Please check your internet connection and try again.
# Aluminium Hydroxide
## Overview
Aluminium hydroxide is an inorganic salt used primarily as an antacid or phosphate binder. It works by neutralizing gastric acid or binding dietary phosphate in the gastrointestinal tract to form insoluble aluminium phosphate, which is then excreted in feces.
## Primary Indications
* **Antacid:** Symptomatic relief of heartburn, acid indigestion, and sour stomach.
* **Phosphate Binder:** Management of hyperphosphatemia in patients with chronic kidney disease (CKD).
## Adult Dosing
* **Antacid:** 500 mg to 1,500 mg orally as needed, ideally 1 hour after meals and at bedtime. Do not exceed 8,000 mg/day for short-term use.
* **Phosphate Binder:** 500 mg to 1,800 mg orally three times daily with meals. Dosage must be titrated based on serum phosphate levels.
## Pediatric Dosing
* **Antacid:** 50–150 mg/kg/day in 4–6 divided doses.
* **Phosphate Binder:** 50–150 mg/kg/day in divided doses administered with meals.
* *Note:* Dosing is highly variable; consult local pediatric formulary or institutional guidelines for specific age-weight protocols.
## Dose Adjustments
* **Renal Impairment:** Use with extreme caution. Chronic use in patients with renal failure may lead to aluminium toxicity (neurotoxicity, osteomalacia) due to impaired excretion. Dose should be reduced, and phosphate levels monitored closely.
## Contraindications
* Hypersensitivity to aluminium salts.
* Severe abdominal pain of unknown origin (potential bowel obstruction/appendicitis).
* Hypophosphatemia.
## Adverse Effects
* **Common:** Constipation (very frequent), which may contribute to bowel obstruction in chronic users.
* **Serious:** Hypophosphatemia (with prolonged use or excessive dose), aluminium toxicity, encephalopathy, and osteomalacia.
## Key Drug Interactions
* **Reduced Absorption:** Aluminium hydroxide decreases the absorption of tetracyclines, fluoroquinolones (e.g., ciprofloxacin), ketoconazole, iron salts, and levothyroxine.
* **Separation:** Administer other medications at least 2 hours before or after aluminium hydroxide to avoid binding interactions.
* **Citrate:** Avoid concomitant use with citrates (commonly found in effervescent vitamin C or potassium citrate), as they significantly increase aluminium absorption and risk of toxicity.
## Monitoring
* **Phosphate Levels:** Monitor serum phosphate regularly when used as a binder; adjust dose to maintain levels within target range.
* **Renal Function:** Monitor renal function in chronic users.
* **Bowel Pattern:** Monitor for constipation.
## Clinical Pearls
* Available in suspension and tablet forms; tablets should be chewed thoroughly before swallowing.
* The "constipating" profile is often balanced in combination products (e.g., Al(OH)₃ + Magnesium Hydroxide) to mitigate GI side effects.
* Chronic use without medical supervision is discouraged due to the risk of accumulation.
***
**Educational Disclaimer:** This information is for educational purposes only. Drug dosing, contraindications, and interaction profiles may change. Always verify current prescribing information in official resources (e.g., Lexicomp, UpToDate, or the manufacturer’s package insert) before clinical application.
