More hydrogen ions are lost from the stomach than are lost from the intestine, resulting in metabolic alkalosis. [42282] [45899]. Hydrocodone; Ibuprofen: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Closely monitor patients for changing analgesic requirements or adverse events. In a drug interaction study, the AUC for raltegravir was decreased by 49% (90% CI, 35% to 60%), 51% (90% CI, 33% to 65%), and 30% (90% CI, 4% to 50%), when administered with, 2 hours before, and 2 hours after aluminum/magnesium hydroxide antacids, respectively. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: (Moderate) Concurrent administration of rilpivirine and antacids may significantly decrease rilpivirine plasma concentrations, potentially resulting in treatment failure. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. Separating adminisration times may help limit any possible interaction. Dosage should be modified depending on clinical response and degree of renal impairment. Increasing the dose of erlotinib without modifying the administration schedule is unlikely to compensate for loss of exposure. Acetaminophen; Dextromethorphan; Doxylamine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Hypermagnesemia has been reported in newborns whose mothers were using magnesium-containing antacid products chronically in high doses. Brompheniramine; Guaifenesin; Hydrocodone: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. Fexofenadine: (Moderate) Coadministration with antacids (containing aluminum or magnesium) within 15 minutes decreases the AUC and Cmax of fexofenadine by 41% and 43%, respectively. Lansoprazole; Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Antacids can impair the absorption of ketoconazole.

