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|Calcium Carbonate and Simethicone

ANTACIDS (Oral)

Some commonly used brand names are:

In the U.S.—

• Advanced Formula Di-Gel ²⁹
• Alamag ²
• Alamag Plus ⁹
• Alenic Alka ¹⁵
• Alenic Alka Extra Strength ¹⁸
• Alka-Mints ²⁷
• Alkets ²⁷
• Alkets Extra Strength ²⁷
• Almacone ⁹
• Almacone II ⁹
• AlternaGEL ²¹
• Alu-Cap ²⁵
• Aludrox ⁹
• Alu-Tab ²⁵
• Amitone ²⁷
• Amphojel ²⁵
• Antacid Gelcaps ³¹
• Antacid Liquid ⁹
• Antacid Liquid Double Strength ⁹
• Basaljel ²³
• Calglycine ²⁷
• Chooz ²⁷
• Dicarbosil ²⁷
• Di-Gel ²⁹
• Equilet ²⁷
• Foamicon ¹⁹
• Gaviscon ¹⁵
• Gaviscon-2 ²⁰
• Gaviscon Extra Strength Relief Formula ¹⁷
• Gelusil ⁹
• Genaton ¹⁵
• Genaton Extra Strength ¹⁸
• Kudrox Double Strength ⁹
• Losopan ³²
• Losopan Plus ³³
• Lowsium Plus ³³
• Maalox ²
• Maalox Antacid Caplets ³¹
• Maalox Heartburn Relief Formula ¹⁴
• Maalox Plus ⁹
• Maalox Plus, Extra Strength ⁹
• Maalox TC ²
• Magnalox ⁹
• Magnalox Plus ⁹
• Mag-Ox 400 ³⁶
• Mallamint ²⁷
• Maox 420 ³⁶
• Marblen ³¹
• Mi-Acid ¹⁰
• Mi-Acid Double Strength ⁹
• Mintox ²
• Mintox Extra Strength ⁹
• Mygel ⁹
• Mygel II ⁹
• Mylanta ¹¹
• Mylanta Double Strength ¹²
• Mylanta Gelcaps ²⁸
• Nephrox ²⁵
• Phillips" ³⁵
• Phillips" Chewable ³⁵
• Phillips" Concentrated Double Strength ³⁵
• Riopan ³²
• Riopan Plus ³³
• Riopan Plus Double Strength ³³
• Rolaids ²⁸
• Rulox ²
• Rulox No. 1 ²
• Rulox No. 2 ²
• Rulox Plus ⁹
• Simaal Gel ⁹
• Simaal 2 Gel ⁹
• Tempo ⁴
• Titralac ²⁷
• Titralac Extra Strength ²⁷
• Titralac Plus ³⁰
• Tums ²⁷
• Tums Anti-gas/Antacid ³⁰
• Tums E-X ²⁷
• Tums Ultra ²⁷
• Uro-Mag ³⁶

In Canada—

• Almagel 200 ²
• Alugel ²⁵
• Alu-Tab ²⁵
• Amphojel ²⁵
• Amphojel 500 ²
• Amphojel Plus ⁸
• Basaljel ²⁵
• Diovol ⁶
• Diovol Caplets ²
• Diovol Ex ²
• Diovol Plus ⁸
• Diovol Plus AF ²⁹
• Gasmas ⁷
• Gaviscon Acid Plus Gas Relief ²⁹
• Gaviscon Acid Relief ²⁸
• Gaviscon Extra Strength Acid Relief ²⁸
• Gaviscon Heartburn Relief ¹³
• Gaviscon Heartburn Relief Extra Strength ¹³
• Gelusil ²
• Gelusil Extra Strength ²
• Life Antacid ²
• Life Antacid Plus ⁹
• Maalox ²
• Maalox Antacid Caplets ³¹
• Maalox HRF ¹³
• Maalox Plus ⁹
• Maalox Plus, Extra Strength ⁹
• Maalox TC ²
• Mylanta ⁹
• Mylanta Double Strength ⁹
• Mylanta Double Strength Plain ²
• Mylanta Extra Strength ⁹
• Neutralca-S ²
• Phillips" ³⁵
• PMS Alumina, Magnesia, and Simethicone ⁹
• Rafton ³
• Riopan ³²
• Riopan Extra Strength ³²
• Riopan Plus ³³
• Riopan Plus Extra Strength ³³
• Rolaids ²⁸
• Rolaids Extra Strength ²⁸
• Trial ²⁷
• Tums ²⁷
• Tums Extra Strength ²⁷
• Tums Ultra ²⁷
• Univol ²

