Maalox side effects. How to take Maalox - instructions for use. Pregnancy and breastfeeding

In this article, you can read the instructions for using the drug Maalox. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Maalox in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Maalox in the presence of existing structural analogues. Use for the treatment of gastritis and ulcers of the gastrointestinal tract in adults, children, as well as during pregnancy and lactation.

Maalox- An antacid. Neutralizes free hydrochloric (hydrochloric) acid, which leads to a decrease in the peptic activity of gastric juice. Does not cause secondary hypersecretion. It also has an adsorbing and enveloping effect, reducing the impact of damaging factors on the mucous membrane.

Compound

Algeldrate (aluminum hydroxide) + Magnesium hydroxide (in the form of a gel) + excipients.

Pharmacokinetics

Magnesium and aluminum hydroxides are considered topical antacids that are practically not absorbed when taken orally at recommended doses.

Indications

peptic ulcer of the stomach and duodenum in the acute phase;
acute gastroduodenitis;
chronic gastroduodenitis with normal or increased secretory function in the acute phase;
hiatal hernia;
reflux esophagitis;
dyspepsia phenomena (and their prevention) resulting from the use of certain drugs (including non-steroidal anti-inflammatory drugs, glucocorticosteroids);
discomfort or pain in the epigastrium, heartburn with errors in the diet, excessive consumption of coffee, alcohol, nicotine.

Release form

Chewable tablets.

Suspension for oral administration (including Maalox mini).

Instructions for use and regimen

Suspension

Maalox is usually taken 1-1.5 hours after a meal or when pain occurs. Maalox in the form of a suspension is taken in 15 ml (1 package). Before use, homogenize the suspension by carefully kneading the bag between the fingers. Squeeze the contents of the package into a spoon or mouth.

For children, the dosage is determined by the attending physician.

If necessary, you can take an additional dose of the drug 2 hours after the previous dose, but not more than 6 doses per day.

Pills

For adults, the drug is prescribed 1-2 tablets or 15 ml (1 tablespoon) suspension 3-4 times a day 1-2 hours after meals and at night.

With reflux esophagitis, the drug is taken after a shorter period of time after meals. Duration of admission should not exceed 2-3 months.

With occasional use (for example, with discomfort after errors in the diet), take 1-2 tablets or 15 ml of the suspension once.

Maalox mini

The contents of 1-2 mini-packets are taken orally 1-1.5 hours after a meal or when heartburn occurs. If necessary, you can take an additional dose of the drug 2 hours after the previous dose. The maximum daily dose is 12 mini-packets. The course of treatment is no more than 2-3 months.

For occasional use, for example, with discomfort after errors in the diet, take 1-2 mini-packets once.

Before opening the mini-package, gently mix the contents of the package by kneading the package between your fingers. Squeeze the contents of the package into a spoon or into the mouth (take the suspension without prior dilution).

Side effect

diarrhea;
constipation;
nausea, vomiting;
change in taste sensations;
hypophosphatemia (especially with a low phosphate content in food);
hypercalciuria;
nephrocalcinosis;
hypocalcemia;
osteoporosis;
development of thirst;
decrease in blood pressure;
encephalopathy;
dementia;
microcytic anemia.

Contraindications

severe renal failure;
hypophosphatemia;
sucrase / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption (due to the presence of sorbitol and sucrose in the preparation);
children and adolescence (up to 15 years);
hypersensitivity to the components of the drug.

Use during pregnancy and lactation

To date, no specific teratogenic effects have been identified with the use of Maalox during pregnancy, however, due to the lack of clinical experience, its use during pregnancy is possible only in low doses, for a short time and in cases where the potential benefit of therapy for the mother justifies the potential risk to fetus.

If it is necessary to use the drug Maalox during lactation, stopping breastfeeding is not required.

In experimental studies on animals, no clear data on the presence of a teratogenic effect in aluminum hydroxide and magnesium hydroxide have been obtained.

special instructions

If during treatment the symptoms of the gastrointestinal tract persist for more than 10 days or there is a deterioration in the condition, then the diagnosis should be clarified and the treatment should be corrected.

