Magaldrate

Trade Names:
Iosopan
- Liquid 540 mg/5 mL

Trade Names:
Riopan
- Suspension 540 mg/5 mL

Pharmacology

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Neutralizes gastric acid, thereby increasing pH of stomach and duodenal bulb. Increases lower esophageal sphincter tone and inhibits smooth muscle contraction and gastric emptying.

Indications and Usage

Symptomatic relief of upset stomach associated with hyperacidity, including heartburn, gastroesophageal reflux, acid indigestion and sour stomach; relief of hyperacidity associated with peptic ulcer, gastritis, peptic esophagitis, gastric hyperacidity and hiatal hernia.

Contraindications

Severe renal dysfunction; hypophosphatemia; nausea; vomiting; severe abdominal pain; acute surgical abdomen; impaction; intestinal obstruction.

Dosage and Administration

PO 480 to 1080 mg 4 times daily as needed or to aid in peptic ulcer healing or chronic reflux, give 1 h and 3 h after meals and at bedtime (7 doses/day).

PO 5 to 10 mg/dose every 3 to 6 h or 1 h and 3 h after meals and at bedtime for peptic ulcer.

Storage/Stability

Store at room temperature (59° to 86°F).

Drug Interactions

Decreased pharmacologic effect of iron.

Decreased pharmacologic effect of ketoconazole.

Decreased effects of nitrofurantoin.

Decreased pharmacologic effect of penicillamine.

Increased pharmacologic effect of quinidine.

Decreased pharmacologic effect of quinolones.

Decreased pharmacologic effect of salicylates.

Concomitant use may cause metabolic alkalosis in patients with renal failure.

Decreased pharmacologic effect of tetracyclines.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Neurotoxicity; encephalopathy.

GI

Diarrhea; constipation; intestinal obstruction; rebound hyperacidity.

Metabolic

Hypophosphatemia; hypermagnesemia.

Miscellaneous

Osteomalacia; bone pain; muscular weakness; malaise; decreased fluoride absorption; aluminum accumulation in serum, bone and CNS; milk-alkali syndrome.

Precautions

Pregnancy

Pregnancy category undetermined.

Lactation

Undetermined.

Renal Function

Use with caution in patients with renal function impairment to avoid hypermagnesemia and toxicity.

GI hemorrhage

Use with care in patients with recent massive upper GI hemorrhage.

Overdosage

Symptoms

Nausea, vomiting, diarrhea, constipation, hypermagnesemia, hypophosphatemia.

Patient Information

• Instruct patient to take medication 1 and 3 h after meals and at bedtime.
• Warn patient not to take other medications within 2 h of antacid.
• Review proper use of suspension or tablet form.
• Advise patient to consult health care provider if problem recurs, if any symptoms that suggest bleeding occur (eg, black, tarry stools) or if patient has taken antacids for more than 2 wk.

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