Aluminum hydroxide acts as an antacid and
is most commonly used in the treatment of
heartburn, gastritis, and peptic ulcer. This drug is also sometimes used to
reduce absorption of phosphorus for people with kidney failure.
Aluminum hydroxide is found in a variety of
antacids. People should read the ingredient label for over-the-counter (OTC) drugs
carefully before purchase to know exactly what they contain.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
May Be Beneficial:Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Calcium
Folic acid
Phosphorus
May Be Beneficial:Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better.
Alginates
Avoid:Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results.
Citrate
Side effect reduction/prevention
None known
Reduced drug
absorption/bioavailability
None known
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Alginates
A thick gel derived from algae has been used together with aluminum antacids to treat
heartburn. Together, alginate gel and antacid were more effective at relieving
symptoms1 and improving healing.2 Alginate is believed to work by
physically blocking stomach acid from touching the esophagus. According to these studies, two
tablets containing 200 mg alginic acid should be chewed before each meal and at bedtime.
Calcium
Aluminum hydroxide may increase urinary and stool loss of calcium.3 Also, aluminum
is a toxic mineral, and a limited amount of aluminum absorption from aluminum-containing
antacids does occur.4 As a result, most doctors do not recommend routine use of
aluminum-containing antacids.5
Other types of antacids containing calcium or
magnesium instead of aluminum are available.
Citrate
Several studies have shown that combination of citrate, either as calcium citrate supplements
or from orange and lemon juice, with aluminum-containing antacids increases aluminum levels in
the body.678 Calcium in forms other than calcium citrate
has been shown to not increase aluminum absorption.9 Drinking 7–10 ounces of
orange juice provides sufficient citrate to be problematic.1011 Intake
of 950 mg calcium citrate greatly elevates aluminum absorption.12 People with renal
failure may be at particular risk of kidney damage due to elevated aluminum levels if they
combine aluminum hydroxide with citrate.13
Folic
acid
Folic acid is needed by the body to utilize
vitamin B12. Antacids,14 including aluminum hydroxide, inhibit folic acid
absorption. People taking antacids are advised to supplement with folic acid.
Phosphorus
Depletion of phosphorus may occur as a result of taking aluminum hydroxide. For those with
kidney failure, reducing phosphorus absorption is the purpose of taking the drug, as excessive
phosphorus levels can result from kidney failure. However, when people with normal kidney
function take aluminum hydroxide for extended periods of time, it is possible to deplete
phosphorus to unnaturally low levels.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. McHardy G. A multicentric, randomized clinical trial of Gaviscon in
reflux esophagitis. South Med J 1978;71(suppl 1):16–21.
2. Graham DY, Lanza F, Dorsch ER. Symptomatic reflux esophagitis: A
double-blind controlled comparison of antacids and alginate. Curr Ther Res
1977;22:653–8.
3. Spencer H, Kramer L. Antacid-induced calcium loss. Arch Intern
Med 1983;143:657–8 [editorial].
4. Anonymous. Is aluminum harmless? Nutr Rev 1980;38:242–3
[review].
5. Gaby AR. Aluminum: The ubiquitous poison. Nutr Healing
1997;4:3,4,11.
6. Walker JA, Sherman RA, Cody RP. The effect of oral bases on enteral
aluminum absorption. Arch Intern Med 1990;150:2037–9.
7. Weberg R, Berstad A. Gastrointestinal absorption of aluminum from
single doses of aluminum containing antacids in man. Eur J Clin Invest
1986;16:428–32.
8. Fairweather-Tait S, Hickson K, McGaw B, Redi M. Orange juice enhances
aluminum absorption from antacid preparation. Eur J Clin Nutr 1994;48:71–3.
9. Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or
calcium citrate on intestinal aluminum absorption. Kidney Int
1990;38:937–41.
10. Anonymous. Preliminary findings suggest calcium citrate supplements
may raise aluminum levels in blood, urine. Family Practice News
1992;22:74–5.
11. Fairweather-Tait S, Hickson K, McGaw B, Redi M. Orange juice enhances
aluminum absorption from antacid preparation. Eur J Clin Nutr 1994;48:71–3.
12. Nolan CR, Califano JR, Butzin CA. Influence of calcium acetate or
calcium citrate on intestinal aluminum absorption. Kidney Int
1990;38:937–41.
13. Walker JA, Sherman RA, Cody RP. The effect of oral bases on enteral
aluminum absorption. Arch Intern Med 1990;150:2037–9.
14. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2
receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med
1988;112:458–63.
The information presented in Healthnotes is for informational purposes
only. It is based on scientific studies (human, animal, or in vitro), clinical
experience, or traditional usage as cited in each article. The results reported may not
necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over the counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires June 2009.