Although this finding is of marginal clinical significance, patients should be monitored for adverse effects in this situation. Periodic antacid use should not be problematic as long as the antacid and enteric-coated naproxen administration are separated by at least 2 hours. Usual administration is at bedtime when used as a laxative and 30 minutes after meals when used as an antacid. Erlotinib displays pH-dependent solubility with decreased solubility at a higher pH; the increased gastric pH resulting from antacid therapy may reduce the bioavailability of erlotinib. Coadministration interferes with cefditoren absorption causing a decrease in the Cmax and AUC. Antacids may decrease the absorption of oral iron preparations. Rilpivirine: (Moderate) Concurrent administration of rilpivirine and antacids may significantly decrease rilpivirine plasma concentrations, potentially resulting in treatment failure. ". Fexofenadine; Pseudoephedrine: (Moderate) Coadministration with antacids (containing aluminum or magnesium) within 15 minutes decreases the AUC and Cmax of fexofenadine by 41% and 43%, respectively. Magnesium hydroxide should not be used in patients with renal failure unless their serum magnesium levels are being closely monitored. Although the exact mechanism is not known, theoretically it may be due to alterations in gastric pH. Polyethylene Glycol; Electrolytes; Bisacodyl: (Minor) The concomitant use of bisacodyl tablets with antacids can cause the enteric coating of the bisacody tablet to dissolve prematurely, leading to possible gastric irritation or dyspepsia. Loop diuretics: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. No effect was observed on the other three major metabolites of capecitabine (5'-DFUR, fluorouracil, FBAL). Antacids containing alkalinizing agents such as sodium bicarbonate can alkalinize the urine, thereby decreasing the effectiveness of methenamine by increasing the amount of non-ionized drug available for renal tubular reabsorption. Closely monitor patients for changing analgesic requirements or adverse events. Concomitant administration with high doses of antacids reduces peak plasma concentrations by 24% and the extent of absorption by 27%. Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Separate administration of tetracycline and antacids by 2 to 3 hours. Dolutegravir: (Moderate) Administer dolutegravir 2 hours before or 6 hours after taking cation-containing gastrointestinal medications such as magnesium hydroxide. Antacids such as aluminum hydroxide/magnesium hydroxide decrease riociguat absorption. Examples of compounds that may interfere with quinolone bioavailability include antacids that contain magnesium hydroxide. Although the exact mechanism is not known, theoretically it may be due to alterations in gastric pH. Acalabrutinib solubility decreases with increasing pH values; therefore, coadministration may result in decreased acalabrutinib exposure and effectiveness. Acetaminophen; Caffeine; Dihydrocodeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Antacids may decrease the absorption of oral iron preparations. Magnesium hydroxide is used to treat constipation and acid indigestion. The dose of digoxin may need to be adjusted. Taking these drugs simultaneously may result in reduced oral bioavailability of cabotegravir. If these drugs must be used together, give glipizide at least 2 hours prior to the antacid. Naproxen; Pseudoephedrine: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. The chemical structure of these GI drugs that contain polyvalent cations, such as magnesium hydroxide, can bind dolutegravir in the GI tract. Levofloxacin: (Moderate) Administer magnesium hydroxide at least 2 hours before or 2 hours after orally administered levofloxacin. Avoid antacids within 1 hour before or after the bisacodyl dosage. The clinical effect of this change is not known, but does not appear to be significant. Periodic antacid use should not be problematic as long as the antacid and enteric-coated naproxen administration are separated by at least 2 hours. Periodic antacid use should not be problematic as long as the antacid and enteric-coated naproxen administration are separated by at least 2 hours. The need to stagger doses of propranolol has not been established, but may be prudent. Separate the administration of atazanavir and antacids to avoid the potential for interaction; give atazanavir 2 hours before or 1 hour after the antacid. Closely monitor patients for changing analgesic requirements or adverse events. However, no dosage guidelines are available; serum magnesium monitoring is recommended if magnesium hydroxide must be used.CrCl less than 10 mL/minute: Avoid use in renal failure. Separating the administration of phenytoin and antacids or calcium salts by at least 2 hours will help minimize the possibility of interaction. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. Glyburide; Metformin: (Moderate) Antacids have been reported to increase the absorption of non-micronized glyburide, enhancing their hypoglycemic effects. Closely monitor patients for changing analgesic requirements or adverse events. Due to the formation of ionic complexes in the gastrointestinal tract, simultaneous administration results in lower elvitegravir plasma concentrations. Register Now. Coadministration may impair absorption of omadacycline which may decrease its efficacy. This interaction results in a 25% reduction in the bradycardic effect of sotalol (measured at rest). Consult package label; maximum daily dosage is age and product specific. Atazanavir: (Major) It is recommended that antacids not be given at the some time as atazanavir because of potential interference with absorption of atazanavir. In-vitro studies suggest that calcium and magnesum cations exert their deleterious effect on replacement enzyme therapy by formation of poorly soluble calcium or magnesium soaps and precipitation of glycine conjugated bile salts. Mefenamic Acid: (Moderate) Ingestion of mefenamic acid with antacids is not recommended. Acetaminophen; Oxycodone: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Diflunisal: (Moderate) Concurrent use of diflunisal with antacids may reduce plasma diflunisal concentrations. Send the page "" Diazepam: (Moderate) The coadministration of diazepam with antacids results in delayed diazepam absorption due to the fact that antacids delay gastric emptying. As the clinical significance of this interaction is not known, the simultaneous administration of zalcitabine and magnesium-containing antacids is not recommended. If using as an antacid, administration with a little water is advised.May be more palatable if refrigerated prior to administration. Potassium Citrate: (Contraindicated) Avoid coadministration of antacids with citrate salts since increased absorption of aluminum can occur. In-vitro studies suggest that calcium and magnesum cations exert their deleterious effect on replacement enzyme therapy by formation of poorly soluble calcium or magnesium soaps and precipitation of glycine conjugated bile salts. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: (Moderate) Separate administration of elvitegravir and antacids by at least 2 hours. Closely monitor patients for changing analgesic requirements or adverse events. Closely monitor patients for changing analgesic requirements or adverse events. Because vitamin D can increase serum magnesium concentrations, the combined use of vitamin D and magnesium-containing drug products should be avoided, if possible, in patients with chronic renal failure.

Bumetanide: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. In both healthy subjects and peptic ulcer patients, Cmax was increased 42.4% and 20.5%, respectively. Moxifloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Moxifloxacin: (Major) Administer oral moxifloxacin at least 4 hours before or 8 hours after magnesium hydroxide. Acetaminophen; Aspirin, ASA; Caffeine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. 15 to 60 mL PO per day, preferably at bedtime, or the daily dose may be given in divided doses or as directed by a prescriber.