A 2-hour interval between the use of Maalox and other drugs and a 4-hour interval between taking Maalox and fluoroquinolones should be observed.

Long-term administration of Maalox should be avoided in case of impaired renal function. When prescribing Maalox to patients with mild to moderate renal insufficiency, plasma concentrations of aluminum and magnesium should be carefully monitored, and if they increase, the use of the drug should be immediately discontinued.

Algeldrate with a low content of phosphates in food can lead to the development of phosphorus deficiency in the body. Therefore, when using it, especially for a long time, it is necessary to ensure sufficient intake of phosphates from food.

One mini-package of the drug contains 3.15 g of sucrose and 0.2 g of sorbitol, respectively, the maximum daily dose contains 37.80 g of sucrose and 2.4 g of sorbitol.

Despite the fact that the drug is available without a prescription, it is recommended to consult a doctor before using the drug during pregnancy and lactation (breastfeeding), as well as in adolescents over 15 years of age and patients with mild to moderate renal insufficiency.

Influence on the ability to drive vehicles and control mechanisms

The drug does not affect the ability to drive vehicles and work with mechanisms.

drug interaction

With simultaneous use with quinidine, an increase in serum concentrations of quinidine and the development of an overdose of quinidine are possible.

When taken simultaneously with Maalox, the absorption of the following drugs from the gastrointestinal tract is reduced: acetylsalicylic acid (and other salicylates), histamine H2 receptor blockers, propranolol, atenolol, metoprolol, chloroquine, diflunisal, digoxin, bisphosphonates, ethambutol, isoniazid, fluoroquinolone, sodium fluoride , GCS (described for prednisolone and dexamethasone), indomethacin, lansoprazole, lincosamides, levothyroxine sodium, ketoconazole, sodium polystyrene sulfate, penicillamine, iron salts, tetracyclines, phenothiazine antipsychotics, phosphorus-containing nutritional supplements, fexofenadine. In the case of a 2-hour interval between taking these drugs and Maalox and a 4-hour interval between taking fluoroquinolones and Maalox, in most cases, unwanted interactions can be avoided.

With the simultaneous administration of salicylates and the drug Maalox, the excretion of salicylates in the urine increases as a result of alkalinization of urine under the influence of the drug Maalox.

When aluminum hydroxide is combined with citrates, an increase in plasma concentrations of aluminum is possible, especially in patients with renal insufficiency.

Analogues of the drug Maalox

Structural analogues for the active substance:

Agiflux;
Almagel;
Almol;
Alumag;
Anacid forte;
gastracid;
Maalox mini;
Rivolox.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Maalox: instructions for use and reviews

Latin name: Maalox

ATX code: A02AD01

Active substance: algeldrate + magnesium hydroxide (algeldrate + magnesium hydroxide)

Manufacturer: Pharmatis (for Laboratoire Theraplix) (France), Sanofi-Aventis S.p.A. (Italy)

Description and photo update: 14.08.2019

Maalox is an antacid.

Release form and composition

Dosage forms:

Chewable tablets: round, flat-cylindrical, white, with a chamfer and engraved "Mx" (10 pcs. in blisters, in a carton pack 1, 2 or 4 blisters);
Suspension for oral administration: milk-like liquid of white or almost white color, with a mint smell (250 ml in dark glass bottles, 1 bottle in a cardboard box; 15 ml in bags (sachets), 30 bags in a cardboard box).

Active ingredients of Maalox:

Algeldrate (in the form of aluminum hydroxide): in 1 tablet - 0.4 g (equivalent to 0.2 g of aluminum oxide), in 100 ml of suspension - 3.5 g;
Magnesium hydroxide: in 1 tablet - 0.4 g, in 100 ml of suspension - 4 g.

Auxiliary components:

Tablets: sodium saccharinate, starch with sucrose (confectionery sugar), sucrose, sorbitol, magnesium stearate, mannitol, peppermint flavor;
Suspension: sodium saccharinate, concentrated hydrochloric acid 10%, peppermint leaf oil, citric acid monohydrate, hydrogen peroxide 30%, methyl parahydroxybenzoate, mannitol, propyl parahydroxybenzoate, sorbitol 70%, purified water.

