Aluminum Hydroxide

Aluminum Hydroxide Brand Names

Alternagel | Alu-Cap | Dermadrox

What is Aluminum Hydroxide

Aluminum hydroxide is an inorganic salt used orally as an antacid and for the management of hyperphosphatemia.

Antacids are no longer considered the primary therapy for peptic ulcer disease, but are continually used by patients for symptomatic relief of dyspepsia.

Aluminum hydroxide alone has a low acid neutralizing capacity and is often combined with magnesium hydroxide in order to increase its efficacy and reduce the constipation associated with monotherapy.

Prolonged use of antacids containing aluminum hydroxide can limit phosphate absorption from the gastrointestinal tract resulting in significant phosphate depletion.

Clinical hypophosphatemia may be considered in patients with a history of long-term antacid use exhibiting malaise, muscle weakness, and osteomalacia.

Historically, aluminum phosphate binders such as aluminum hydroxide were first line agents in the treatment of hyperphosphatemia, however today their use is limited.

Due to the increased risk of aluminum toxicity, leading to encephalopathy and anemia, therapy with aluminum based salts are reserved for patients whose serum phosphate is above 7 mg/dL.

Aluminum hydroxide was in use prior to 1938 and approved by the FDA at its inception.

Indications

  1. duodenal ulcer
  2. gastric ulcer
  3. hyperphosphatemia
  4. stress gastritis prophylaxis

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

Side Effects

  1. anorexia
  2. constipation
  3. encephalopathy
  4. GI obstruction
  5. hemorrhoids
  6. hypercalcemia
  7. hypophosphatemia
  8. impaired cognition
  9. malaise
  10. nephrolithiasis
  11. osteomalacia
  12. osteoporosis
  13. weakness

Monitoring Parameters

  • serum calcium
  • serum phosphate

Contraindications

  • anticholinergic medications
  • ascites
  • breast-feeding
  • children
  • colostomy
  • constipation
  • dehydration
  • diarrhea
  • diverticulitis
  • fecal impaction
  • geriatric
  • GI bleeding
  • GI obstruction
  • heart failure
  • hemorrhoids
  • hepatic disease
  • hypophosphatemia
  • ileostomy
  • ileus
  • infants
  • neonates
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Acalabrutinib
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
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  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
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  • Acetaminophen; Hydrocodone
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  • Glipizide
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  • Halofantrine
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  • Hydrocodone; Pseudoephedrine
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