Acetaminophen; Chlorpheniramine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected.

Ascorbic Acid, Vitamin C: (Minor) Because antacids can alkalinize the urine, they can interact with urinary acidifiers, such as ascorbic acid. Due to the formation of ionic complexes in the gastrointestinal tract, simultaneous administration results in lower elvitegravir plasma concentrations. dehydration / Delayed / Incidence not knownhypermagnesemia / Delayed / Incidence not known, diarrhea / Early / Incidence not knownnausea / Early / Incidence not knowndiuresis / Early / Incidence not knownvomiting / Early / Incidence not known. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. Vitamin D analogs: (Moderate) Magnesium-containing antacids, such as magnesium hydroxide, should be used cautiously in patients receiving vitamin D analogs. The chemical structure of these antacids contains aluminum or magnesium which can bind cabotegravir in the GI tract. Brompheniramine; Hydrocodone; Pseudoephedrine: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. In case of overdose, get medical help or contact a Poison Control Center immediately. Super Tips to Boost Digestive Health: Bloating, Constipation, and More. Magnesium hydroxide is available over-the-counter (OTC) and as a generic. Controlled studies in pregnant women show no evidence of fetal risk. Sucralfate: (Moderate) Antacids can interfere with the binding capacity of sucralfate to the GI mucosa, decreasing its effectiveness. All rights reserved. Hydrocodone; Phenylephrine: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. To decrease the risk of virologic failure, avoid use of antacids for at least 2 hours before and at least 4 hours after administering rilpivirine. Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: (Major) The therapeutic action of methenamine requires an acidic urine. However, to limit any potential interaction, it would be prudent to administer ezetimibe at least 1 hour before or 2 hours after administering antacids. What Are the Best PsA Treatments for You? 15 to 30 mL PO per day as a single dose at bedtime, or the daily dose may be given in divided doses or as directed by a prescriber. Delafloxacin: (Major) Administer oral delafloxacin at least 2 hours before or 6 hours after products that contain magnesium hydroxide. Coadministration may decrease infigratinib exposure resulting in decreased efficacy. Copyright 2022 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. If use is necessary, monitor serum magnesium levels. The effect of the antacids in this regard is not expected to have a significant effect on the ability of ezetimibe to lower cholesterol. Neratinib: (Major) Administer neratinib at least 3 hours after administration of antacids if concomitant use is necessary due to decreased absorption and systemic exposure of neratinib; the solubility of neratinib decreases with increasing pH of the GI tract. Staggering the times of administration may avoid this pharmacokinetic interaction.

If antacids must be used while a patient is taking glyburide, give the glyburide at least 2 hours prior to the antacid. Cabotegravir; Rilpivirine: (Moderate) Administer antacids at least two hours before or four hours after taking oral cabotegravir.

This interaction may be due to surface absorption of the antibacterial onto the antacid. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Captopril: (Major) Antacids can decrease the GI absorption of captopril if administered simultaneously. Valproic Acid, Divalproex Sodium: (Minor) Antacids containing magnesium and aluminum hydroxide have been shown to increase valproic acid AUC by an average of 12%. Omadacycline: (Moderate) Separate administration of omadacycline and antacids by 4 hours. Polysaccharide-Iron Complex: (Moderate) Doses of antacids and iron should be taken as far apart as possible to minimize the potential for interaction. Examples of compounds that may interfere with quinolone bioavailability include antacids that contain magnesium hydroxide. Methenamine; Sodium Acid Phosphate: (Major) The therapeutic action of methenamine requires an acidic urine. Delafloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Due to the formation of ionic complexes in the gastrointestinal tract, simultaneous administration results in lower elvitegravir plasma concentrations. Magnesium hydroxide is relatively contraindicated in patients with colostomy, diverticulitis, or ileostomy because it increases the risk of developing electrolyte imbalance. Antacids, Magnesium-basedMagnesium SupplementsOsmotically-Acting Laxatives, Magnesium hydroxide is an oral saline laxative; also known as milk of magnesiaUsed most commonly for occasional constipation in adult and pediatric patients 2 years and olderCan be used as an antacid although it is usually combined with an aluminum- or calcium-containing antacid for this use, Dulcolax, Ex-Lax, Fleet, Phillips Milk of Magnesia, Dulcolax/Ex-Lax/Magnesium Hydroxide/Phillips Milk of Magnesia Oral Susp: 5mL, 15mL, 400mg, 1200mgDulcolax/Fleet Oral Tab Chew: 400mg, 1200mg. Daily doses of rifampin should be given at least 1 hour before the ingestion of antacids. Magnesium hydroxide is administered orally. Single use of magnesium citrate solution for bowel cleansing may warrant caution if significant renal impairment exists. (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Ezetimibe; Simvastatin: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. The oral absorption of phenytoin may be reduced by calcium carbonate (e.g., as found in antacids) or other calcium salts. Indomethacin: (Moderate) Antacids may inhibit the oral absorption of indomethacin.