Pharmacological properties

Pharmacodynamics

Maalox neutralizes unbound hydrochloric acid without causing secondary hypersecretion of this compound. Its intake contributes to an increase in pH, which leads to a decrease in the peptic activity of gastric juice. The drug is also characterized by an enveloping and adsorbing effect, as a result of which the influence of damaging factors on the mucous membrane decreases.

Pharmacokinetics

Algeldrate (aluminum hydroxide) and magnesium hydroxide are local antacids and are practically not absorbed when taken in therapeutic doses, so there are no systemic effects when using Maalox.

Indications for use

Exacerbation of peptic ulcer of the stomach and duodenum;
Exacerbation of chronic gastroduodenitis with normal or increased secretory function;
Gastroduodenitis in acute form;
Reflux esophagitis;
Treatment and prevention of dyspeptic phenomena that occur against the background of the use of glucocorticosteroids, non-steroidal anti-inflammatory drugs and other drugs;
Hernia of the esophageal opening of the diaphragm;
Heartburn, discomfort or pain in the epigastrium, sour belching that occurs with excessive use of alcohol, coffee, nicotine or errors in the diet.

Contraindications

For tablets:

Hypersensitivity to the components of the drug;
Severe renal dysfunction.

For suspension:

Glucose-galactose malabsorption, sucrase or isomaltase deficiency, fructose intolerance;
Severe renal failure;
hypophosphatemia;
Age up to 15 years.

Under regular medical supervision, Maalox suspension should be used: in patients with impaired renal function (since there is a risk of increasing plasma concentrations of aluminum and magnesium, and long-term use in high doses (including high therapeutic doses) can cause the development of dementia, encephalopathy, microcytic anemia); patients with porphyria on hemodialysis; diets low in phosphate (risk of developing phosphate deficiency).

According to the instructions, Maalox should be administered with caution in both dosage forms to patients with Alzheimer's disease; during pregnancy and breastfeeding.

Instructions for use Maalox: method and dosage

Maalox tablets are taken orally, chewed thoroughly. Recommended dosage: 1-2 tablets 3-4 times a day 1-2 hours after meals and at bedtime. With reflux esophagitis, the interval between meals and taking pills should be shortened. The course of treatment is no more than 2-3 months. For episodic use, a single dose of 1-2 tablets is indicated;

Suspension Maalox is intended for oral administration in undissolved form. The drug in the sachet should be thoroughly kneaded with your fingers beforehand. Recommended dosage for adults and children over 15 years old: 15 ml 1-2 hours after each meal and in case of heartburn or epigastric pain. The maximum daily dose is not more than 90 ml. With reflux esophagitis, the suspension should be taken 0.5-1 hour after a meal, gastric ulcer - 0.5 hour before a meal. The course of treatment is no more than 2-3 months. With episodic use, associated, for example, with discomfort after errors in the diet - 15 ml once. Patients with impaired renal function should not be prescribed the drug for a long period and / or in high doses.

Side effects

Tablets: in case of impaired renal function and / or against the background of long-term therapy - an increase in the content of magnesium and / or aluminum in the blood plasma, encephalopathy, lack of phosphorus in the body, exacerbation of Alzheimer's disease and musculoskeletal pathologies in elderly patients;
Suspension: rarely - diarrhea; with prolonged use of high doses - hypophosphatemia (more often with a low-phosphate diet), nephrocalcinosis, hypercalciuria, hypocalcemia, osteomalacia, osteoporosis, functional disorder of the kidneys. In case of impaired renal function: possibly - hyporeflexia, an increase in the level of plasma concentrations of aluminum and / or magnesium, the development of a feeling of thirst, a decrease in blood pressure; rarely - with prolonged use of high doses, the development of dementia, encephalopathy, microcytic anemia is possible.

In addition, in rare cases, the use of Maalox causes an upset of the digestive system in the form of a change in taste sensations, nausea, constipation, and vomiting.

