Tolfenamic acid Aluminium hydroxide

Information is very limited but it would appear that if rapid analgesia is needed with either mefenamic acid or tolfenamic acid, magnesium hydroxide can be given concurrently but aluminium hydroxide should be avoided. However, note that this applies to the fasted state, whereas NSAIDs are usually taken with or after food. Also note that magnesium hydroxide increased the endoscopically-detected gastric toxicity of ibuprofen in one study, see NSAIDs Ibuprofen and related drugs -i- Antacids , below. Aluminium hydroxide markedly reduces the speed of absorption. Sodium bicarbonate does not interact. Consider also NSAIDs Miscellaneous + Antacids , p.l42. 

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... 

The absorption of mefenamic acid and tolfenamic acid is markedly accelerated by magnesium hydroxide in fasted subjects. The rate of tolfenamic acid absorption is reduced by aluminium hydroxide alone or combined with magnesium hydroxide/magnesi-um carbonate, but is not affected by sodium bicarbonate. 

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