Aluminum Hydroxide, History, Action, Uses, Dosage, Side effects, Precaution, and 15 Brands.

Introduction

Aluminum Hydroxide is an antacid medication used to treat heartburn, indigestion, and upset stomach. chemical formula Al(OH), is an over-the-counter (OTC) medication, it is available in various formulations, including tablets, capsules, and liquid suspensions.

Aluminum Hydroxide exhibits amphoteric properties, it possesses both basic and acidic characteristics, allowing it to neutralize stomach acid and provide relief from gastrointestinal discomfort. Its unique properties and versatility make it dominant in many treatment regimens for acid reflux and ulcer management.

History of Aluminum Hydroxide

Early History (1827-1880s)

• Friedrich Wöhler discovers Aluminum Hydroxide in 1827
• Initially used as a precipitating agent in chemical reactions
• Later used in water purification and paper production.

Development as an Antacid (1880s-1920s)

• Aluminum Hydroxide’s antacid properties were discovered in the late 1800s
• First used to treat heartburn and indigestion in the early 1900s
• Becomes widely used as an antacid in the 1920s.

Commercialization and Expansion (1920s-1950s)

• Aluminum Hydroxide is commercialized and marketed as an antacid
• Becomes widely available over-the-counter (OTC)
• Use expands to treat acid reflux, GERD, and stomach ulcers.

Research and Development (1950s-1980s)

• Studies conducted on Aluminium Hydroxide’s mechanism of action
• New formulations and preparations developed (e.g., chewable tablets)
• Use in hyperphosphatemia treatment discovered.

Modern Era (1980s-Present)

• Aluminum Hydroxide remains a widely used antacid and antiulcer medication
• Continued research on its uses and potential interactions
• Availability in various forms (tablets, capsules, liquid suspensions).

Mechanism of action

A detailed explanation of the mechanism of action of Aluminum Hydroxide are:

Neutralization of Stomach Acid

• Aluminum Hydroxide reacts with hydrochloric acid in the stomach to form aluminum chloride and water:
  Al(OH)3 + 3HCl ? AlCl3 + 3H2O
• This reaction reduces the amount of stomach acid, providing quick relief from heartburn and indigestion.

Antacid Effect

• Aluminum Hydroxide acts as a buffer, neutralizing excess stomach acid and maintaining a pH balance in the stomach:
  Al(OH)3 + H+ ? Al(OH)2+ + H2O
• This helps to alleviate symptoms of acid reflux and GERD.

Protection of Mucous Lining

• Aluminum Hydroxide forms a protective barrier on the mucous lining of the stomach and intestines, preventing damage from stomach acid and pepsin:
  Al(OH)3 + H+ ? Al(OH)2+ + H2O
• This helps to heal and protect the mucous lining, reducing inflammation and ulceration.

Inhibition of Pepsin Activity

• Aluminum Hydroxide inhibits the activity of pepsin, a digestive enzyme that breaks down proteins:
  Al(OH)3 + pepsin ? Al-pepsin complex
• This reduces protein degradation and helps to alleviate symptoms of indigestion and upset stomach.

Absorption and Elimination

Aluminum Hydroxide is not absorbed into the bloodstream and is eliminated in the faeces, making it a safe and effective treatment for gastrointestinal issues.

Uses of Aluminium Hydroxide

Aluminum hydroxide’s medical utility spans across a wide spectrum of conditions, making it a versatile and essential component in healthcare. Here’s a breakdown of its various medical uses:

1. Antacid:

Aluminum hydroxide effectively neutralizes stomach acid, providing rapid relief from heartburn, indigestion, and upset stomach.

2. Antiulcer

By protecting the mucous lining of the stomach and intestines,  It is used for the healing and prevention of ulcers, offering long-term gastrointestinal comfort.

3. Antireflux

It is used in the treatment of acid reflux and gastroesophageal reflux disease (GERD), helping to alleviate symptoms and prevent oesophagal damage.

4. Phosphate Binder

In patients with kidney disease experiencing hyperphosphatemia, aluminum hydroxide is used as a phosphate binder, regulating phosphate levels to prevent complications.

5. Gastrointestinal Protector

Aluminum hydroxide shields the gastrointestinal tract from irritation and inflammation, fostering a healthy digestive environment.

6. Peptic Ulcer Treatment

It is utilized in the management of peptic ulcers, including gastric and duodenal ulcers, aiding in their healing and reducing associated discomfort.

7. Gastroesophageal Reflux Treatment:

Aluminum hydroxide effectively treats GERD and acid reflux, reducing symptoms such as heartburn and regurgitation to improve quality of life.

8. Indigestion Relief:

It is used for Symptoms of indigestion, including bloating, gas, and stomach discomfort, which are alleviated by aluminum hydroxide’s antacid properties.

