U.S. BRAND NAMES — Acid Gone Extra Strength [OTC]; Acid Gone [OTC]; Alenic Alka [OTC] [DSC]; Gaviscon® Extra Strength [OTC]; Gaviscon® Liquid [OTC]; Genaton™ [OTC]
PHARMACOLOGIC CATEGORY
Antacid
DOSING: ADULTS — Dyspepsia, gastric acidity: Oral:
Liquid:
Gaviscon® Regular Strength: 15-30 mL 4 times/day after meals and at bedtime
Gaviscon® Extra Strength: 15-30 mL 4 times/day after meals
Tablet (Gaviscon® Extra Strength): Chew 2-4 tablets 4 times/day
DOSING: ELDERLY — Refer to adult dosing.
DOSING: RENAL IMPAIRMENT — Aluminum and/or magnesium may accumulate in renal impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Liquid:
Acid Gone: Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL (360 mL)
Alenic Alka: Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL (355 mL) [contains magnesium 35 mg/5 mL, sodium 13 mg/5 mL, and benzyl alcohol; cool mint flavor] [DSC]
Gaviscon®: Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL (355 mL) [contains sodium 0.57 mEq/5 mL and benzyl alcohol; cool mint flavor]
Gaviscon® Extra Strength: Aluminum hydroxide 84.6 mg and magnesium carbonate 79.1 mg per 5 mL (355 mL) [contains sodium 0.9 mEq/5 mL and benzyl alcohol; cool mint flavor]
Genaton™ : Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL (360 mL)
Tablet, chewable:
Acid Gone Extra Strength: Aluminum hydroxide 160 mg and magnesium carbonate 105 mg
Gaviscon® Extra Strength: Aluminum hydroxide 160 mg and magnesium carbonate 105 mg [contains sodium 19 mg/tablet (1.3 mEq/tablet); cherry and original flavors]
DOSAGE FORMS: CONCISE
Liquid: Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL; aluminum hydroxide 84.6 mg and magnesium carbonate 79.1 mg per 5 mL
Acid Gone [OTC], Gaviscon® [OTC], Genaton™ [OTC]: Aluminum hydroxide 31.7 mg and magnesium carbonate 119.3 mg per 5 mL
Gaviscon® Extra Strength [OTC]: Aluminum hydroxide 84.6 mg and magnesium carbonate 79.1 mg per 5 mL
Tablet, chewable: Aluminum hydroxide 160 mg and magnesium carbonate 105 mg
Acid Gone Extra Strength [OTC], Gaviscon® Extra Strength [OTC]: Aluminum hydroxide 160 mg and magnesium carbonate 105 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Temporary relief of symptoms associated with gastric acidity
ADVERSE REACTIONS SIGNIFICANT — 1% to 10%:
Endocrine & metabolic: Hypermagnesemia, aluminum intoxication (prolonged use and concomitant renal failure), hypophosphatemia
Gastrointestinal: Constipation, diarrhea
Neuromuscular & skeletal: Osteomalacia
DRUG INTERACTIONS
ACE Inhibitors: Antacids may decrease the serum concentration of ACE Inhibitors. Risk C: Monitor therapy
Allopurinol: Antacids may decrease the absorption of Allopurinol. Risk D: Consider therapy modification
Alpha-/Beta-Agonists: Antacids may decrease the excretion of Alpha-/Beta-Agonists. Exceptions: Dipivefrin. Risk C: Monitor therapy
Amphetamines: Antacids may decrease the excretion of Amphetamines. Risk C: Monitor therapy
Anticonvulsants (Hydantoin): Antacids may decrease the serum concentration of Anticonvulsants (Hydantoin). Risk C: Monitor therapy
Antifungal Agents (Azole Derivatives, Systemic): Antacids may decrease the absorption of Antifungal Agents (Azole Derivatives, Systemic). Exceptions: Fluconazole; Miconazole; Voriconazole. Risk D: Consider therapy modification
Antipsychotic Agents (Phenothiazines): Antacids may decrease the absorption of Antipsychotic Agents (Phenothiazines). Risk C: Monitor therapy
Ascorbic Acid: May increase the absorption of Aluminum Hydroxide. Risk D: Consider therapy modification
Atazanavir: Antacids may decrease the absorption of Atazanavir. Risk D: Consider therapy modification
Bisacodyl: Antacids may diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Risk D: Consider therapy modification
Bisphosphonate Derivatives: Antacids may decrease the absorption of Bisphosphonate Derivatives. Antacids containing aluminum, calcium, or magnesium are of specific concern. Exceptions: Pamidronate; Zoledronic Acid. Risk D: Consider therapy modification
Cefpodoxime: Antacids may decrease the serum concentration of Cefpodoxime. Risk C: Monitor therapy
Cefuroxime: Antacids may decrease the serum concentration of Cefuroxime. Risk C: Monitor therapy
