If concomitant use is unavoidable, take selpercatinib 2 hours before or 2 hours after administration of antacids.
This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Gastrointestinal Enzymes: (Major) The effectiveness of gastrointestinal enzymes can be diminished with concurrent administration of antacids. Hypermagnesemia, hypomagnesemia, and increased tendon reflexes have been reported in newborns whose mothers were using aluminum and magnesium containing antacid products chronically and in high or excessive doses during their pregnancy. Concurrent use may reduce the efficacy of levothyroxine by binding and delaying or preventing oral absorption, potentially resulting in hypothyroidism. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. However, most clinicians consider the interaction of atenolol with antacids to be of minor clinical significance, since clinical efficacy (heart rate and blood pressure parameters) appear to be unchanged under usual intermittent clinical use. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Patients at increased risk of aluminum accumulation include patients with renal impairment or renal failure. Talk to your pharmacist about the potential option(s) noted below. Butalbital; Acetaminophen; Caffeine; Codeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. (Moderate) To minimize an interaction, administer thyroid hormones at least 4 hours before or after antacids or other drugs containing aluminum hydroxide. Do not double the dose to catch up. Do not freeze.
If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Concomitant use of oral budesonide and antacids, milk, or other drugs that increase gastric pH levels can cause the coating of the granules to dissolve prematurely, possibly affecting release properties and absorption of the drug in the duodenum. Follow dose with a full glass of water. Periodic antacid use should not be problematic as long as the antacid and enteric-coated naproxen administration are separated by at least 2 hours. Canada residents can call a provincial poison control center. Examples of compounds that may interfere with quinolone bioavailability include antacids that contain aluminum hydroxide. Aluminum hydroxide; magnesium hydroxide; simethicone should be used cautiously in geriatric patients and in patients with renal impairment or renal disease because of the increased risk of developing hypermagnesemia and magnesium toxicity and aluminum toxicity, especially dialysis dementia in dialysis patients with long term use of aluminum containing antacids. Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Desloratadine; Pseudoephedrine: (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Capecitabine: (Minor) Monitor for an increase in capecitabine-related adverse reactions if coadministration with aluminum hydroxide is necessary.
Children are typically not able to appropriately describe symptoms, and proper diagnosis should precede use of an antacid due to the serious nature of the complications associated with reflux in children and infants (such as failure to thrive, esophageal stricture, Barrett's esophagus, intraesophageal polyps, and associated pulmonary diseases). Lansoprazole; Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. All orders will be subject to courier charges and supplies are normally dispatched through internationally accredited courier services. Single use of magnesium citrate solution for bowel cleansing may warrant caution if significant renal impairment exists. Disclaimer - All information and content on this site are for information and educational purposes only. The serum phosphate, calcium and calculated calcium-phosphate product (serum Ca x PO4) should be monitored closely.
Examples of compounds that may interfere with quinolone bioavailability include antacids that contain magnesium hydroxide. Gemifloxacin: (Major) Administer magnesium hydroxide at least 3 hours before or 2 hours after gemifloxacin. Closely monitor patients for changing analgesic requirements or adverse events. The gas bubbles coalesce and are more quickly eliminated by flatus, belching, or absorption into the bloodstream. Members are required to pay for all prescription purchases. Such medications can include antacids, iron salts, aluminum hydroxide, dietary supplements containing polyvalent minerals, and zinc salts.
In drug interaction studies, simultaneous administration of bictegravir and antacids under fasted and fed conditions decreased the mean AUC of bictegravir by approximately 79% and 47%, respectively. Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Separate administration of tetracycline and antacids by 2 to 3 hours. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Using an antacid that contains only aluminum along with this product can help control diarrhea. Atenolol: (Minor) Aluminum hydroxide antacids have been reported to decrease atenolol mean peak concentrations by about 20% and the AUC of atenolol by 57%. Drug information is sourced fromGSDD (Gold Standard Drug Database )provided by Elsevier. To help limit an interaction, do not take antacids at the same time as the amphetamine product. If aluminum or magnesium containing antacids are required during cefdinir therapy, cefdinir should be taken at least 2 hours before or after the antacid. All rights reserved. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. In general, it would be illogical to concurrently administer these drugs at the same time. Levothyroxine; Liothyronine (Porcine): (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Coadministration may impair absorption of tetracycline which may decrease its efficacy. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered.