Category

• Antacid—Alumina, Calcium Carbonate, and Sodium Bicarbonate; Alumina and Magnesia; Alumina, Magnesia, Calcium Carbonate, and Simethicone; Alumina, Magnesia, and Magnesium Carbonate; Alumina, Magnesia, Magnesium Carbonate, and Simethicone; Alumina, Magnesia, and Simethicone; Alumina, Magnesium Alginate, and Magnesium Carbonate; Alumina and Magnesium Carbonate; Alumina, Magnesium Carbonate, and Simethicone; Alumina, Magnesium Carbonate, and Sodium Bicarbonate; Alumina and Magnesium Trisilicate; Alumina, Magnesium Trisilicate, and Sodium Bicarbonate; Alumina and Simethicone; Alumina and Sodium Bicarbonate; Aluminum Carbonate, Basic; Aluminum Carbonate, Basic, and Simethicone; Aluminum Hydroxide; Calcium Carbonate; Calcium Carbonate and Magnesia; Calcium Carbonate, Magnesia, and Simethicone; Calcium Carbonate and Simethicone; Calcium and Magnesium Carbonates; Magaldrate; Magaldrate and Simethicone; Magnesium Carbonate and Sodium Bicarbonate; Magnesium Hydroxide; Magnesium Oxide
• Antiurolithic (phosphate calculi)—Aluminum Carbonate, Basic; Aluminum Hydroxide
• Laxative, hyperosmotic, saline—Magnesium Hydroxide; Magnesium Oxide
• Antihyperphosphatemic—Aluminum Carbonate, Basic; Aluminum Hydroxide; Calcium Carbonate
• Antihypocalcemic—Calcium Carbonate
• Antiurolithic (calcium calculi)—Magnesium Hydroxide

Description

Antacids are taken by mouth to relieve heartburn, sour stomach, or acid indigestion. They work by neutralizing excess stomach acid. Some antacid combinations also contain simethicone, which may relieve the symptoms of excess gas. Antacids alone or in combination with simethicone may also be used to treat the symptoms of stomach or duodenal ulcers.

With larger doses than those used for the antacid effect, magnesium hydroxide (magnesia) and magnesium oxide antacids produce a laxative effect. The information that follows applies only to their use as an antacid.

Some antacids, like aluminum carbonate and aluminum hydroxide, may be prescribed with a low-phosphate diet to treat hyperphosphatemia (too much phosphate in the blood). Aluminum carbonate and aluminum hydroxide may also be used with a low-phosphate diet to prevent the formation of some kinds of kidney stones. Aluminum hydroxide may also be used for other conditions as determined by your doctor.

These medicines are available without a prescription. However, your doctor may have special instructions on the proper use and dose of these medicines for your medical problem. They are available in the following dosage forms:

• Oral
• Alumina, Calcium Carbonate, and Sodium Bicarbonate
  • Oral suspension (Canada)
• Alumina and Magnesia
  • Oral suspension (U.S. and Canada)
  • Tablets (Canada)
  • Chewable tablets (U.S. and Canada)
• Alumina, Magnesia, Calcium Carbonate, and Simethicone
  • Chewable tablets (U.S.)
• Alumina, Magnesia, and Magnesium Carbonate
  • Chewable tablets (Canada)
• Alumina, Magnesia, Magnesium Carbonate, and Simethicone
  • Chewable tablets (Canada)
• Alumina, Magnesia, and Simethicone
  • Oral suspension (U.S. and Canada)
  • Chewable tablets (U.S. and Canada)
• Alumina, Magnesium Alginate, and Magnesium Carbonate
  • Oral suspension (Canada)
  • Chewable tablets (Canada)
• Alumina and Magnesium Carbonate
  • Oral suspension (U.S.)
  • Chewable tablets (U.S.)
• Alumina, Magnesium Carbonate, and Simethicone
  • Oral suspension (U.S.)
• Alumina, Magnesium Carbonate, and Sodium Bicarbonate
  • Chewable tablets (U.S.)
• Alumina and Magnesium Trisilicate
  • Chewable tablets (U.S.)
• Alumina, Magnesium Trisilicate, and Sodium Bicarbonate
  • Chewable tablets (U.S.)
• Alumina and Simethicone
  • Gel (U.S.)
• Alumina and Sodium Bicarbonate
  • Chewable tablets (Canada)
• Aluminum Carbonate, Basic
  • Capsules (U.S.)
  • Tablets (U.S.)
• Aluminum Carbonate, Basic, and Simethicone
  • Oral suspension (U.S.)
• Aluminum Hydroxide
  • Capsules (U.S. and Canada)
  • Oral suspension (U.S. and Canada)
  • Gel (U.S. and Canada)
  • Tablets (U.S. and Canada)
  • Chewable tablets (Canada)
• Calcium Carbonate
  • Chewing gum (U.S.)
  • Lozenges (U.S.)
  • Oral suspension (U.S.)
  • Tablets (U.S.)
  • Chewable tablets (U.S. and Canada)
• Calcium Carbonate and Magnesia
  • Oral suspension (Canada)
  • Tablets (U.S.)
  • Chewable tablets (U.S. and Canada)
• Calcium Carbonate, Magnesia, and Simethicone
  • Oral suspension (Canada)
  • Chewable tablets (U.S. and Canada)
• Calcium Carbonate and Simethicone
  • Oral suspension (U.S.)
  • Chewable tablets (U.S.)
• Calcium and Magnesium Carbonates
  • Oral suspension (U.S.)
  • Tablets (U.S. and Canada)
• Magaldrate
  • Oral suspension (U.S. and Canada)
  • Chewable tablets (Canada)
• Magaldrate and Simethicone
  • Oral suspension (U.S. and Canada)
  • Chewable tablets (U.S. and Canada)
• Magnesium Carbonate and Sodium Bicarbonate
  • Chewable tablets (Canada)
• Magnesium Hydroxide
  • Milk of magnesia (U.S. and Canada)
  • Chewable tablets (U.S. and Canada)
• Magnesium Oxide
  • Capsules (U.S.)
  • Tablets (U.S.)

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For antacids, the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to aluminum-, calcium-, magnesium-, simethicone-, or sodium bicarbonate-containing medicines. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet—Make certain your health care professional knows if you are on a low-sodium diet. Some antacids contain large amounts of sodium.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals. However, there have been reports of antacids causing side effects in babies whose mothers took antacids for a long time, especially in high doses during pregnancy. Also, sodium-containing medicines should be avoided if you tend to retain (keep) body water.

Breast-feeding—Some aluminum-, calcium-, or magnesium-containing antacids may pass into breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Children—Antacids should not be given to young children (under 6 years of age) unless ordered by their doctor. Since children cannot usually describe their symptoms very well, a doctor should first check the child. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse. In addition, aluminum- or magnesium-containing medicines should not be given to premature or very young children because they may cause serious side effects, especially when given to children who have kidney disease or who are dehydrated.

Older adults—Aluminum-containing antacids should not be used by elderly persons with bone problems or with Alzheimer"s disease. The aluminum may cause their condition to get worse.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking antacids, it is especially important that your health care professional know if you are taking any of the following:

• Cellulose sodium phosphate (e.g., Calcibind)—Calcium-containing antacids may decrease the effects of cellulose sodium phosphate; use with magnesium-containing antacids may prevent either medicine from working properly; antacids should not be taken within 1 hour of cellulose sodium phosphate

• Fluoroquinolones (medicine for infection)—Antacids may decrease the effects of these medicines

• Isoniazid taken by mouth (e.g., INH)—Aluminum-containing antacids may decrease the effects of isoniazid; isoniazid should be taken at least 1 hour before or after the antacid

• Ketoconazole (e.g., Nizoral) or
• Methenamine (e.g., Mandelamine)—Antacids may decrease the effects of ketoconazole or methenamine; these medicines should be taken 3 hours before the antacid

• Mecamylamine (e.g., Inversine)—Antacids may increase the effects and possibly the side effects of mecamylamine

• Sodium polystyrene sulfonate resin (SPSR) (e.g., Kayexalate)—This medicine may decrease the effects of antacids

