aluminum hydroxide

aluminum /alu·mi·num/ (Al) (ah-loo´mĭ-num) a chemical element, at. no. 13.

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aluminum acetate  a salt prepared by the reaction of aluminum hydroxide and acetic acid; used in solution as an astringent.

basic aluminum carbonate  see under gel.

aluminum chloride  a topical astringent and anhidrotic.

aluminum chlorohydrate  the hydrate of aluminum chloride hydroxide, astringent and anhidrotic; used as an antiperspirant and as an anhidrotic in the treatment of hyperhidrosis.

aluminum hydroxide  Al(OH)3, used as an antacid, and as an adjuvant in adsorbed vaccines and toxoids; see also under gel.

aluminum oxide  Al2O3, occurring naturally as various minerals such as corundum; used in the production of abrasives, refractories, ceramics, catalysts, to strengthen dental ceramics, and in chromatography.

aluminum phosphate  an aluminum salt used as an adjuvant in adsorbed vaccines and toxoids, with calcium sulfate and sodium silicate in dental cements, and as an antacid.

aluminum subacetate  a basic acetate ester derivative used topically as an astringent.

aluminum sulfate  an astringent, used topically as a local antiperspirant; also used in the preparation of aluminum subacetate topical solution.

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aluminum hydroxide

Etymology: L, alumen, alum; Gk, hydor, water, oxys, sharp; L, gelare, to congeal

an antacid that works by chemical neutralization and also by adsorption of hydrochloric acid, gases, and toxins.

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aluminum hydroxide,

n brand names: AlternaGEL, Alu-Cap, Alu-Tab, Amphojel, Dialume;
drug class: antacid;
action: neutralizes gastric acidity, binds phosphates in GI tract;
uses: antacid, hyperphosphatemia in chronic renal failure.

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aluminum hydroxide

AlternaGEL, Alu-Cap, Alugel (CA), Alu-Tab

Pharmacologic class: Inorganic salt

Therapeutic class: Antacid

Pregnancy risk category NR

Action

Dissolves in acidic gastric secretions, releasing anions that partially neutralize gastric hydrochloric acid. Also elevates gastric pH, inhibiting the action of pepsin (an effect important in peptic ulcer disease).

Availability

Capsules: 400 mg, 475 mg, 500 mg

Oral suspension: 320 mg/5 ml, 450 mg/5 ml, 600 mg/5 ml, 675 mg/5 ml

Tablets: 300 mg, 500 mg, 600 mg

⊘Indications and dosages

➣ Hyperacidity

Adults: 500 to 1,500 mg (tablet or capsule) P.O. 1 hour after meals and at bedtime; or 5 to 30 ml (oral suspension) between meals and at bedtime, as needed or directed

Off-label uses

• Bleeding from stress ulcers
• Gastroesophageal reflux disease

Contraindications

• Signs or symptoms of appendicitis or inflamed bowel

Precautions

Use cautiously in:
• gastric outlet obstruction, hypercalcemia, hypophosphatemia, massive upper GI hemorrhage
• patients using other aluminum products concurrently
• patients on dialysis
• pregnant or breastfeeding patients.

Administration

• Administer with water or fruit juice.
• Give 1 hour after meals and at bedtime.
• In reflux esophagitis, administer 20 to 40 minutes after meals and at bedtime.
• Don't give within 1 to 2 hours of antibiotics, histamine₂ (H₂) blockers, iron preparations, corticosteroids, or enteric-coated drugs.
• Provide care as appropriate if patient becomes constipated.

Route	Onset	Peak	Duration
P.O.	15-30 min	30 min	30 min-3 hr

Adverse reactions

CNS: malaise (with prolonged use), neurotoxicity, encephalopathy

GI: constipation, anorexia (with prolonged use), intestinal obstruction

Metabolic: hypophosphatemia (with prolonged use)

Musculoskeletal: osteomalacia and chronic phosphate deficiency with bone pain, malaise, muscle weakness (with prolonged use)

Other: aluminum toxicity

Interactions

Drug-drug. Allopurinol, anti-infectives (including quinolones, tetracyclines), corticosteroids, diflunisal, digoxin, ethambutol, H₂ blockers, hydantoins, iron salts, isoniazid, penicillamine, phenothiazines, salicylates, thyroid hormone, ticlopidine: decreased effects of these drugs

Enteric-coated drugs: premature release of these drugs in stomach

Drug-diagnostic tests. Gastrin: increased level

Phosphate: decreased level

Some imaging studies: test interference

Drug-food. Milk, other foods high in vitamin D: milk-alkali syndrome (nausea, vomiting, distaste for food, headache, confusion, hypercalcemia, hypercalciuria)

Patient monitoring

• Monitor long-term use of high doses if patient is on sodium-restricted diet. (Drug contains sodium.)
• Assess for GI bleeding.
• Watch for constipation.
• With long-term use, monitor blood phosphate level and assess for signs and symptoms of hypophosphatemia (anorexia, malaise, muscle weakness). Also monitor bone density.

Patient teaching

• Tell patient to take drug 1 hour after meals and at bedtime.
• Caution patient not to take drug within 1 to 2 hours of anti-infectives, H₂ blockers, iron, corticosteroids, or enteric-coated drugs.
• Advise patient to take drug with water or fruit juice.
• Instruct patient to report signs and symptoms of GI bleeding and hypophosphatemia (appetite loss, malaise, muscle weakness).
• Recommend increased fiber and fluid intake and regular physical activity to help ease constipation.
• Inform patient that drug contains sodium, so he should discuss drug therapy with health care providers if he's later told to consume a low-sodium diet.
• Advise patient that he'll need to undergo periodic blood testing and bone mineral density tests if he's receiving long-term therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.