Overdose

Symptoms of acute overdose associated with taking a drug that includes salts of magnesium and aluminum hydroxide include vomiting, diarrhea and pain in the abdomen. In patients at risk, the introduction of Maalox in high doses may provoke or exacerbate conditions such as intestinal obstruction or intestinal obstruction.

Since magnesium and aluminum are excreted through the kidneys, treatment of acute overdose includes fluid replacement and forced diuresis. Patients with renal insufficiency are recommended to undergo peritoneal dialysis or hemodialysis.

special instructions

In case of impaired renal function, the drug should be administered with caution.

If it is necessary to prescribe Maalox tablets to children under 12 years of age, the dosage regimen should be set individually, according to clinical indications.

If symptoms persist or the condition of the gastrointestinal tract worsens after 10 days of taking the suspension, you should consult a doctor to clarify the diagnosis and correct therapy.

The use of the drug in adolescents, during pregnancy and breastfeeding, as well as in mild to moderate renal failure should be started only after consulting a doctor.

Since the action of algeldrate with a low-phosphate diet can contribute to the development of phosphorus deficiency in the body, it is recommended to provide the patient with food rich in phosphates, especially during long-term therapy.

Maalox does not affect the ability of patients to drive vehicles and mechanisms.

Use during pregnancy and lactation

There is no clear indication from animal studies that aluminum hydroxide and magnesium hydroxide are likely to be teratogenic. To date, specific teratogenic effects have not been identified with the use of Maalox during pregnancy, however, due to insufficient clinical experience, its administration to pregnant women is possible only in cases where the potential benefit of treatment for the mother significantly outweighs the possible risks to the fetus.

drug interaction

If a two-hour break between doses is not observed, Maalox tablets reduce the absorption of the following concurrently used drugs: tetracyclines, acetylsalicylic acid (and other salicylates), atenolol, propranolol, metoprolol, diflunisal, chloroquine, digoxin, H2-histamine receptor blockers, bisphosphonates, sodium fluoride, isoniazid, ethambutol, fluoroquinolones, glucocorticosteroids (described for dexamethasone and prednisolone), lansoprazole, indomethacin, lincosamides, ketoconazole, levothyroxine sodium, sodium polystyrene sulfate, iron salts, penicillamine, phenothiazine antipsychotics, fexofenadine, phosphorus-containing nutritional supplements.

To avoid undesirable interaction of the drug with fluoroquinolones, the break in admission should not be less than 4 hours.

When combined with quinidine, it is possible to increase the level of its concentration in the blood serum, which can cause an overdose of quinidine.

Against the background of alkalization of urine under the action of Maalox, with the simultaneous use of salicylates, their excretion in the urine increases.

Concomitant therapy with citrates may increase the level of aluminum concentration in the blood plasma, especially in patients with renal insufficiency.

Analogues

Analogues of Maalox are: Ajiflux, Alumag, Almagel, Almol, Almagel Neo, Altacid, Anacid Forte, Palmagel, Maalox Mini, Gastracid, Maalukol, Rivoloks, Phosphalugel.

Terms and conditions of storage

Store below 25°C. Keep away from children.

Shelf life: chewable tablets - 5 years, oral suspension - 3 years.

Unfortunately, disorders of the digestive tract can hardly be considered a rarity. And most people at least once in their lives faced such an unpleasant problem as heartburn. This phenomenon significantly impairs the patient's quality of life. That is why drugs that help get rid of this phenomenon are more than in demand today.

Modern pharmaceuticals offer a huge selection of such drugs. And many patients are interested in questions about what the Maalox drug is, indications for use and the effect of taking it. Are there side effects? Are there any contraindications? Can the drug be used by pregnant women? This information will be useful to many readers.

Forms of drug release

Liquid suspension and tablets are the forms of release of the drug "Maalox". The suspension is a white liquid with a slight mint odor. It is sold either in glass bottles with a volume of 250 ml, or in small bags.

In the pharmacy, you can buy small round-shaped white tablets, which also have a mild mint smell and taste.

The chemical composition of the tablets

The drug contains two active ingredients at once. Each Maalox tablet contains 400 mg of magnesium hydroxide and aluminum hydroxide. As auxiliary agents in the manufacture of the drug, substances such as sodium saccharinate, powdered mint flavor, mannitol, sorbitol, as well as magnesium stearate, sucrose and powdered sugar with starch are used.