Coadministration may impair absorption of demeclocycline which may decrease its efficacy. Calcium carbonate is generally considered the first choice for antacid use during breast-feeding, but magnesium hydroxide is also considered compatible. Anticholinergics: (Moderate) Antacids may inhibit the oral absorption of anticholinergics. Check with your physician if you have health questions or concerns. (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. PDR.net is to be used only as a reference aid. Bempedoic Acid; Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. Rosuvastatin: (Moderate) Coadministration of rosuvastatin with antacids has reduced rosuvastatin plasma concentrations by 54%. It is recommended to separate times of administration. (Moderate) Concurrent administration of rilpivirine and antacids may significantly decrease rilpivirine plasma concentrations, potentially resulting in treatment failure. The effects of antacids on erlotinib pharmacokinetics has not been evaluated. Magnesium and aluminum hydroxide antacids may increase the blood concentration of tacrolimus. Ezetimibe: (Minor) Antacids may decrease the peak plasma concentration (Cmax) of total ezetimibe by 30%. Aluminum/magnesium hydroxide antacids decrease the AUC of mycophenolic acid by about 17% when given as mycophenolate mofetil. Chlorpheniramine; Hydrocodone: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption. Acetaminophen; Dextromethorphan: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected.

This may lead to increased amphetamine concentrations. Side effects of magnesium hydroxide include: This document does not contain all possible side effects and others may occur. Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. In addition, some antacids like calcium carbonate, share the potential with the citrate salts for development of metabolic alkalosis, when given in higher dosage. Taking these drugs simultaneously may result in reduced bioavailability of dolutegravir. Max: 3 tablets/day. Norfloxacin: (Major) Administer magnesium hydroxide at least 2 hours before or 2 hours after norfloxacin. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed. Coadministration may impair absorption of sarecycline which may decrease its efficacy. Acetaminophen; Propoxyphene: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected.

400 mg to 1,200 mg (5 mL to 15 mL of original strength suspension) as a single dose PO; may repeat up to 4 times per day if needed or as directed by a physician.

The federal Omnibus Budget Reconciliation Act (OBRA) regulates the use of medications in residents of long-term care facilities. At higher pH values, iron is more readily ionized to its ferric state and is more poorly absorbed.