PO - Up to 1 g/day usually given with an Al-containing antacid. Bempedoic Acid; Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction. The chemical structure of these GI drugs that contain polyvalent cations, such as magnesium hydroxide, can bind dolutegravir in the GI tract. Diphenhydramine; Hydrocodone; Phenylephrine: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Vitamin D: (Moderate) Magnesium-containing antacids, such as magnesium hydroxide, should be used cautiously in patients receiving vitamin D (cholecalciferol). Gemifloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Indomethacin: (Moderate) Antacids may inhibit the oral absorption of indomethacin. Liothyronine: (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Many people using this medication do not have serious side effects. Avoid antacids within 1 hour before or after the bisacodyl dosage. Stagger the administration of halofantrine and antacids by at least 2 hours to limit an interaction. Other mesalamine products do not have an interaction with antacids. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Fexofenadine; Pseudoephedrine: (Moderate) Coadministration with antacids (containing aluminum or magnesium) within 15 minutes decreases the AUC and Cmax of fexofenadine by 41% and 43%, respectively. Polyvalent cations, such as magnesium, can chelate with baloxavir, reducing its absorption. Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Enter your medication into the WebMD interaction checker, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Fitness vs. Monitor serum potassium levels to determine the need for potassium supplementation and/or alteration in drug therapy. Coadministration may impair absorption of tetracycline which may decrease its efficacy. It may be advisable to separate chlorpromazine administration from antacids by 1 to 2 hours. Due to the formation of ionic complexes in the gastrointestinal tract, simultaneous administration results in lower elvitegravir plasma concentrations. Closely monitor patients for changing analgesic requirements or adverse events. Cefdinir: (Moderate) Antacids containing magnesium or aluminum can interfere with the absorption of cefdinir. This increased pressure minimizes the amount of reflux to the esophagus. Simethicone has been reported to chelate oral levothyroxine within the GI tract when administered simultaneously, leading to decreased thyroid hormone absorption. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Chenodiol: (Moderate) Aluminum hydroxide based antacids have been shown to adsorb bile acids in vitro and are expected to interfere with the efficacy of chenodiol. Tramadol; Acetaminophen: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Do not store in the bathroom. Hypotension, muscle weakness, and electrocardiographic changes are indicative of magnesium toxicity. Diazepam: (Moderate) The coadministration of diazepam with antacids results in delayed diazepam absorption due to the fact that antacids delay gastric emptying. Get medical help right away if you have any very serious side effects or symptoms of a serious medical problem, including: black/tarry stools, slow/shallow breathing, slow/irregular heartbeat, mental/mood changes (such as confusion), deep sleep, pain with urination, stomach/abdominal pain, vomit that looks like coffee grounds. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. (Moderate) Administer dolutegravir 2 hours before or 6 hours after taking cation-containing gastrointestinal medications such as magnesium hydroxide. Levothyroxine: (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Acetaminophen: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Staggering the times of administration may avoid this pharmacokinetic interaction. Amprenavir: (Moderate) Coadministration with antacids decreases amprenavir plasma concentrations. Ticlopidine: (Major) Administration of ticlopidine after antacids resulted in an 18% decrease in plasma levels of ticlopidine. (Major) Avoid coadministration of aluminum hydroxide with citrate salts due to the potential for increased absorption of aluminum. You can mix your dose with a little water if needed. The aluminum in this product can cause constipation. Talk to your pharmacist for more details. Coadministration may decrease the absorption of azithromycin which may decrease its efficacy. Norethindrone; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Doses of antacids and iron should be taken as far apart as possible to minimize the potential for interaction. These actions in vivo have not been clearly established. The increased pH and decreased pepsin production helps in the healing of peptic ulcers. Hydrocodone; Ibuprofen: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Acetaminophen; Chlorpheniramine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Omadacycline: (Moderate) Separate administration of omadacycline and antacids by 4 hours. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. This program is administered by Medical Security Card Company, LLC, Tucson, AZ. Minocycline: (Moderate) Separate administration of minocycline and antacids by 2 to 3 hours. Ibandronate: (Moderate) Separate administration of oral ibandronate and aluminum hydroxide by at least 1 hour. Such insertions do not conform to our. Before taking this product, tell your doctor or pharmacist if you are allergic to aluminum hydroxide; or to magnesium; or to simethicone; or if you have any other allergies. Bumetanide: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. If hypokalemia occurs or persists, consider reducing the dichlorphenamide dose or discontinuing dichlorphenamide therapy. This is of primary significance in patients with renal failure. Administer hydroxychloroquine and antacids at least 4 hours apart. The effect of the antacids in this regard is not expected to have a significant effect on the ability of ezetimibe to lower cholesterol.
The editorial team reserves the right to review and moderate the comments posted on the site. However, due to the fact that simethicone is not absorbed systemically, it seems unlikely that simethicone would be excreted in the milk of breast-feeding women. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier. Be sure to check with your pharmacist before taking antacids with any other medication. Itraconazole: (Moderate) When administering antacids with the 100 mg itraconazole capsule and 200 mg itraconazole tablet formulations, systemic exposure to itraconazole is decreased. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. What conditions does Liquid Antacid Suspension treat? Taking these drugs simultaneously may result in reduced bioavailability of dolutegravir.