Citric Acid Derivatives: May increase the absorption of Aluminum Hydroxide. Risk D: Consider therapy modification
Corticosteroids (Oral): Antacids may decrease the bioavailability of Corticosteroids (Oral). Risk D: Consider therapy modification
CycloSPORINE: Antacids may decrease the serum concentration of CycloSPORINE. Specifically when cyclosporine is administered orally. Risk C: Monitor therapy
Dabigatran Etexilate: Antacids may decrease the serum concentration of Dabigatran Etexilate. Risk C: Monitor therapy
Dasatinib: Antacids may decrease the absorption of Dasatinib. Risk D: Consider therapy modification
Deferasirox: Aluminum Hydroxide may diminish the therapeutic effect of Deferasirox. Risk D: Consider therapy modification
Delavirdine: Antacids may decrease the absorption of Delavirdine. Risk D: Consider therapy modification
Eltrombopag: Aluminum Hydroxide may decrease the serum concentration of Eltrombopag. Management: Separate administration of eltrombopag and any polyvalent cation (e.g., aluminum-containing products) by at least 4 hours. Risk D: Consider therapy modification
Erlotinib: Antacids may decrease the serum concentration of Erlotinib. Management: Separate the administration of erlotinib and any antacid by several hours in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification
Ethambutol: Aluminum Hydroxide may decrease the absorption of Ethambutol. Risk D: Consider therapy modification
Fexofenadine: Antacids may decrease the serum concentration of Fexofenadine. Management: No specific recommendations concerning the time required between their administration are provided. Separate administration of each agent by as much time as possible to decrease the risk of an interaction. Risk D: Consider therapy modification
Iron Salts: Antacids may decrease the absorption of Iron Salts. Exceptions: Ferric Gluconate; Ferumoxytol; Iron Dextran Complex; Iron Sucrose. Risk D: Consider therapy modification
Isoniazid: Antacids may decrease the absorption of Isoniazid. Risk D: Consider therapy modification
Mesalamine: Antacids may diminish the therapeutic effect of Mesalamine. Antacid-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Avoid concurrent administration of antacids with sustained-release mesalamine products. Separating antacid and mesalamine administration, and/or using lower antacid doses may be adequate means of avoiding this interaction. Risk D: Consider therapy modification
Methenamine: Antacids may diminish the therapeutic effect of Methenamine. Risk D: Consider therapy modification
Mycophenolate: Antacids may decrease the absorption of Mycophenolate. Risk D: Consider therapy modification
Penicillamine: Antacids may decrease the serum concentration of Penicillamine. Risk D: Consider therapy modification
Phosphate Supplements: Antacids may decrease the absorption of Phosphate Supplements. Risk D: Consider therapy modification
Protease Inhibitors: Antacids may decrease the absorption of Protease Inhibitors. Exceptions: Darunavir. Risk C: Monitor therapy
QuiNIDine: Antacids may decrease the excretion of QuiNIDine. Risk C: Monitor therapy
QuiNINE: Antacids may decrease the serum concentration of QuiNINE. Risk X: Avoid combination
Quinolone Antibiotics: Antacids may decrease the absorption of Quinolone Antibiotics. Of concern only with oral administration of quinolones. Risk D: Consider therapy modification
Sodium Polystyrene Sulfonate: May enhance the adverse/toxic effect of Antacids. The combined use of these two agents may result in metabolic alkalosis. Risk D: Consider therapy modification
Tetracycline Derivatives: Antacids may decrease the absorption of Tetracycline Derivatives. Risk D: Consider therapy modification
Tocainide: Antacids may increase the serum concentration of Tocainide. Risk C: Monitor therapy
Trientine: Antacids may decrease the absorption of Trientine. Risk D: Consider therapy modification
DIETARY CONSIDERATIONS — Should be taken 1-3 hours after meals with water, milk or juice. Some products contain sodium; Gaviscon® regular strength liquid: 0.57 mEq/5 mL, Gaviscon® Extra Strength liquid: 0.9 mEq/5 mL extra strength liquid, Gaviscon® Extra Strength tablet 19 mg [1.3 mEq], Alenic Alka liquid: 13 mg/5 mL
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