aluminium hydroxide, dried + magnesium hydroxide: clinical use

Prescribing considerations

• Confirm that recurrent or persistent symptoms do not require investigation or acid-suppressing treatment.
• Review all oral medicines for absorption interactions.
• The selected product is not licensed for children under 12 years.
• Consider sorbitol and parahydroxybenzoate content when assessing excipient suitability.

Contraindications and cautions

• Hypersensitivity to either active ingredient or an excipient
• Kidney failure
• Severe debility
• Hereditary fructose intolerance because the suspension contains sorbitol

Monitoring

• No specific monitoring is generally needed for occasional use in people with normal renal function.
• Review renal function and consider magnesium monitoring if exposure is prolonged or renal impairment is suspected.
• Reassess persistent, worsening or frequently recurring upper gastrointestinal symptoms.

Clinical pharmacology

The two locally acting antacid salts neutralise gastric hydrochloric acid. Their opposing gastrointestinal effects help make constipation and diarrhoea less likely with the combined formulation.

Formulation and product differences

• The selected product is a white, peppermint-flavoured oral suspension that must be shaken before use.
• It contains sorbitol, mannitol, methyl and propyl parahydroxybenzoates, saccharin, peppermint oil and simeticone emulsion as excipients.
• It is essentially sodium-free.
• Once opened, the selected suspension should be discarded after 28 days; store below 25°C and do not freeze.