Usage
This combination medication is prescribed for the symptomatic relief of gastrointestinal discomfort associated with hyperacidity, such as:
- Heartburn
- Acid indigestion
- Sour stomach
- Upset stomach
- Gas (Methylpolysiloxane acts as an anti-flatulent)
Pharmacological Classification: Antacid and anti-flatulent.
Mechanism of Action: Aluminium hydroxide and magnesium hydroxide neutralize gastric acid, providing relief from symptoms. Methylpolysiloxane reduces the surface tension of gas bubbles, aiding in their elimination.
Alternate Names
This combination doesn’t have a single international nonproprietary name (INN). It is often referred to by its components.
Brand Names: Many brand names exist, including Maalox, Mylanta, and Rulox (some formulations may vary in specific ingredients or proportions).
How It Works
Pharmacodynamics: The antacids work by chemically neutralizing gastric acid, raising the pH of the stomach contents. This alleviates the discomfort associated with conditions like heartburn and peptic ulcers. Methylpolysiloxane disperses gas bubbles, reducing bloating and flatulence.
Pharmacokinetics: Aluminium hydroxide and magnesium hydroxide are poorly absorbed systemically, with minimal effects beyond the gastrointestinal tract. Methylpolysiloxane is not absorbed and is eliminated unchanged in the feces.
Mode of Action: These antacids directly neutralize HCl by reacting with it to produce aluminum chloride, magnesium chloride, and water.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: This combination medication does not involve receptor binding, enzyme inhibition, or neurotransmitter modulation. Its action is primarily based on chemical neutralization.
Elimination Pathways: Unabsorbed aluminum and magnesium hydroxide are eliminated in the feces. Methylpolysiloxane is also eliminated in the feces. Small amounts of aluminum and magnesium that are absorbed are excreted renally.
Dosage
Standard Dosage
Adults:
- Suspension: 10-20 mL orally 4 times daily, taken 20 minutes to 1 hour after meals and at bedtime, or as needed. Maximum dose: 80 mL/24 hours.
- Tablets (chewable): 1-2 tablets chewed thoroughly before swallowing, administered as above. The maximum dose varies depending on the strength of the tablet.
Children:
Dosing in children should be determined by a physician. Generally, the dose is based on weight and age. Safety and efficacy in children younger than 6 years old haven’t been established for all formulations. Consult a physician before administering this medication to children.
Special Cases:
- Elderly Patients: Use with caution. Start with a lower dose and adjust based on response and renal function.
- Patients with Renal Impairment: Use with caution due to potential for aluminum and magnesium accumulation. Dose adjustments may be necessary.
- Patients with Hepatic Dysfunction: No specific dose adjustments are typically required.
- Patients with Comorbid Conditions: Use with caution in patients with conditions such as diabetes, heart failure, or those on a low-phosphate diet.
Clinical Use Cases
This specific combination is not typically employed in the clinical settings described (Intubation, Surgical Procedures, Mechanical Ventilation, ICU Use, Emergency Situations).
Dosage Adjustments
Dose adjustments should be made based on the patient’s age, renal function, and other individual factors. Consult the specific product information or a physician for guidance.
Side Effects
Common Side Effects:
- Constipation (aluminum hydroxide)
- Diarrhea (magnesium hydroxide)
- Nausea
- Headache
Rare but Serious Side Effects:
- Allergic reactions (hives, difficulty breathing, swelling)
- Symptoms of hypermagnesemia (confusion, muscle weakness, slow or irregular heartbeat)
- Signs of hypophosphatemia (loss of appetite, fatigue, muscle weakness)
Long-Term Effects:
Prolonged use, especially at high doses, may lead to hypophosphatemia, osteomalacia, or aluminum toxicity in patients with renal impairment.
Adverse Drug Reactions (ADR):
Severe allergic reactions and hypermagnesemia require urgent medical intervention.
Contraindications
- Known hypersensitivity to any of the components.
- Severe renal impairment.
- Bowel obstruction.
- Appendicitis.
Drug Interactions
This combination can decrease the absorption of various medications, including certain antibiotics (tetracyclines, quinolones), iron supplements, levothyroxine, digoxin, and others. Administer other medications at least 2 hours before or after this combination. Consult a physician or pharmacist for comprehensive drug interaction information.
Pregnancy and Breastfeeding
Consult a physician before use during pregnancy. While generally considered safe, especially in the second and third trimesters, it should only be used when clearly needed.
It is considered compatible with breastfeeding as systemic absorption is minimal. However, monitor infants for diarrhea or constipation.
Drug Profile Summary
- Mechanism of Action: Neutralizes gastric acid, reduces gas bubble surface tension.
- Side Effects: Constipation, diarrhea, nausea, headache, allergic reactions, hypermagnesemia, hypophosphatemia.
- Contraindications: Severe renal impairment, bowel obstruction, appendicitis, hypersensitivity.
- Drug Interactions: Numerous, particularly with antibiotics, iron, and levothyroxine.
- Pregnancy & Breastfeeding: Use with caution; consult a physician.
- Dosage: See Dosage section above.
- Monitoring Parameters: Aluminum, magnesium, and phosphate levels (in patients with renal impairment).
Popular Combinations
This combination is typically used alone but may be combined with other antacids or H2 blockers depending on the severity and nature of the symptoms.
Precautions
Evaluate pre-existing medical conditions. Exercise caution in patients with renal impairment, pregnancy, or breastfeeding. Avoid excessive alcohol use, as it can worsen symptoms. Do not use for more than two weeks without consulting a physician if symptoms persist.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Aluminium Hydroxide + Magnesium Hydroxide + Methylpolysiloxane?
A: See Dosage section above.
Q2: What are the primary uses of this medication?
A: Relief of heartburn, acid indigestion, sour stomach, upset stomach, and gas.
Q3: How does this medication work?
A: The aluminum and magnesium hydroxide components neutralize stomach acid, while simethicone breaks down gas bubbles.
Q4: What are the common side effects?
A: Constipation, diarrhea, nausea, and headache are the most common side effects.
Q5: Are there any serious side effects I should be aware of?
A: While rare, serious side effects can include allergic reactions, hypermagnesemia (high magnesium levels), and hypophosphatemia (low phosphate levels).
Q6: Who should not take this medication?
A: Individuals with severe renal impairment, bowel obstruction, appendicitis, or a hypersensitivity to any of the ingredients should avoid this medication.
Q7: Can I take this medication while pregnant or breastfeeding?
A: Consult your physician before use during pregnancy or breastfeeding. It is generally considered safe during the second and third trimesters of pregnancy, and while breastfeeding, but use should be limited to when clearly needed.
Q8: Does this medication interact with other drugs?
A: Yes, this medication can interact with numerous other drugs, including certain antibiotics and iron supplements. Inform your physician of all medications you are currently taking.
Q9: How long can I take this medication?
A: You should not use this medication for longer than two weeks without consulting a physician. If symptoms persist, seek medical advice.
Q10: What should I do if I miss a dose?
A: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue your regular schedule. Do not double the dose.
