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any of various trademark preparations of magnesium and aluminum salts (usually magnesium hydroxide and aluminum hydroxide) used as antacids.

magnesium hydroxide/aluminum hydroxide

(mag-nee-zhum hye-drox-ide/ a-loo-mi-num hye-drox-ide) ,


(trade name),

Diovol Plus

(trade name),


(trade name),

Mylanta Ultimate

(trade name),


(trade name)


Therapeutic: antiulcer agents
Pharmacologic: antacids
Pregnancy Category: C


Useful in a variety of GI complaints, including:
  • Hyperacidity,
  • Indigestion,
  • GERD,
  • Heartburn.


Neutralize gastric acid following dissolution in gastric contents.
Inactivate pepsin if pH is raised to ≥4.

Therapeutic effects

Neutralization of gastric acid with healing of ulcers and decrease in associated pain.


Absorption: During routine use, antacids are nonabsorbable. With chronic use, 15–30% of magnesium and smaller amounts of aluminum may be absorbed.
Distribution: Small amounts absorbed are widely distributed, cross the placenta, and appear in breast milk. Aluminum concentrates in the CNS.
Metabolism and Excretion: Excreted by the kidneys.
Half-life: Unknown.

Time/action profile

Aluminum POslightly delayed30 min30 min-1 hr (empty stomach); 3 hr (after meals)
Magnesium POslightly delayed30 min30 min-1 hr (empty stomach); 3 hr (after meals)


Contraindicated in: Severe abdominal pain of unknown cause, especially if accompanied by fever; Renal failure (CrCl <30 mL/min); Products containing tartrazine or sugar in patients with known intolerance.
Use Cautiously in: Antacids containing magnesium in patients with any degree of renal insufficiency; ↓ bowel motility ; Dehydration; Upper GI hemorrhage; Children <12 yr (safety not established).

Adverse Reactions/Side Effects


    aluminum salts:
  • constipation (most frequent)
  • magnesium salts:
  • diarrhea (most frequent)

Fluid and Electrolyte

    magnesium salts:
  • hypermagnesemia
  • aluminum salts:
  • hypophosphatemia


Drug-Drug interaction

Absorption of tetracyclines, phenothiazines, ketoconazole, itraconazole, iron salts, fluoroquinolones, and isoniazid may be ↓ (separate by at least 2 hr).


Oral (Adults and Children ≥12 yr) 5–30 mL or 1–2 tablets 1–3 hr after meals and at bedtime.

Availability (generic available)

Chewable Tablets: 300 mg aluminum hydroxide/150 mg magnesium hydroxideOTC
Suspension: 225 mg aluminum hydroxide/200 mg magnesium hydroxide/5 mLOTC, 500 mg aluminum hydroxide/500 mg magnesium hydroxide/5 mLOTC
In combination with: simethiconeOTC. See combination drugs.

Nursing implications

Nursing assessment

  • Antacid: Assess for heartburn and indigestion as well as location, duration, character, and precipitating factors of gastric pain.
  • Lab Test Considerations: Monitor serum phosphate, potassium, and calcium levels periodically during chronic use. May cause ↑ serum calcium and ↓ serum phosphate concentrations.

Potential Nursing Diagnoses

Acute pain (Indications)


  • Magnesium and aluminum are combined as antacids to balance the constipating effects of aluminum with the laxative effects of magnesium.
  • Oral: To prevent tablets from entering small intestine in undissolved form, they must be chewed thoroughly before swallowing. Follow with at least ½ glass of water.
    • Shake suspensions well before administration.
    • For an antacid effect, administer 1–3 hr after meals and at bedtime.

Patient/Family Teaching

  • Caution patient to consult health care professional before taking antacids for more than 2 wk if problem is recurring, if relief is not obtained, or if symptoms of gastric bleeding (black, tarry stools; coffee-ground emesis) occur.
  • Advise patient not to take this medication within 2 hr of taking other medications.
  • Pediatric: Aluminum- or magnesium-containing medicines can cause serious side effects in children, especially when given to children with renal disease or dehydration. Advise parents or caregivers not to administer OTC antacids to children without consulting health care professional.

Evaluation/Desired Outcomes

  • Relief of gastric pain and irritation.


A trademark for a preparation containing simethicone, aluminum hydroxide, and magnesium hydroxide that is used as an antacid and antiflatulent.


A brand name for a preparation containing ALUMINIUM HYDROXIDE and MAGNESIUM HYDROXIDE.
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