• Tetracyclines (medicine for infection) taken by mouth—Use with antacids may decrease the effects of both medicines; antacids should not be taken within 3 to 4 hours of tetracyclines

Other medical problems—The presence of other medical problems may affect the use of antacids. Make sure you tell your doctor if you have any other medical problems, especially:

• Alzheimer"s disease (for aluminum-containing antacids only) or
• Appendicitis (or signs of) or
• Bone fractures or
• Colitis or
• Constipation (severe and continuing) or
• Hemorrhoids or
• Intestinal blockage or
• Intestinal or rectal bleeding—Antacids may make these conditions worse

• Colostomy or
• Ileostomy or
• Inflamed bowel—Use of antacids may cause the body to retain (keep) water and electrolytes such as sodium and/or potassium

• Diarrhea (continuing)—Aluminum-containing antacids may cause the body to lose too much phosphorus; magnesium-containing antacids may make diarrhea worse

• Edema (swelling of feet or lower legs) or
• Heart disease or
• Liver disease or
• Toxemia of pregnancy—Use of sodium-containing antacids may cause the body to retain (keep) water

• Kidney disease—Antacids may cause higher blood levels of aluminum, calcium, or magnesium, which may increase the risk of serious side effects

• Sarcoidosis—Use of calcium-containing antacids may cause kidney problems or too much calcium in the blood

• Underactive parathyroid glands—Use with calcium-containing antacids may cause too much calcium in the blood

Proper Use of This Medicine

For patients taking the chewable tablet form of this medicine:

• Chew the tablets well before swallowing. This is to allow the medicine to work faster and be more effective.

For patients taking this medicine for a stomach or duodenal ulcer :

• Take it exactly as directed and for the full time of treatment as ordered by your doctor , to obtain maximum relief of your symptoms.
• Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.

For patients taking aluminum carbonate or aluminum hydroxide to prevent kidney stones :

• Drink plenty of fluids for best results, unless otherwise directed by your doctor.

For patients taking aluminum carbonate or aluminum hydroxide for hyperphosphatemia (too much phosphate in the blood):

• Your doctor may want you to follow a low-phosphate diet. If you have any questions about this, check with your doctor.

Dosing—The dose of an antacid will be different for different patients. Follow your doctor"s orders or the directions on the label .

Missed dose—If your doctor has told you to take this medicine on a regular schedule and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule, tablet, or lozenge form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid or gel form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If this medicine has been ordered by your doctor and you will be taking it in large doses, or for a long time, your doctor should check your progress at regular visits. This is to make sure the medicine does not cause unwanted effects.

Some tests may be affected by this medicine. Tell the doctor in charge that you are taking this medicine before you have any tests to determine how much acid your stomach produces.

Do not take this medicine :

• if you have any signs of appendicitis or inflamed bowel (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Instead, check with your doctor as soon as possible.
• within 1 to 2 hours or more of taking other medicine by mouth . To do so may keep the other medicine from working properly.

For patients on a sodium-restricted diet :

• Some antacids (especially those containing sodium bicarbonate) contain a large amount of sodium. If you have any questions about this, check with your health care professional.

For patients taking this medicine for increased stomach acid:

• Do not take it for more than 2 weeks unless otherwise directed by your doctor . Antacids should be used only for occasional relief.
• If your stomach problem is not helped by the antacid or if it keeps coming back, check with your doctor.
• Using magnesium- or sodium bicarbonate-containing antacids too often, or in high doses, may produce a laxative effect. This happens fairly often and depends on the individual"s sensitivity to the medicine.

For patients taking aluminum-containing antacids (including magaldrate):

• Before you have any test in which a radiopharmaceutical will be used, tell the doctor in charge that you are taking this medicine. The results of the test may be affected by aluminum-containing antacids.

For patients taking calcium- or sodium bicarbonate-containing antacids :

• Do not take the antacid with large amounts of milk or milk products . To do so may increase the chance of side effects.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although the following side effects occur very rarely when this medicine is taken as recommended, they may be more likely to occur if:

• too much medicine is taken
• it is taken in large doses
• it is taken for a long time
• it is taken by patients with kidney disease

Check with your doctor as soon as possible if any of the following side effects (which may be signs of overdose) occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 07/18/1996

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