Tablets are placed in blisters of 10 pieces. Today they sell cardboard packs with two or four blisters.

The composition of the suspension "Maalox"

What does this form of the drug "Maalox" consist of? The suspension, of course, contains the same active substances. In 100 ml of liquid there are 4 g of sodium hydroxide and 3.5 g of aluminum hydroxide. Purified water is used as the basis for the preparation of the suspension. In addition, the medicine contains some excipients - hydrogen peroxide, concentrated hydrochloric acid, as well as mannitol, sodium saccharin, sorbitol, citric acid monohydrate, methyl parahydroxybenzoate, peppermint essential oil and propyl parahydroxybenzoate.

Main pharmacological properties

"Maalox" today is considered one of the most effective and fast-acting antacids. Its active ingredients have the ability to quickly neutralize free hydrochloric acid, which is present in gastric juice and often causes severe heartburn.

Under the influence of the drug, an increase in the pH of gastric juice occurs, which leads to a decrease in the activity of the pepsin enzyme. On the other hand, the drug has strong enveloping and adsorbing properties. Thus, it neutralizes the impact of negative factors on the mucous membrane of the stomach and esophagus.

It is worth noting that aluminum and magnesium hydroxide have a local effect. These components are practically not adsorbed into the blood.

The drug "Maalox": indications for use

In fact, this drug helps to eliminate a lot of problems caused by a violation in the digestive system. So when do doctors prescribe Maalox to patients? Indications for use are as follows:

The drug is recommended for patients with peptic ulcer of the stomach and intestines in the acute phase.
The indications include acute gastroduodenitis and the chronic form of the disease at the stage of exacerbation.
The medicine is indispensable for reflux esophagitis, as well as hiatal hernia, which are often accompanied by severe heartburn.
It's no secret that taking certain medications is accompanied by various dyspeptic symptoms, in particular, heartburn, pain in the stomach, and sour belching. In such cases, the drug "Maalox" also helps to cope with the symptoms, and is sometimes used to prevent such side effects.
This medicine also copes well with digestive disorders caused by errors in diet, smoking, abuse of alcoholic beverages and coffee.

How to take the drug "Maalox"? The instruction in this case is quite simple. Doctors recommend drinking one or two tablets 1 to 2 hours after a meal. Also, take the medicine mono at night, since it is during sleep that most patients suffer from heartburn.

By the way, in no case should you swallow a pill - it must be kept in your mouth until it is completely absorbed. If the discomfort in the abdomen is caused by an improper diet, then the medication can be taken once. In all other cases, you must adhere to the schedule prescribed by the doctor. But in any case, do not forget that the maximum duration of treatment is 2 - 3 months.

How to take the suspension "Maalox"? The instruction in this case states that the maximum single dose is 15 ml (this is approximately equal to one tablespoon of liquid). You need to take the medicine in the same way as tablets - 1 to 2 hours after eating or when discomfort occurs in the epigastric region. Before use, you need to shake the jar with the suspension.

In some cases, this drug is prescribed to children. But the dosage for small patients can only be determined by the attending physician.

Are there any contraindications to treatment?

The medicine "Maalox" perfectly copes with the symptoms of many diseases of the digestive system. Unfortunately, not everyone can accept it. To begin with, as a contraindication, it is worth noting the increased individual sensitivity of the patient to any of the constituent components. Otherwise, an allergic reaction may develop, the intensity of which will depend on the degree of sensitivity.

In addition, the drug is not prescribed to patients with severe renal failure. Hypophosphatemia is also considered one of the contraindications. And the medicine is not used to treat people suffering from sucrase deficiency or fructose intolerance. Given the presence of sorbitol in the preparation, glucose-galactose malabsorption is also a contraindication to therapy.

Naturally, there are so-called relative contraindications. For example, the treatment of people with certain disorders in the work of the kidneys is carried out very carefully. Patients with porphyria and Alzheimer's disease are also at risk. The drug should be used with caution if your diet contains a low amount of phosphates, as there is a risk of developing phosphate deficiency. Pregnancy and childhood are also considered relative contraindications, but with the correct dosage, the health risk is minimal.