Antacid administration two hours after the sotalol dose does not alter sotalol pharmacokinetics or pharmacodynamics. Concurrent use may reduce the efficacy of levothyroxine by binding and delaying or preventing oral absorption, potentially resulting in hypothyroidism. Bosutinib: (Moderate) Bosutinib displays pH-dependent aqueous solubility; therefore, concomitant use of bosutinib and antacids may result in decreased plasma exposure of bosutinib. Velpatasvir solubility decreases as pH increases; therefore, drugs that increase gastric pH are expected to decrease the concentrations of velpatasvir, potentially resulting in loss of antiviral efficacy. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate: (Moderate) Doses of antacids and iron should be taken as far apart as possible to minimize the potential for interaction. Patients at increased risk of aluminum accumulation include patients with renal impairment or renal failure. (Moderate) The chronic use of aluminum-containing antacids for hyperphosphatemia in conjunction with vitamin D analogs can lead to increased aluminum concentrations and toxicity. Chelation of divalent cations with levofloxacin is less than with other quinolones. As the clinical significance of this interaction is not known, the simultaneous administration of zalcitabine and aluminum is not recommended. The effect of the antacids in this regard is not expected to have a significant effect on the ability of ezetimibe to lower cholesterol. Butalbital; Acetaminophen; Caffeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. If used in patients with impaired renal function or at high doses for extended periods of time, patients are at risk for developing hypermagnesemia and accumulating aluminum in the bones, lungs, and nerve tissues. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Pharmacokinetics:Aluminum hydroxide; magnesium hydroxide; simethicone is administered orally.-Aluminum Hydroxide: Aluminum hydroxide is slowly solubilized in the stomach and reacts with hydrochloric acid in the stomach to produce aluminum chloride and water. Naproxen; Pseudoephedrine: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. As these compounds enter the small intestine, they react with bicarbonate, forming magnesium carbonate and calcium carbonate, which are insoluble. The mechanisms by which antacids reduce phenytoin absorption may involve increased gastric transit time, chelation, adsorption, and/or altered solubility. Gefitinib: (Major) Avoid coadministration of antacids with gefitinib if possible due to decreased exposure to gefitinib, which may lead to reduced efficacy. Drugs used to treat constipation, such as laxatives, would counteract the effect of antidiarrheals. If polystyrene is administered, it blocks this reaction by binding to the magnesium and calcium ions before they can react with the bicarbonate. Acetaminophen; Dextromethorphan: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Manufacturer Coupons and Offers Available. Do not use a household spoon because you may not get the right dose. In general, it may be prudent to avoid drugs such as antacids in combination with enteric-coated budesonide. Selected from data included with permission and copyrighted by First Databank, Inc. Sumatriptan; Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Erdafitinib: (Major) Avoid coadministration of aluminum hydroxide with erdafitinib before the initial dose increase period (days 14 to 21) which is based on serum phosphate levels. Coadministration of aluminum/magnesium hydroxide and bazedoxifene decreased Cmax of bazedoxifene by 8% and increased AUC of bazedoxifene by 7%. Loop diuretics: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. The day supply is based upon the average dispensing patterns for the specific drug and strength. ALUMINUM HYDROXIDE; MAGNESIUM HYDROXIDE; SIMETHICONE (a LOO mi num hye DROX ide; mag NEE zhum hye DROX ide; sye METH i kone) is an antacid and antigas medicine. Delavirdine: (Major) Coadministration of delavirdine with antacids results in decreased absorption of delavirdine. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. (Minor) Monitor for an increase in capecitabine-related adverse reactions if coadministration with magnesium hydroxide is necessary. This product may react with other medications (including digoxin, iron, pazopanib, tetracycline antibiotics, quinolone antibiotics such as ciprofloxacin), preventing them from being fully absorbed by your body. Tetracycline: (Moderate) Separate administration of tetracycline and antacids by 2 to 3 hours.
If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. During pregnancy, this medication should be used only when clearly needed. Norfloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. About 17-30% of the resulting aluminum chloride is absorbed and is rapidly excreted by the kidneys in patients with normal renal function.
