Antacids: Uses, Dosage Range & Side Effects Guideline
USES
Relief of symptoms associated with hyperacidity (e.g., heartburn, acid indigestion, sour stomach), hyperacidity associated with gastric/duodenal ulcers, treatment of pathologic gastric hypersecretion associated with Zollinger-Ellison syndrome, symptomatic treatment of gastroesophageal reflux disease (GERD), prevention and treatment of upper GI stress-induced ulceration and bleeding (esp. in intensive care unit [ICU]). Aluminum hydroxide in conjunction with a low-phosphate diet to reduce elevated phosphate in pts with renal insufficiency.
- Calcium for calcium deficiency,
- magnesium for magnesium deficiency.
Antacids: Uses, Dosage Range & Side Effects Guideline
Antacid Brand Names Availability Dosage Range Side Effects
Calcium
Carbonate
Citrate
Tums, Caltrate
600, Oyst-Cal 500
Calcitrate
T (chewable): 500 mg, 750 mg, 1,000 mg T: 1,250 mg
C: 225 mg
T: 200 mg
500–1,500 mg as needed (Maximum:
7,000 mg in 24 hrs)
500–2,000 mg
Chalky taste Large doses: Fecal impaction, peripheral edema, metabolic alkalosisâ•… Long-term use: Difficult/painful urination. Constipation, nausea, vomiting
Magnesium
Hydroxide
Oxide
Milk of Magnesia
Mag-Ox 400
T (chewable): 311 mg
L: 400 mg/5 ml, 800 mg/5 ml
T: 400 mg, 420 mg, 500 mg
T: 622–1,244 mg
up to 4 times/day
L: 2.5–7.5 ml
up to 4 times/day
400–800 mg/day
Chalky taste, diarrhea, laxative effect,
electrolyte imbalance (dizziness, irregular
heartbeat, fatigue)
Same as above
Aluminum
Hydroxide
Amphojel, Alu-Tab, Dialume
T: 300 mg, 500 mg, 600 mg C: 500 mg
500–1,500 mg
3–6 times/day
Chalky taste, mild constipation, abdominal cramps
Long-term use: Neurotoxicity in dialysis pts, hypercalcemia, osteoporosisâ•… Large doses:
Fecal impaction, peripheral edema
ACTION
Antacids act primarily in the stomach to neutralize gastric acid (increase pH). Antacids do not have a direct effect on acid output. The ability to increase pH depends on the dose, dosage form used, presence or absence of food in the stomach, and acid-neutralizing capacity (ANC). ANC is the number of mEq of hydrochloric acid that can be neutralized by a particular weight or volume of antacid. Antacids reduce elevated phosphate by binding with phosphate in the intestine to form an insoluble complex, which is then eliminated.