Side effects from treatment

It is immediately worth noting that with the correct intake of Maalox tablets, it is extremely rare to lead to the development of certain abnormalities. Only occasionally do patients complain of some digestive disorders. In particular, sometimes therapy is associated with the appearance of constipation or, conversely, diarrhea. Some patients experience occasional nausea or vomiting. Much less often, the drug leads to a change in taste sensations.

But long-term use of this drug can affect the mineral balance in the body. Some patients develop hypophosphateria. Rare side effects include nephrocalcinosis, disruption of normal kidney function, as well as osteoporosis and osteomalacia, which are associated with a lack of certain beneficial substances in the body.

Very carefully it is necessary to use the drug for the treatment of patients with impaired renal function. The fact is that these people are most prone to the manifestation of adverse reactions. In particular, against the background of therapy, a decrease in blood pressure, the appearance of constant thirst, hyporeflexia are possible, microcytic anemia, encephalopathy and dementia develop much less frequently.

In any case, if any deterioration occurs, you should immediately seek medical help - you may have to replace the drug with an analogue or at least reduce the dose.

Interaction with other drugs

Be sure to tell your doctor about any other medicines you are taking before you start taking the medicine. For example, with the simultaneous use of Maalox with quinidine, the risk of overdose increases.

In addition, this drug slows down the absorption of drugs such as acetylsalicylic acid, glucocorticosteroids, ketoconazole, atenolol, propanolol, lincosamides, tetracyclines, fexofenadine, etc.

With the simultaneous administration of citrates, an increase in plasma concentrations of aluminum is possible, especially when it comes to patients with renal insufficiency.

Can pregnant women take the drug?

Pregnancy is an extremely important period in the life of every woman. Unfortunately, many of the fair sex at this stage have to deal with a lot of problems - hormonal disruptions, reduced immune defenses and, of course, digestive problems. In particular, many pregnant women suffer from heartburn, which is mainly the result of a sharp increase in the volume of the uterus due to the growth of the child. The fetus presses on all internal organs and often leads to the backflow of gastric juice into the esophagus.

Is it possible to use the drug "Maalox" to treat such heartburn? Indications for use indicate that it was to eliminate this problem that the medicine was created. But, as you know, during pregnancy, the range of permitted drugs is greatly reduced.

It should be said right away that studies on a group of pregnant women have not been conducted, so modern medicine does not have enough information to confirm the presence or absence of a teratogenic effect. On the other hand, some doctors still prescribe the drug to pregnant patients, but only if the expected positive effect for the mother outweighs the potential risks for the growing fetus.

Separately, it is worth talking about the use of medication during breastfeeding. Studies have shown that the active components of the drug do not penetrate into breast milk, so there is no need to stop feeding the baby for the duration of treatment.

The drug "Maalox": price. Suspension or tablets - which is cheaper?

Of course, the issue of cost for many patients is extremely important. And the drug "Maalox" in this regard can please customers. Do not forget that the cost may depend on many factors - this is the form of release, the manufacturer, and the financial policy of the pharmacy.

For example, Maalox Suspension, contained in a 250 ml bottle, will cost you about 300 rubles. The price of "Maalox-mini" will be the same - this is the same suspension, but only packaged in convenient bags, which, by the way, some pharmacies sell by the piece. This form of the drug is more convenient if you need to always keep it with you.

What is the cost of the tablet form of the drug "Maalox"? The price (tablets) is approximately 150 - 200 rubles - this package contains 20 pieces. The cost of 40 tablets ranges from 280 to 350 rubles.

The drug Maalox is another original antacid drug, along with Almagel, which is, in fact, a synonym for the latter and is used to correct pathological conditions caused by increased acidity of gastric juice .. Both of these drugs contain the same active ingredients - aluminum and magnesium hydroxide gel, as well as lemon flavoring. True, Maalox, unlike Almagel, is produced not only in suspension, but also in chewable tablets, which is a significant advantage in the competition between these two undoubtedly respected brands. The suspension of maalox resembles milk in its color and consistency, from which it can be distinguished by the characteristic mint smell of the essential oil introduced into the preparation. There is nothing remarkable in the tablets of Maalox, with the exception of the branded engraving "Mx".

