ALMAGEL Oral Suspension
Category:
Antacid—Alumina, Calcium Carbonate, and Sodium Bicarbonate; Alumina and Magnesia; Alumina, Magnesia, Calcium Carbonate, and Simethicone; Alumina, Magnesia, and Magnesium Carbonate; Alumina, Magnesia, Magnesium Carbonate, and Simethicone; Alumina, Magnesia, and Simethicone; Alumina, Magnesium Alginate, and Magnesium Carbonate; Alumina and Magnesium Carbonate; Alumina, Magnesium Carbonate, and Simethicone; Alumina, Magnesium Carbonate, and Sodium Bicarbonate; Alumina and Magnesium Trisilicate; Alumina, Magnesium Trisilicate, and Sodium Bicarbonate; Alumina and Simethicone; Alumina and Sodium Bicarbonate; Aluminum Carbonate, Basic; Aluminum Carbonate, Basic, and Simethicone; Aluminum Hydroxide; Calcium Carbonate; Calcium Carbonate and Magnesia; Calcium Carbonate, Magnesia, and Simethicone; Calcium Carbonate and Simethicone; Calcium and Magnesium Carbonates; Magaldrate; Magaldrate and Simethicone; Magnesium Carbonate and Sodium Bicarbonate; Magnesium Hydroxide; Magnesium Oxide
Antiurolithic (phosphate calculi)—Aluminum Carbonate, Basic; Aluminum Hydroxide
Laxative, hyperosmotic, saline—Magnesium Hydroxide; Magnesium Oxide
Antihyperphosphatemic—Aluminum Carbonate, Basic; Aluminum Hydroxide; Calcium Carbonate
Antihypocalcemic—Calcium Carbonate
Antiurolithic (calcium calculi)—Magnesium Hydroxide
Description
Antacids are taken by mouth to relieve heartburn, sour stomach, or acid indigestion. They work by neutralizing excess stomach acid. Some antacid combinations also contain simethicone, which may relieve the symptoms of excess gas. Antacids alone or in combination with simethicone may also be used to treat the symptoms of stomach or duodenal ulcers.
With larger doses than those used for the antacid effect, magnesium hydroxide (magnesia) and magnesium oxide antacids produce a laxative effect. The information that follows applies only to their use as an antacid.
Some antacids, like aluminum carbonate and aluminum hydroxide, may be prescribed with a low-phosphate diet to treat hyperphosphatemia (too much phosphate in the blood). Aluminum carbonate and aluminum hydroxide may also be used with a low-phosphate diet to prevent the formation of some kinds of kidney stones. Aluminum hydroxide may also be used for other conditions as determined by your doctor.
These medicines are available without a prescription. However, your doctor may have special instructions on the proper use and dose of these medicines for your medical problem.
Before Using This Medicine
If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For antacids, the following should be considered:
Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to aluminum-, calcium-, magnesium-, simethicone-, or sodium bicarbonate-containing medicines. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Diet—Make certain your health care professional knows if you are on a low-sodium diet. Some antacids contain large amounts of sodium.
Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals. However, there have been reports of antacids causing side effects in babies whose mothers took antacids for a long time, especially in high doses during pregnancy. Also, sodium-containing medicines should be avoided if you tend to retain (keep) body water.
Breast-feeding—Some aluminum-, calcium-, or magnesium-containing antacids may pass into breast milk. However, these medicines have not been reported to cause problems in nursing babies.
Children—Antacids should not be given to young children (under 6 years of age) unless ordered by their doctor. Since children cannot usually describe their symptoms very well, a doctor should first check the child. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse. In addition, aluminum- or magnesium-containing medicines should not be given to premature or very young children because they may cause serious side effects, especially when given to children who have kidney disease or who are dehydrated.
Older adults—Aluminum-containing antacids should not be used by elderly persons with bone problems or with Alzheimer's disease. The aluminum may cause their condition to get worse.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking antacids, it is especially important that your health care professional know if you are taking any of the following:
Cellulose sodium phosphate (e.g., Calcibind)—Calcium-containing antacids may decrease the effects of cellulose sodium phosphate; use with magnesium-containing antacids may prevent either medicine from working properly; antacids should not be taken within 1 hour of cellulose sodium phosphate
Fluoroquinolones (medicine for infection)—Antacids may decrease the effects of these medicines
Isoniazid taken by mouth (e.g., INH)—Aluminum-containing antacids may decrease the effects of isoniazid; isoniazid should be taken at least 1 hour before or after the antacid
Ketoconazole (e.g., Nizoral) or
Methenamine (e.g., Mandelamine)—Antacids may decrease the effects of ketoconazole or methenamine; these medicines should be taken 3 hours before the antacid
Mecamylamine (e.g., Inversine)—Antacids may increase the effects and possibly the side effects of mecamylamine
Sodium polystyrene sulfonate resin (SPSR) (e.g., Kayexalate)—This medicine may decrease the effects of antacids
Tetracyclines (medicine for infection) taken by mouth—Use with antacids may decrease the effects of both medicines; antacids should not be taken within 3 to 4 hours of tetracyclines
Other medical problems—The presence of other medical problems may affect the use of antacids. Make sure you tell your doctor if you have any other medical problems, especially:
Alzheimer's disease (for aluminum-containing antacids only) or
Appendicitis (or signs of) or
Bone fractures or
Colitis or
Constipation (severe and continuing) or
Hemorrhoids or
Intestinal blockage or
Intestinal or rectal bleeding—Antacids may make these conditions worse
Colostomy or
Ileostomy or
Inflamed bowel—Use of antacids may cause the body to retain (keep) water and electrolytes such as sodium and/or potassium
Diarrhea (continuing)—Aluminum-containing antacids may cause the body to lose too much phosphorus; magnesium-containing antacids may make diarrhea worse
Edema (swelling of feet or lower legs) or
Heart disease or
Liver disease or
Toxemia of pregnancy—Use of sodium-containing antacids may cause the body to retain (keep) water
Kidney disease—Antacids may cause higher blood levels of aluminum, calcium, or magnesium, which may increase the risk of serious side effects
Sarcoidosis—Use of calcium-containing antacids may cause kidney problems or too much calcium in the blood
Underactive parathyroid glands—Use with calcium-containing antacids may cause too much calcium in the blood
Proper Use of This Medicine
For patients taking the chewable tablet form of this medicine:
Chew the tablets well before swallowing. This is to allow the medicine to work faster and be more effective.