If these drugs must be used together, give glipizide at least 2 hours prior to the antacid. Please note for the minimum order for Exports is of US$ 100. Drug interactions may change how your medications work or increase your risk for serious side effects. This is of primary significance in patients with renal failure. Calcium Carbonate; Risedronate: (Moderate) Magnesium hydroxide will interfere with the absorption of risedronate. Full Disclaimer, Advertise with us | Medindia Copyright | Privacy Policy | Terms of Use. aluminum hydroxide) because a reduction in cholic acid absorption will occur. Acetaminophen; Diphenhydramine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. (Major) Avoid coadministration of aluminum hydroxide with citrate salts due to the potential for increased absorption of aluminum. Budesonide; Glycopyrrolate; Formoterol: (Moderate) Enteric-coated budesonide granules dissolve at a pH more than 5.5. Refer to storage information printed on the package. Take your next dose at the regular time. Taking these drugs simultaneously may result in reduced bioavailability of dolutegravir.
Keep all regular medical and laboratory appointments. (Minor) The side effects associated with magnesium hydroxide may potentially be increased during concurrent use with didanosine, ddI because some ddI products also contain similar antacid ingredients. It is also used as a laxative. Antacids may decrease the absorption of oral iron preparations. Sofosbuvir; Velpatasvir; Voxilaprevir: (Moderate) Separate the use of antacids and velpatasvir administration by 4 hours. After initiating vitamin D analog therapy, the dose of phosphate binders should be decreased to correct persistent mild hypercalcemia or increased to correct persistent mild hyperphosphatemia. Sarecycline: (Major) Separate administration of sarecycline and antacids by 2 to 3 hours. Problems in infants have not been documented with the use of antacids containing these ingredients. With prolonged use, the aluminum in aluminum hydroxide; magnesium hydroxide; simethicone causes an increase in bone resorption and an increase in the intestinal absorption of calcium, possibly leading to hypercalcemia. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. In addition, some antacids like calcium carbonate, share the potential with the citrate salts for development of metabolic alkalosis, when given in higher dosage. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Cefpodoxime: (Moderate) Cefpodoxime proxetil requires a low gastric pH for dissolution; therefore, concurrent administration with medications that increase gastric pH (e.g., antacids) may decrease the bioavailability of cefpodoxime. Rosuvastatin; Ezetimibe: (Moderate) Coadministration of rosuvastatin with antacids has reduced rosuvastatin plasma concentrations by 54%. If antacids must be used while a patient is taking glyburide, give the glyburide at least 2 hours prior to the antacid. It is recommended that the administration of amprenavir and antacids be separated by at least 1 hour. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Closely monitor patients for changing analgesic requirements or adverse events. Antacids may decrease the absorption of oral iron preparations. Atorvastatin; Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. (Major) Magnesium hydroxide inhibits the absorption of ethotoin. Antacids may decrease the absorption of oral iron preparations. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Aluminum also combines with dietary phosphate in the intestine forming insoluble, nonabsorbable aluminum phosphate which is excreted in the feces.-Magnesium Hydroxide: In the stomach magnesium hydroxide reacts with hydrochloric acid to form magnesium chloride and water. Levothyroxine; Liothyronine (Synthetic): (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Phenytoin: (Moderate) Because the absorption of phenytoin suspension can be reduced by antacids containing magnesium, aluminum, or calcium, administration at the same time of day should be avoided when possible. The accumulation of aluminum can lead to dialysis encephalopathy, dialysis osteomalacia, or 'dialysis dementia' (impaired cognition). Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Brompheniramine; Guaifenesin; Hydrocodone: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Use aluminum hydroxide; magnesium hydroxide; simethicone products with caution in patients on sodium restricted diets and in those with congestive heart failure, renal disease, edema, or cirrhosis with ascites (severe hepatic disease) as the total daily dose may exceed 5 mEq (115 mg) of sodium.Aluminum hydroxide; magnesium hydroxide; simethicone is relatively contraindicated in patients with ulcerative colitis, which can be aggravated by the laxative effect of magnesium-containing antacids.Aluminum hydroxide; magnesium hydroxide; simethicone is relatively contraindicated in patients with colostomy, diverticulitis, or ileostomy because it increases the risk of developing electrolyte imbalance.Patients with constipation, fecal impaction, GI obstruction, ileus, hemorrhoids, or undiagnosed rectal or GI bleeding should receive aluminum hydroxide; magnesium hydroxide; simethicone with caution; it is possible that these conditions could be aggravated or the patient could develop sepsis, peritonitis, or ischemic bowel.Aluminum hydroxide; magnesium hydroxide; simethicone should be used with caution in patients with chronic diarrhea; diarrhea can be aggravated by the laxative effect of the magnesium component and diarrhea increases the risk of developing hypophosphatemia associated with the aluminum component.Over-the-counter use of aluminum hydroxide; magnesium hydroxide; simethicone is not recommended for relief of dyspepsia or pyrosis associated with intestinal gas or flatulence in children < 6 years without supervision of a physician.
