aluminium hydroxide + magnesium hydroxide + simeticone: clinical use

Prescribing considerations

• Confirm exact formulation, age suitability and excipients.
• Use caution with renal impairment, dehydration, advanced age, low-phosphate diets or reduced bowel motility.
• Assess persistent, recurrent or worsening symptoms for an underlying cause.
• Review the full medicines list for absorption interactions.

Contraindications and cautions

• Hypersensitivity to an active ingredient or excipient
• Hypophosphataemia
• Kidney failure and severe debility for the selected suspension
• Hereditary fructose intolerance for sorbitol-containing formulations; tablets also have sucrose-related restrictions

Monitoring

• Renal function and clinical evidence of magnesium or aluminium accumulation where exposure is prolonged or renal function is impaired
• Serum phosphate where depletion risk is present
• Bowel function and symptoms of obstruction or ileus
• Symptom persistence, recurrence or alarm features

Clinical pharmacology

The aluminium and magnesium salts neutralise gastric hydrochloric acid locally. Magnesium hydroxide acts more rapidly, while aluminium hydroxide provides longer buffering. Simeticone is a locally acting anti-foaming agent with negligible gastrointestinal absorption.

Formulation and product differences

• Tablets are sucked or chewed and contain sucrose and sorbitol.
• Suspension must be shaken before use and contains sorbitol.
• Contraindications and paediatric suitability differ between selected tablet and suspension formulations.