who have recently suffered massive gastrointestinal hemorrhage

    Ask a doctor or pharmacist before use if taking a prescription drug

    Antacids may interact with certain prescription drugs

    If symptoms last >2 weeks, discontinue use and ask a healthcare professional


    May use for the treatment of gastroesophageal reflux or heartburn during pregnancy when lifestyle modification and dietary changes are insufficient; use at recommended doses; avoid high doses of aluminum hydroxide


    Considered compatible with milk at recommended doses; monitor breastfeeding infant for adverse effects; aluminum is endogenous to breast milk

    Consult package label; maximum daily dosage is age and product specific. Do not exceed recommended daily dosage in any 24 hour period.

    Aluminum hydroxide

    oral suspension

    • 320mg/5mL