This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Gastrointestinal Enzymes: (Major) The effectiveness of gastrointestinal enzymes can be diminished with concurrent administration of antacids. Hypermagnesemia, hypomagnesemia, and increased tendon reflexes have been reported in newborns whose mothers were using aluminum and magnesium containing antacid products chronically and in high or excessive doses during their pregnancy. Concurrent use may reduce the efficacy of levothyroxine by binding and delaying or preventing oral absorption, potentially resulting in hypothyroidism. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. However, most clinicians consider the interaction of atenolol with antacids to be of minor clinical significance, since clinical efficacy (heart rate and blood pressure parameters) appear to be unchanged under usual intermittent clinical use. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Patients at increased risk of aluminum accumulation include patients with renal impairment or renal failure. Talk to your pharmacist about the potential option(s) noted below. Butalbital; Acetaminophen; Caffeine; Codeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. (Moderate) To minimize an interaction, administer thyroid hormones at least 4 hours before or after antacids or other drugs containing aluminum hydroxide. Do not double the dose to catch up. Do not freeze.
If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Concomitant use of oral budesonide and antacids, milk, or other drugs that increase gastric pH levels can cause the coating of the granules to dissolve prematurely, possibly affecting release properties and absorption of the drug in the duodenum. Follow dose with a full glass of water. Periodic antacid use should not be problematic as long as the antacid and enteric-coated naproxen administration are separated by at least 2 hours. Canada residents can call a provincial poison control center. Examples of compounds that may interfere with quinolone bioavailability include antacids that contain aluminum hydroxide. Aluminum hydroxide; magnesium hydroxide; simethicone should be used cautiously in geriatric patients and in patients with renal impairment or renal disease because of the increased risk of developing hypermagnesemia and magnesium toxicity and aluminum toxicity, especially dialysis dementia in dialysis patients with long term use of aluminum containing antacids. Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Desloratadine; Pseudoephedrine: (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Capecitabine: (Minor) Monitor for an increase in capecitabine-related adverse reactions if coadministration with aluminum hydroxide is necessary.
Children are typically not able to appropriately describe symptoms, and proper diagnosis should precede use of an antacid due to the serious nature of the complications associated with reflux in children and infants (such as failure to thrive, esophageal stricture, Barrett's esophagus, intraesophageal polyps, and associated pulmonary diseases). Lansoprazole; Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. All orders will be subject to courier charges and supplies are normally dispatched through internationally accredited courier services. Single use of magnesium citrate solution for bowel cleansing may warrant caution if significant renal impairment exists. Disclaimer - All information and content on this site are for information and educational purposes only. The serum phosphate, calcium and calculated calcium-phosphate product (serum Ca x PO4) should be monitored closely.
Examples of compounds that may interfere with quinolone bioavailability include antacids that contain magnesium hydroxide. Gemifloxacin: (Major) Administer magnesium hydroxide at least 3 hours before or 2 hours after gemifloxacin. Closely monitor patients for changing analgesic requirements or adverse events. The gas bubbles coalesce and are more quickly eliminated by flatus, belching, or absorption into the bloodstream. Members are required to pay for all prescription purchases. Such medications can include antacids, iron salts, aluminum hydroxide, dietary supplements containing polyvalent minerals, and zinc salts.
In drug interaction studies, simultaneous administration of bictegravir and antacids under fasted and fed conditions decreased the mean AUC of bictegravir by approximately 79% and 47%, respectively. Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Separate administration of tetracycline and antacids by 2 to 3 hours. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Using an antacid that contains only aluminum along with this product can help control diarrhea. Atenolol: (Minor) Aluminum hydroxide antacids have been reported to decrease atenolol mean peak concentrations by about 20% and the AUC of atenolol by 57%. Drug information is sourced fromGSDD (Gold Standard Drug Database )provided by Elsevier. To help limit an interaction, do not take antacids at the same time as the amphetamine product. If aluminum or magnesium containing antacids are required during cefdinir therapy, cefdinir should be taken at least 2 hours before or after the antacid. All rights reserved. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. In general, it would be illogical to concurrently administer these drugs at the same time. Levothyroxine; Liothyronine (Porcine): (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Coadministration may impair absorption of tetracycline which may decrease its efficacy. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered.