1 to 3 tablets/day PO as a single dose or in divided doses. Ciprofloxacin: (Moderate) Administer oral ciprofloxacin at least 2 hours before or 6 hours after magnesium hydroxide. Velpatasvir solubility decreases as pH increases; therefore, drugs that increase gastric pH are expected to decrease the concentrations of velpatasvir, potentially resulting in loss of antiviral efficacy. Closely monitor patients for changing analgesic requirements or adverse events. Naproxen: (Minor) Concomitant administration of antacids can delay the absorption of naproxen. Magnesium may cause tocolysis in late pregnancy, but this is not a risk with the occasional use of over-the-counter preparations. Consider closely monitoring blood glucose concentrations. Acetaminophen; Pseudoephedrine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Long-term use of diuretics may impair the magnesium-conserving ability of the kidneys and lead to hypomagnesemia. Amphetamines: (Moderate) Antacids and other gastrointestinal alkalinizing agents increase the oral absorption of amphetamines. Conversely, exposure to itraconazole is increased when antacids are administered with the 65 mg itraconazole capsule. When a magnesium hydroxide-containing antacid was administered immediately after capecitabine, the AUC and Cmax of capecitabine increased by 16% and 35%, respectively; the AUC and Cmax of metabolite 5'-DFCR increased by 18% and 22%, respectively. It may be prudent to separate dosing by 2 hours to limit any potential interaction. 10 Things People With Depression Wish You Knew, Magnesium hydroxide (400 mg/5 mL): 30-60 mL/day orally at bedtime or in divided doses, Magnesium hydroxide (800 mg/5 mL): 15-30 mL/day orally at bedtime or in divided doses, Chewable tablet: 8 tablets/day orally at bedtime or in divided doses, Magnesium hydroxide (400 mg/5 mL): 5-15 mL orally every 4 hours; no more than 4 doses per 24-hour period, Chewable tablet: 2-4 tablets orally every 4 hours; no more than 4 doses per 24-hour period, 2-6 years: 5-15 mL/day of regular-strength liquid orally at bedtime or in divided doses, 6-12 years: 15-30 mL/day (400 mg/5 mL) or 7.5-15 mL/day (800 mg/5 mL) orally at bedtime or in divided doses, 12 years and older: 30-60 mL/day (400 mg/5 mL) or 15-30 mL/day (800 mg/5 mL) orally at bedtime or in divided doses, 3-6 years: 2 tablets orally once daily or in divided doses, 6-12 years: 4 tablets orally once daily or in divided doses, 12 years and older: 8 tablets orally once daily or in divided doses, 12 years and older: 5-15 mL (400 mg/5 mL) orally every 4 hours; no more than 4 doses per 24-hour period, 12 years and older: 2-4 tablets orally every 4 hours; no more than 4 doses per 24-hour period, See "What Are Side Effects Associated with Using Magnesium Hydroxide? Closely monitor patients for changing analgesic requirements or adverse events. Ciprofloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. 0.5 mL/kg/day PO as a single dose. Captopril; Hydrochlorothiazide, HCTZ: (Major) Antacids can decrease the GI absorption of captopril if administered simultaneously. Trospium: (Moderate) Antacids may inhibit the oral absorption of antimuscarinics. Gefitinib: (Major) Avoid coadministration of antacids with gefitinib if possible due to decreased exposure to gefitinib, which may lead to reduced efficacy. Bictegravir; Emtricitabine; Tenofovir Alafenamide: (Moderate) Administer bictegravir on an empty stomach 2 hours before or 6 hours after taking antacids containing aluminum or magnesium. For use under health care professional advice only. Closely monitor patients for changing analgesic requirements or adverse events. Although the effects of locally-acting antacids on pexidartinib pharmacokinetics have not been studied, other acid-reducing agents have been shown to decrease pexidartinib exposure by 50%. When chronic high doses are avoided, magnesium hydroxide appears to be safe and effective to use during pregnancy to relieve constipation, dyspepsia, and pyrosis. Coadministration may decrease sotorasib exposure resulting in decreased efficacy. Carbonic anhydrase inhibitors: (Moderate) Diuretics may interfere with the kidneys ability to regulate magnesium concentrations. Acidifying Agents: (Major) Aluminum hydroxide and magnesium hydroxide (as well as other antacids, i.e. No specific dosage adjustment is needed for hepatic impairment, unless the patient also has renal dysfunction. In healthy subjects, the AUC of acalabrutinib was decreased by 53% when acalabrutinib was coadministered with another antacid. Acetaminophen; Dextromethorphan; Guaifenesin; Pseudoephedrine: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. Coadministration may impair absorption of tetracycline which may decrease its efficacy. Guaifenesin; Hydrocodone: (Minor) Concurrent use of hydrocodone with strong laxatives that rapidly increase gastrointestinal motility, such as magnesium hydroxide, may decrease hydrocodone absorption.

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