Aluminium-containing antacids

Konturek, S.J., Brzozowski, T., Majka, J., Szlachcic, A., Slo-miany, B. and Nauert, C. (1992a). Role of nitric oxide and prostag ndins in gastroprotection by aluminium containing antacid. Gastroenterology 102, AlOl. 

Aluminium-containing antacids exhibit cytoprotective activity or enhancement of natural mucosal defence mechanisms. 

Opioid analgesics Tricyclic antidepressants Sedating antihistamines 5HT3 antagonists Calcium channel blockers Antispasmodics, e.g. hyoscine butylbromide Antimuscarinic drugs used in parkinsonism Aluminium-containing antacids Loperamide... 

NSAIDs ANTACIDS 1. Magnesium hydroxide T absorption of ibuprofen, flurbiprofen, mefenamic acid and tolfenamic acid 2. Aluminium-containing antacids l absorption of these NSAIDs Uncertain These effects are 1 by taking these drugs with food... 

Osteomalacia due to aluminium-containing antacids has been associated with stainable bone aluminium in patients with normal renal function (61). 

Table 1 The effects of aluminium-containing antacids on the absorption of some other drugs...

Absorption of isoniazid can be inhibited by aluminium-containing antacids (51). 

Antacids Indometacin ( other NSAIDs) Variable effects of different formulations aluminium-containing antacids reduce the rate and extent of absorption of indometacin sodium bicarbonate increases the rate and extent of absorption of indometacin No action required, unless a marked reduction in absorption results in a poor response to the NSAID, in which case dosages may need to be increased or the antacid withdrawn... 

The systemic availability of ofloxacin is reduced by aluminium-containing antacids, but not by antacids containing magnesium or calcium (14). 

Aluminium-containing antacids appear to reduce the absorption of diflunisal in the fasted state, but not if taken with food. Since NSAIDs should be taken with or after food, if appears that this interaction has little clinical relevance. See also NSAIDs Miscellaneous -I-Antacids , p.l42. Magnesium hydroxide increases the absorption of diflunisal in the fasted state. 

Adequately but not extensively documented. Some small reduction in plasma indometacin levels is possible with some aluminium containing antacids. Despite this the manufacturers of indometacin recommend that it be taken with food, milk or an antacid to minimise gastrointestinal disturbances. Sulindac absorption is not affected. 

Aluminium-containing antacids and sucralfate can interact with high-protein liquid enteral feeds to produce an obstructive plug. 

Weberg R, Berstad A. Gastrointestinal absorption of aluminium from single doses of aluminium containing antacids in man. EurJ Clin Invest (1986) 16, 428-32. 

Although concurrent use has not been formally studied, the manufacturer recommends that deferasirox is not taken with aluminium-containing antacids. - Deferasirox has a lower affinity for aluminium than for iron, but theoretically aluminium might reduce the efficacy of deferasirox. 

This patient, a 49-year-old woman, had since January 1971 taken large amounts of aluminium-containing antacids, amounting latterly to an intake of about 20 g aluminium hydroxide daily. In 1973 the patient was admitted for pain in the left hip, weakness and difficulty in walking. The patient appeared to have a low plasma phosphorus level, raised alkaline phosphatase, and a high calcium and low phosphorus urinary content. A bone marrow biopsy was consistent with osteomalacia. 

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