PO - Up to 1 g/day usually given with an Al-containing antacid. Bempedoic Acid; Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction. The chemical structure of these GI drugs that contain polyvalent cations, such as magnesium hydroxide, can bind dolutegravir in the GI tract. Diphenhydramine; Hydrocodone; Phenylephrine: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Vitamin D: (Moderate) Magnesium-containing antacids, such as magnesium hydroxide, should be used cautiously in patients receiving vitamin D (cholecalciferol). Gemifloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Indomethacin: (Moderate) Antacids may inhibit the oral absorption of indomethacin. Liothyronine: (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Many people using this medication do not have serious side effects. Avoid antacids within 1 hour before or after the bisacodyl dosage. Stagger the administration of halofantrine and antacids by at least 2 hours to limit an interaction. Other mesalamine products do not have an interaction with antacids. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Fexofenadine; Pseudoephedrine: (Moderate) Coadministration with antacids (containing aluminum or magnesium) within 15 minutes decreases the AUC and Cmax of fexofenadine by 41% and 43%, respectively. Polyvalent cations, such as magnesium, can chelate with baloxavir, reducing its absorption. Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Enter your medication into the WebMD interaction checker, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Fitness vs. Monitor serum potassium levels to determine the need for potassium supplementation and/or alteration in drug therapy. Coadministration may impair absorption of tetracycline which may decrease its efficacy. It may be advisable to separate chlorpromazine administration from antacids by 1 to 2 hours. Due to the formation of ionic complexes in the gastrointestinal tract, simultaneous administration results in lower elvitegravir plasma concentrations. Closely monitor patients for changing analgesic requirements or adverse events. Cefdinir: (Moderate) Antacids containing magnesium or aluminum can interfere with the absorption of cefdinir. This increased pressure minimizes the amount of reflux to the esophagus. Simethicone has been reported to chelate oral levothyroxine within the GI tract when administered simultaneously, leading to decreased thyroid hormone absorption. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Chenodiol: (Moderate) Aluminum hydroxide based antacids have been shown to adsorb bile acids in vitro and are expected to interfere with the efficacy of chenodiol. Tramadol; Acetaminophen: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Do not store in the bathroom. Hypotension, muscle weakness, and electrocardiographic changes are indicative of magnesium toxicity. Diazepam: (Moderate) The coadministration of diazepam with antacids results in delayed diazepam absorption due to the fact that antacids delay gastric emptying. Get medical help right away if you have any very serious side effects or symptoms of a serious medical problem, including: black/tarry stools, slow/shallow breathing, slow/irregular heartbeat, mental/mood changes (such as confusion), deep sleep, pain with urination, stomach/abdominal pain, vomit that looks like coffee grounds. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. (Moderate) Administer dolutegravir 2 hours before or 6 hours after taking cation-containing gastrointestinal medications such as magnesium hydroxide. Levothyroxine: (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Acetaminophen: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Staggering the times of administration may avoid this pharmacokinetic interaction. Amprenavir: (Moderate) Coadministration with antacids decreases amprenavir plasma concentrations. Ticlopidine: (Major) Administration of ticlopidine after antacids resulted in an 18% decrease in plasma levels of ticlopidine. (Major) Avoid coadministration of aluminum hydroxide with citrate salts due to the potential for increased absorption of aluminum. You can mix your dose with a little water if needed. The aluminum in this product can cause constipation. Talk to your pharmacist for more details. Coadministration may decrease the absorption of azithromycin which may decrease its efficacy. Norethindrone; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Doses of antacids and iron should be taken as far apart as possible to minimize the potential for interaction. These actions in vivo have not been clearly established. The increased pH and decreased pepsin production helps in the healing of peptic ulcers. Hydrocodone; Ibuprofen: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Acetaminophen; Chlorpheniramine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Omadacycline: (Moderate) Separate administration of omadacycline and antacids by 4 hours. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. (Minor) It appears that antacids containing aluminum hydroxide may increase pseudoephedrine plasma concentrations. This program is administered by Medical Security Card Company, LLC, Tucson, AZ. Minocycline: (Moderate) Separate administration of minocycline and antacids by 2 to 3 hours. Ibandronate: (Moderate) Separate administration of oral ibandronate and aluminum hydroxide by at least 1 hour. Such insertions do not conform to our. Before taking this product, tell your doctor or pharmacist if you are allergic to aluminum hydroxide; or to magnesium; or to simethicone; or if you have any other allergies. Bumetanide: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. If hypokalemia occurs or persists, consider reducing the dichlorphenamide dose or discontinuing dichlorphenamide therapy. This is of primary significance in patients with renal failure. Administer hydroxychloroquine and antacids at least 4 hours apart. The effect of the antacids in this regard is not expected to have a significant effect on the ability of ezetimibe to lower cholesterol.
The editorial team reserves the right to review and moderate the comments posted on the site. However, due to the fact that simethicone is not absorbed systemically, it seems unlikely that simethicone would be excreted in the milk of breast-feeding women. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier. Be sure to check with your pharmacist before taking antacids with any other medication. Itraconazole: (Moderate) When administering antacids with the 100 mg itraconazole capsule and 200 mg itraconazole tablet formulations, systemic exposure to itraconazole is decreased. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. What conditions does Liquid Antacid Suspension treat? Taking these drugs simultaneously may result in reduced bioavailability of dolutegravir.
