Drug Detail:Aluminum hydroxide (Aluminum hydroxide [ a-loo-mi-num-hye-drox-ide ])
Drug Class: Antacids Phosphate binders
Usual Adult Dose for Dyspepsia
640 mg orally up to 5 to 6 times a day as needed after meals and at bedtime
- Maximum dose: 3840 mg/day
- Duration of therapy: Up to 2 weeks
Comments:
- Patients should shake the bottle prior to dosing.
- The dose may be followed by a sip of water, if needed.
Uses:
- Relief of acid indigestion
- Relief of heartburn
- Relief of sour stomach
Usual Adult Dose for Duodenal Ulcer
American Society of Health-System Pharmacists (ASHP) Recommendations:
Acute management of moderate/severe esophageal reflux: 320 mg orally every hour
Long-term therapy of esophageal reflux: 640 mg orally 1 and 3 hours after meals and at bedtime
Uncomplicated duodenal/gastric ulcers: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 4 to 6 weeks (duodenal ulcers); Until healing is complete (gastric ulcers)
Recurrent duodenal ulcers:
Treatment: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 1 week
Maintenance: 640 mg orally 1 and 3 hours after meals and at bedtime, decreasing the frequency
- Duration of therapy: 1 to 2 weeks
Comments:
- Patients with acute moderate/severe esophageal reflux disease who have persistent symptoms may receive doses every 30 minutes.
Uses:
- To increase gastric pH and lower esophageal sphincter pressure in the management of esophageal reflux
- Initial therapy for mild gastroesophageal reflux disease (GERD)
Usual Adult Dose for Erosive Esophagitis
American Society of Health-System Pharmacists (ASHP) Recommendations:
Acute management of moderate/severe esophageal reflux: 320 mg orally every hour
Long-term therapy of esophageal reflux: 640 mg orally 1 and 3 hours after meals and at bedtime
Uncomplicated duodenal/gastric ulcers: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 4 to 6 weeks (duodenal ulcers); Until healing is complete (gastric ulcers)
Recurrent duodenal ulcers:
Treatment: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 1 week
Maintenance: 640 mg orally 1 and 3 hours after meals and at bedtime, decreasing the frequency
- Duration of therapy: 1 to 2 weeks
Comments:
- Patients with acute moderate/severe esophageal reflux disease who have persistent symptoms may receive doses every 30 minutes.
Uses:
- To increase gastric pH and lower esophageal sphincter pressure in the management of esophageal reflux
- Initial therapy for mild gastroesophageal reflux disease (GERD)
Usual Adult Dose for Gastric Ulcer
American Society of Health-System Pharmacists (ASHP) Recommendations:
Acute management of moderate/severe esophageal reflux: 320 mg orally every hour
Long-term therapy of esophageal reflux: 640 mg orally 1 and 3 hours after meals and at bedtime
Uncomplicated duodenal/gastric ulcers: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 4 to 6 weeks (duodenal ulcers); Until healing is complete (gastric ulcers)
Recurrent duodenal ulcers:
Treatment: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 1 week
Maintenance: 640 mg orally 1 and 3 hours after meals and at bedtime, decreasing the frequency
- Duration of therapy: 1 to 2 weeks
Comments:
- Patients with acute moderate/severe esophageal reflux disease who have persistent symptoms may receive doses every 30 minutes.
Uses:
- To increase gastric pH and lower esophageal sphincter pressure in the management of esophageal reflux
- Initial therapy for mild gastroesophageal reflux disease (GERD)
Usual Adult Dose for Gastroesophageal Reflux Disease
American Society of Health-System Pharmacists (ASHP) Recommendations:
Acute management of moderate/severe esophageal reflux: 320 mg orally every hour
Long-term therapy of esophageal reflux: 640 mg orally 1 and 3 hours after meals and at bedtime
Uncomplicated duodenal/gastric ulcers: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 4 to 6 weeks (duodenal ulcers); Until healing is complete (gastric ulcers)
Recurrent duodenal ulcers:
Treatment: 640 mg orally 1 and 3 hours after meals and at bedtime
- Duration of therapy: 1 week
Maintenance: 640 mg orally 1 and 3 hours after meals and at bedtime, decreasing the frequency
- Duration of therapy: 1 to 2 weeks
Comments:
- Patients with acute moderate/severe esophageal reflux disease who have persistent symptoms may receive doses every 30 minutes.
Uses:
- To increase gastric pH and lower esophageal sphincter pressure in the management of esophageal reflux
- Initial therapy for mild gastroesophageal reflux disease (GERD)
Usual Adult Dose for Stress Ulcer Prophylaxis
ASHP Recommendations: 640 mg orally up to 5 to 6 times a day as needed after meals and at bedtime
- Maximum dose: 3840 mg/day
- Duration of therapy: Up to 2 weeks
Comments:
- Patients with severe symptoms may be given this drug (diluted with water or milk) via continuous intragastric infusion.
- Patients with gastrointestinal bleeding should be given doses to maintain nasogastric aspirate over a pH of 3.5.
Uses:
- Prevention of gastrointestinal bleeding
- Prevention of stress ulceration
Usual Adult Dose for Upper GI Hemorrhage
ASHP Recommendations: 640 mg orally up to 5 to 6 times a day as needed after meals and at bedtime
- Maximum dose: 3840 mg/day
- Duration of therapy: Up to 2 weeks
Comments:
- Patients with severe symptoms may be given this drug (diluted with water or milk) via continuous intragastric infusion.
- Patients with gastrointestinal bleeding should be given doses to maintain nasogastric aspirate over a pH of 3.5.
Uses:
- Prevention of gastrointestinal bleeding
- Prevention of stress ulceration
Usual Adult Dose for Gastrointestinal Hemorrhage
ASHP Recommendations: 640 mg orally up to 5 to 6 times a day as needed after meals and at bedtime
- Maximum dose: 3840 mg/day
- Duration of therapy: Up to 2 weeks
Comments:
- Patients with severe symptoms may be given this drug (diluted with water or milk) via continuous intragastric infusion.
- Patients with gastrointestinal bleeding should be given doses to maintain nasogastric aspirate over a pH of 3.5.
Uses:
- Prevention of gastrointestinal bleeding
- Prevention of stress ulceration
Usual Adult Dose for Surgical Prophylaxis
ASHP Recommendations: 640 mg orally ONCE 30 minutes prior to anesthesia
Use: Adjunct of prophylactic therapy to reduce the risk of gastric acid aspiration in patients undergoing cesarean section or emergency surgery
Usual Adult Dose for Hyperphosphatemia
ASHP Recommendations: 1920 to 2560 mg orally 3 to 4 times a day
Comment: Aluminum carbonate binds more phosphate and may be preferred to this drug.
Use: In conjunction with dietary phosphate restriction in the management of hyperphosphatemia, including calcinosis universalis, hyperparathyroidism secondary to chronic hemodialysis, and to prevent recurrent phosphoric renal calculi
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
Therapeutic drug monitoring/range:
- Gastric pH: Above 3.5
- Nasogastric aspirate (pH): 3.5
Precautions
CONTRAINDICATIONS: None.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Liquid: Shake well before use.
Storage requirements:
- Liquid: Protect from freezing; keep tightly closed when not in use.
Monitoring:
- METABOLIC: Bimonthly serum phosphate levels in patients receiving maintenance dialysis
Patient advice:
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
