Drug Interaction Report

If you have kidney disease, you may need to limit the use of aluminum hydroxide. Chronic use of aluminum hydroxide or other medications that contain aluminum may cause toxicity in patients with advanced kidney disease due to impaired ability to clear aluminum from the body. Aluminum can accumulate and deposit in various tissues over time, causing toxicities such as weak bones, fractures, bone pain, muscle weakness, anemia, mental changes, seizures, dementia, and coma. The risk of aluminum toxicity may be further increased with high doses of ascorbic acid, which increase the absorption of aluminum from the intestine. You should avoid taking medications that contain aluminum if you have impaired kidney function unless otherwise directed by your doctor. Always check the labels of over-the-counter medications to be sure they do not contain aluminum before you use them. Talk to your doctor or other healthcare professional if you are not sure whether a product contains aluminum. They may also be able to suggest alternative medications when necessary. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Citrate, or citric acid, can increase the absorption of aluminum hydroxide. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using aluminum hydroxide if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with aluminum hydroxide. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of aluminum hydroxide and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When aluminum hydroxide is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, aluminum hydroxide should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.