Aluminium Hydroxide + Magnesium Hydroxide
OTC
Therapeutic ClassAntacid Combination
Common Dose1–2 tablets or 10–20 mL suspension after meals & at bedtime
Max / 24h8 doses
PregnancyCategory C
Indications ▼
Heartburn: Neutralizes excess stomach acid and provides rapid relief.
Acid Indigestion: Reduces discomfort and bloating caused by hyperacidity.
Sour Stomach: Alleviates symptoms like belching, nausea, and regurgitation.
Peptic Ulcer Disease (adjunct therapy): Helps neutralize gastric acid to aid healing of gastric or duodenal ulcers.
Gastroesophageal Reflux Symptoms: Reduces esophageal irritation caused by acid reflux.
Mechanism & Pharmacokinetics ▼
Mechanism: Aluminium hydroxide acts as an acid neutralizer and phosphate binder, while magnesium hydroxide neutralizes acid and counteracts aluminium-induced constipation.
Pharmacokinetics: Minimal systemic absorption. Aluminium hydroxide may bind phosphate in the gut. Magnesium hydroxide exerts local osmotic laxative effects. Both are excreted primarily in the feces, with negligible renal absorption in normal renal function.
Dosage & Administration ▼
| Patient Category | Recommended Dose | Max / 24h |
|---|---|---|
| Adults | 1–2 tablets or 10–20 mL suspension after meals & at bedtime | 8 doses |
| Children (≥12 years) | 1 tablet or 10 mL suspension after meals & at bedtime | 4–6 doses |
Side Effects ▼
Constipation (from aluminium component)
Diarrhea (from magnesium component)
Rare: Hypophosphatemia, electrolyte imbalance with prolonged or excessive use
Allergic reactions are extremely rare but may include rash or itching.
Contraindications ▼
Severe renal impairment (risk of aluminium or magnesium accumulation)
Hypersensitivity to aluminium hydroxide, magnesium hydroxide, or other components
Obstructive bowel disease (for magnesium hydroxide due to laxative effect)
Drug Interaction ▼
May reduce absorption of tetracyclines, fluoroquinolones, iron supplements, levothyroxine, and some antifungal agents.
Other medications should be taken at least 2 hours before or after the antacid.
Pregnancy & Lactation ▼
Generally considered safe when used as directed in pregnancy (Category C).
Minimal systemic absorption; compatible with breastfeeding.
Clinical / Research Summary ▼
Effectiveness in Heartburn & Acid Indigestion: Randomized trials demonstrate rapid symptom relief within minutes, reducing epigastric pain, bloating, and regurgitation compared to placebo.
Peptic Ulcer Adjunct Therapy: Studies show that antacids can increase gastric pH and provide symptomatic relief, but healing requires concurrent H2 blockers, PPIs, or eradication therapy for H. pylori.
Combination Benefits: Aluminium and magnesium combination balances constipating and laxative effects, improving tolerability for short-term use.
Long-Term Use Considerations: Prolonged or excessive use may lead to electrolyte disturbances, hypophosphatemia, or magnesium/aluminium accumulation in renal impairment. Close monitoring is advised.
Clinical Guidelines: Antacids are recommended for rapid, short-term symptom relief in GERD and dyspepsia but are not substitutes for disease-modifying therapy. They remain widely used for self-limiting symptoms.
Research Trends: Recent research focuses on optimizing dosing schedules to maximize symptom relief while minimizing electrolyte disturbances, and on combining antacids with alginate formulations to enhance esophageal protection.
Patient Counseling Points ▼
Shake suspension well before use.
Take 1–2 tablets or 10–20 mL suspension after meals & at bedtime.
Do not exceed recommended dose; prolonged use may cause electrolyte imbalance.
Separate administration from other medications by at least 2 hours.
Seek medical attention if symptoms persist beyond 2 weeks or worsen.
Monitor bowel habits; constipation or diarrhea may occur.
Use caution in renal impairment; consult a doctor before use.
Storage & Handling ▼
Store at 15–30°C; protect from moisture and direct sunlight.
Keep out of reach of children.
Brand Names (Bangladesh & Global) ▼
Gelusil
Maalox
Alumag
Antacid-M
Gelusil
Maalox
Gaviscon
Mylanta
Medical Disclaimer: This clinical summary is for informational purposes only. Always follow guidance from a qualified healthcare professional for dosage, interactions, and use.
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