For patients taking this medicine for a stomach or duodenal ulcer :
Take it exactly as directed and for the full time of treatment as ordered by your doctor , to obtain maximum relief of your symptoms.
Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.
For patients taking aluminum carbonate or aluminum hydroxide to prevent kidney stones :
Drink plenty of fluids for best results, unless otherwise directed by your doctor.
For patients taking aluminum carbonate or aluminum hydroxide for hyperphosphatemia (too much phosphate in the blood):
Your doctor may want you to follow a low-phosphate diet. If you have any questions about this, check with your doctor.
Dosing—The dose of an antacid will be different for different patients. Follow your doctor's orders or the directions on the label .
Missed dose—If your doctor has told you to take this medicine on a regular schedule and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
Keep out of the reach of children.
Store away from heat and direct light.
Do not store the capsule, tablet, or lozenge form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
Keep the liquid or gel form of this medicine from freezing.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
If this medicine has been ordered by your doctor and you will be taking it in large doses, or for a long time, your doctor should check your progress at regular visits. This is to make sure the medicine does not cause unwanted effects.
Some tests may be affected by this medicine. Tell the doctor in charge that you are taking this medicine before you have any tests to determine how much acid your stomach produces.
Do not take this medicine :
if you have any signs of appendicitis or inflamed bowel (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Instead, check with your doctor as soon as possible.
within 1 to 2 hours or more of taking other medicine by mouth . To do so may keep the other medicine from working properly.
For patients on a sodium-restricted diet :
Some antacids (especially those containing sodium bicarbonate) contain a large amount of sodium. If you have any questions about this, check with your health care professional.
For patients taking this medicine for increased stomach acid:
Do not take it for more than 2 weeks unless otherwise directed by your doctor . Antacids should be used only for occasional relief.
If your stomach problem is not helped by the antacid or if it keeps coming back, check with your doctor.
Using magnesium- or sodium bicarbonate-containing antacids too often, or in high doses, may produce a laxative effect. This happens fairly often and depends on the individual's sensitivity to the medicine.
For patients taking aluminum-containing antacids (including magaldrate):
Before you have any test in which a radiopharmaceutical will be used, tell the doctor in charge that you are taking this medicine. The results of the test may be affected by aluminum-containing antacids.
For patients taking calcium- or sodium bicarbonate-containing antacids :
Do not take the antacid with large amounts of milk or milk products . To do so may increase the chance of side effects.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although the following side effects occur very rarely when this medicine is taken as recommended, they may be more likely to occur if:
too much medicine is taken
it is taken in large doses
it is taken for a long time
it is taken by patients with kidney disease
Check with your doctor as soon as possible if any of the following side effects (which may be signs of overdose) occur:
For aluminum-containing antacids (including magaldrate)
Bone pain; constipation (severe and continuing); feeling of discomfort (continuing); loss of appetite (continuing); mood or mental changes; muscle weakness; swelling of wrists or ankles; weight loss (unusual)
For calcium-containing antacids
Constipation (severe and continuing); difficult or painful urination; frequent urge to urinate; headache (continuing); loss of appetite (continuing); mood or mental changes; muscle pain or twitching; nausea or vomiting; nervousness or restlessness; slow breathing; unpleasant taste; unusual tiredness or weakness
For magnesium-containing antacids (including magaldrate)
Difficult or painful urination (with magnesium trisilicate); dizziness or lightheadedness; feeling of discomfort (continuing); irregular heartbeat; loss of appetite (continuing); mood or mental changes; muscle weakness; unusual tiredness or weakness; weight loss (unusual)
For sodium bicarbonate-containing antacids
Frequent urge to urinate; headache (continuing); loss of appetite (continuing); mood or mental changes; muscle pain or twitching; nausea or vomiting; nervousness or restlessness; slow breathing; swelling of feet or lower legs; unpleasant taste; unusual tiredness or weakness
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Chalky taste
Less common
Constipation (mild); diarrhea or laxative effect; increased thirst; speckling or whitish discoloration of stools; stomach cramps
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.