Antacid administration two hours after the sotalol dose does not alter sotalol pharmacokinetics or pharmacodynamics. Concurrent use may reduce the efficacy of levothyroxine by binding and delaying or preventing oral absorption, potentially resulting in hypothyroidism. Bosutinib: (Moderate) Bosutinib displays pH-dependent aqueous solubility; therefore, concomitant use of bosutinib and antacids may result in decreased plasma exposure of bosutinib. Velpatasvir solubility decreases as pH increases; therefore, drugs that increase gastric pH are expected to decrease the concentrations of velpatasvir, potentially resulting in loss of antiviral efficacy. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate: (Moderate) Doses of antacids and iron should be taken as far apart as possible to minimize the potential for interaction. Patients at increased risk of aluminum accumulation include patients with renal impairment or renal failure. (Moderate) The chronic use of aluminum-containing antacids for hyperphosphatemia in conjunction with vitamin D analogs can lead to increased aluminum concentrations and toxicity. Chelation of divalent cations with levofloxacin is less than with other quinolones. As the clinical significance of this interaction is not known, the simultaneous administration of zalcitabine and aluminum is not recommended. The effect of the antacids in this regard is not expected to have a significant effect on the ability of ezetimibe to lower cholesterol. Butalbital; Acetaminophen; Caffeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. If used in patients with impaired renal function or at high doses for extended periods of time, patients are at risk for developing hypermagnesemia and accumulating aluminum in the bones, lungs, and nerve tissues. If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. Pharmacokinetics:Aluminum hydroxide; magnesium hydroxide; simethicone is administered orally.-Aluminum Hydroxide: Aluminum hydroxide is slowly solubilized in the stomach and reacts with hydrochloric acid in the stomach to produce aluminum chloride and water. Naproxen; Pseudoephedrine: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. As these compounds enter the small intestine, they react with bicarbonate, forming magnesium carbonate and calcium carbonate, which are insoluble. The mechanisms by which antacids reduce phenytoin absorption may involve increased gastric transit time, chelation, adsorption, and/or altered solubility. Gefitinib: (Major) Avoid coadministration of antacids with gefitinib if possible due to decreased exposure to gefitinib, which may lead to reduced efficacy. Drugs used to treat constipation, such as laxatives, would counteract the effect of antidiarrheals. If polystyrene is administered, it blocks this reaction by binding to the magnesium and calcium ions before they can react with the bicarbonate. Acetaminophen; Dextromethorphan: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Manufacturer Coupons and Offers Available. Do not use a household spoon because you may not get the right dose. In general, it may be prudent to avoid drugs such as antacids in combination with enteric-coated budesonide. Selected from data included with permission and copyrighted by First Databank, Inc. Sumatriptan; Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Erdafitinib: (Major) Avoid coadministration of aluminum hydroxide with erdafitinib before the initial dose increase period (days 14 to 21) which is based on serum phosphate levels. Coadministration of aluminum/magnesium hydroxide and bazedoxifene decreased Cmax of bazedoxifene by 8% and increased AUC of bazedoxifene by 7%. Loop diuretics: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. The day supply is based upon the average dispensing patterns for the specific drug and strength. ALUMINUM HYDROXIDE; MAGNESIUM HYDROXIDE; SIMETHICONE (a LOO mi num hye DROX ide; mag NEE zhum hye DROX ide; sye METH i kone) is an antacid and antigas medicine. Delavirdine: (Major) Coadministration of delavirdine with antacids results in decreased absorption of delavirdine. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. (Minor) Monitor for an increase in capecitabine-related adverse reactions if coadministration with magnesium hydroxide is necessary. This product may react with other medications (including digoxin, iron, pazopanib, tetracycline antibiotics, quinolone antibiotics such as ciprofloxacin), preventing them from being fully absorbed by your body. Tetracycline: (Moderate) Separate administration of tetracycline and antacids by 2 to 3 hours.
If aluminum-based antacids are used on a regular basis, an alternative to pseudoephedrine may be considered. During pregnancy, this medication should be used only when clearly needed. Norfloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. About 17-30% of the resulting aluminum chloride is absorbed and is rapidly excreted by the kidneys in patients with normal renal function.
If these drugs must be used together, give glipizide at least 2 hours prior to the antacid. Please note for the minimum order for Exports is of US$ 100. Drug interactions may change how your medications work or increase your risk for serious side effects. This is of primary significance in patients with renal failure. Calcium Carbonate; Risedronate: (Moderate) Magnesium hydroxide will interfere with the absorption of risedronate. Full Disclaimer, Advertise with us | Medindia Copyright | Privacy Policy | Terms of Use. aluminum hydroxide) because a reduction in cholic acid absorption will occur. Acetaminophen; Diphenhydramine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. Gastric acidity is an essential requirement for adequate absorption of levothyroxine. (Major) Avoid coadministration of aluminum hydroxide with citrate salts due to the potential for increased absorption of aluminum. Budesonide; Glycopyrrolate; Formoterol: (Moderate) Enteric-coated budesonide granules dissolve at a pH more than 5.5. Refer to storage information printed on the package. Take your next dose at the regular time. Taking these drugs simultaneously may result in reduced bioavailability of dolutegravir.