9. Stomach Upset Relief:

Aluminum hydroxide provides relief from various symptoms of stomach upset, including nausea, vomiting, and stomach pain, restoring comfort and well-being.

Dosage

The dosage of aluminum hydroxide can vary depending on the specific formulation and the individual’s medical condition. It’s essential to follow the instructions provided by a healthcare professional or those outlined on the medication label. However, here are some general dosage guidelines for common uses:

For Antacid:

• For adults and children 12 years and older: Take 600 to 1200 milligrams (mg) of aluminum hydroxide orally every 4 to 6 hours as needed, up to a maximum of 4,800 mg per day.
• For children under 12 years old: The dosage should be determined by a healthcare provider based on weight and medical condition.

For Antiulcer:

• The dosage for treating ulcers typically ranges from 300 to 600 mg of aluminium hydroxide orally, taken 4 times daily, or as directed by a healthcare provider.

For Phosphate Binder:

• The dosage for treating hyperphosphatemia in patients with kidney disease varies depending on phosphate levels and individual response to treatment. A healthcare provider will determine the appropriate dosage regimen.

For Gastroesophageal Reflux Disease (GERD) and Acid Reflux:

• The recommended dosage for GERD and acid reflux typically range from 600 to 1200 mg of it orally, taken as needed for symptom relief.

Indigestion and Stomach Upset:

• For relief of symptoms of indigestion and stomach upset, the dosage is similar to that of antacid use, typically ranging from 600 to 1200 mg orally every 4 to 6 hours as needed.

Side effects

Aluminum hydroxide is generally safe when used as directed, but can potentially cause side effects. some common and serious side effects are the following:

Common Side Effects:

• Stomach Issues: Aluminum hydroxide causes stomach upset, leading to constipation, diarrhoea, cramps, nausea, and vomiting.
• Gas and Bloating: It can also cause gas and bloating, leading to discomfort and abdominal pain.
• Headache and Dizziness: Some people experience headaches and dizziness after taking it.
• Fatigue: It can also cause fatigue and tiredness.

Serious Side Effects:

• Severe Stomach Pain: In rare cases, aluminum hydroxide can cause severe stomach pain, which can be a sign of a more serious condition.
• Bloody Stools or Vomit: If you experience bloody stools or vomit, it may be a sign of a serious side effect.
• Breathing Difficulties: Aluminum hydroxide can cause breathing difficulties, such as shortness of breath or wheezing.
• Swelling and Hives: Some people may experience swelling and hives, which can be a sign of an allergic reaction.
• Muscle Weakness and Seizures: In rare cases, it cause muscle weakness and seizures.
• Heartbeat and Phosphate/Magnesium Level Issues: It can also affect heartbeat and phosphate/magnesium levels, leading to serious health issues.

Precautions for Aluminum Hydroxide

Aluminum hydroxide is generally considered safe for most individuals, there are some precautions to be aware of when using this medication:

Medical History: Inform your healthcare provider about any medical conditions you have, especially kidney disease, gastrointestinal disorders, or electrolyte imbalances. These conditions may affect how your body responds to aluminum hydroxide.

Allergies: If you have a known allergy to aluminum hydroxide or any other medications, inform your doctor. Allergic reactions to its are rare but can be serious.

Drug Interactions: Aluminum hydroxide interacts with certain medications, including antibiotics, heart medications, and antacids containing calcium carbonate. Inform your healthcare provider about all the medications you are taking, including prescription, over-the-counter, and herbal supplements.

Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, consult your doctor before using aluminum hydroxide. it is generally considered safe during pregnancy and breastfeeding, it’s important to discuss the potential risks and benefits with your healthcare provider.

Dietary Considerations: Aluminum hydroxide can affect the absorption of other medications and nutrients. Take it at least 1-2 hours before or after taking other medications or consuming foods high in phosphorus or calcium.

Hydration: Ensure adequate hydration while taking it, especially if experiencing diarrhoea or vomiting. Dehydration can worsen constipation, a common side effect of it.

Regular Monitoring: If using it for as long as a phosphate binder, your healthcare provider monitors your kidney function, phosphate levels, and electrolyte levels regularly to prevent complications.

Dosage and Duration: Take it as directed by your healthcare provider or as indicated on the medication label. Do not exceed the recommended dosage or use it for longer than prescribed without medical supervision.

Aluminum Hydroxide brands

The aluminium hydroxide products available in Pakistan are listed below:

1. Trisil tablet
2. Mucaine Suspension
3. Dijex MP syrup
4. Manacid Syrup
5. Alex
6. Antanil
7. Apcocid
8. Biocid
9. Biocid MH
10. Cytocid
11. Dolocid
12. Duomeal
13. Entacyd
14. Epazel
15. G-Antacid
16. Hi Gel
17. Hydrocid
18. Jpdrox
19. Lactameal.