Keep all regular medical and laboratory appointments. (Minor) The side effects associated with magnesium hydroxide may potentially be increased during concurrent use with didanosine, ddI because some ddI products also contain similar antacid ingredients. It is also used as a laxative. Antacids may decrease the absorption of oral iron preparations. Sofosbuvir; Velpatasvir; Voxilaprevir: (Moderate) Separate the use of antacids and velpatasvir administration by 4 hours. After initiating vitamin D analog therapy, the dose of phosphate binders should be decreased to correct persistent mild hypercalcemia or increased to correct persistent mild hyperphosphatemia. Sarecycline: (Major) Separate administration of sarecycline and antacids by 2 to 3 hours. Problems in infants have not been documented with the use of antacids containing these ingredients. With prolonged use, the aluminum in aluminum hydroxide; magnesium hydroxide; simethicone causes an increase in bone resorption and an increase in the intestinal absorption of calcium, possibly leading to hypercalcemia. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. In addition, some antacids like calcium carbonate, share the potential with the citrate salts for development of metabolic alkalosis, when given in higher dosage. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Cefpodoxime: (Moderate) Cefpodoxime proxetil requires a low gastric pH for dissolution; therefore, concurrent administration with medications that increase gastric pH (e.g., antacids) may decrease the bioavailability of cefpodoxime. Rosuvastatin; Ezetimibe: (Moderate) Coadministration of rosuvastatin with antacids has reduced rosuvastatin plasma concentrations by 54%. If antacids must be used while a patient is taking glyburide, give the glyburide at least 2 hours prior to the antacid. It is recommended that the administration of amprenavir and antacids be separated by at least 1 hour. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Closely monitor patients for changing analgesic requirements or adverse events. Antacids may decrease the absorption of oral iron preparations. Atorvastatin; Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. (Major) Magnesium hydroxide inhibits the absorption of ethotoin. Antacids may decrease the absorption of oral iron preparations. This interaction can be avoided by separating the administration of pseudoephedrine and antacids by 1 to 2 hours. Aluminum also combines with dietary phosphate in the intestine forming insoluble, nonabsorbable aluminum phosphate which is excreted in the feces.-Magnesium Hydroxide: In the stomach magnesium hydroxide reacts with hydrochloric acid to form magnesium chloride and water. Levothyroxine; Liothyronine (Synthetic): (Moderate) Oral thyroid hormones should be administered at least 4 hours before or after a dose of simethicone. Phenytoin: (Moderate) Because the absorption of phenytoin suspension can be reduced by antacids containing magnesium, aluminum, or calcium, administration at the same time of day should be avoided when possible. The accumulation of aluminum can lead to dialysis encephalopathy, dialysis osteomalacia, or 'dialysis dementia' (impaired cognition). Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Brompheniramine; Guaifenesin; Hydrocodone: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Use aluminum hydroxide; magnesium hydroxide; simethicone products with caution in patients on sodium restricted diets and in those with congestive heart failure, renal disease, edema, or cirrhosis with ascites (severe hepatic disease) as the total daily dose may exceed 5 mEq (115 mg) of sodium.Aluminum hydroxide; magnesium hydroxide; simethicone is relatively contraindicated in patients with ulcerative colitis, which can be aggravated by the laxative effect of magnesium-containing antacids.Aluminum hydroxide; magnesium hydroxide; simethicone is relatively contraindicated in patients with colostomy, diverticulitis, or ileostomy because it increases the risk of developing electrolyte imbalance.Patients with constipation, fecal impaction, GI obstruction, ileus, hemorrhoids, or undiagnosed rectal or GI bleeding should receive aluminum hydroxide; magnesium hydroxide; simethicone with caution; it is possible that these conditions could be aggravated or the patient could develop sepsis, peritonitis, or ischemic bowel.Aluminum hydroxide; magnesium hydroxide; simethicone should be used with caution in patients with chronic diarrhea; diarrhea can be aggravated by the laxative effect of the magnesium component and diarrhea increases the risk of developing hypophosphatemia associated with the aluminum component.Over-the-counter use of aluminum hydroxide; magnesium hydroxide; simethicone is not recommended for relief of dyspepsia or pyrosis associated with intestinal gas or flatulence in children < 6 years without supervision of a physician.