The predetermining pharmacological effect of Maalox is a duet of its active ingredients, which is a well-thought-out and balanced combination that provides a stable neutralizing effect and a pronounced protective effect. Maalox "disarms" hydrochloric acid freely circulating in the lumen of the stomach. At the same time, despite the decrease in its active concentration, the body does not react to this by hypersecretion of chlorine and hydrogen ions, which can be safely written as an asset of maalox. A shift in the pH of the stomach to the alkaline side, in turn, reduces the digestive capacity of gastric juice.

The protective functions of Maalox are expressed in a decrease in the degree of impact on the gastric mucosa of various damaging factors, which is achieved due to the adsorbing and enveloping properties of the drug. If pathological processes in the digestive tract are accompanied by pain, then Maalox helps to alleviate them for several hours. The drug does not cause difficulty in defecation.

Maalox tablets should be thoroughly chewed or sucked. Adults and adolescents over the age of 15 are prescribed 1-2 tablets of the drug 3-4 times a day 1-2 hours after meals and at bedtime (no more than 6 doses per day). With reflux esophagitis (backward reflux of food from the stomach into the esophagus), Maalox should be taken almost immediately after a meal. The maximum daily dose is 12 tablets. The duration of the course of treatment should not exceed 2-3 months. Sporadic administration of the drug is also possible with unpleasant sensations after excessive gluttony. In such cases, 1-2 tablets of the drug are taken once. For a suspension of maalox, a single dose is 15 ml. For pediatric patients, the optimal dosage is determined by the pediatrician.

When taken simultaneously with other drugs along with maalox, it can to a certain extent reduce their adsorption in the digestive tract, so doctors recommend doing a two-hour temporary “backlash” both before and after taking maalox, outside of which other drugs can be taken.

Pharmacology

An antacid drug. Neutralizes free hydrochloric acid of gastric juice without causing its secondary hypersecretion. Due to the increase in the pH of gastric juice when taking the drug Maalox ®, the peptic activity of gastric juice decreases. The drug also has an adsorbing and enveloping effect, due to which the impact of damaging factors on the mucous membrane of the esophagus and stomach is reduced.

Pharmacokinetics

Magnesium hydroxide and aluminum hydroxide are considered topical antacids that are practically not absorbed when taken at recommended doses and, accordingly, do not have systemic effects.

Release form

Chewable tablets (without sugar) from white to yellowish color with slight marbling, round, flat-cylindrical, chamfered, engraved "MAALOX" on one side and "sans sucre" on the other, with a lemon smell.

Excipients: liquid sorbitol (non-crystallizing) - 157 mg (equivalent to 109.9 mg of sorbitol), maltitol - 632.62 mg, magnesium stearate - 16.36 mg, lemon flavor (flavors, natural flavors, acacia gum (E414), citric acid (E330) , butylhydroxyanisole (E320)) - 17 mg, sodium saccharinate - 1.9 mg, glycerol 85% - 30 mg (equivalent to 25.5 mg glycerol), talc - 32.72 mg.

10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (2) - packs of cardboard.
10 pieces. - blisters (4) - packs of cardboard.

Dosage

Tablets should be sucked or chewed thoroughly.

For adults and adolescents over 15 years of age, the drug is prescribed 1-2 tablets. 3-4 times / day 1-2 hours after meals and at night.

With reflux esophagitis, the drug is taken after a short period of time after a meal.

The maximum frequency of reception - 6 times / day. Do not take more than 12 tablets / day.

Duration of admission should not exceed 2-3 months.

With occasional use, for example, with discomfort after errors in the diet, take 1-2 tablets. once.

Overdose

Symptoms: Diarrhea, abdominal pain and vomiting are possible. In patients at risk, taking the drug in high doses may cause or exacerbate intestinal obstruction or intestinal obstruction.

Treatment: aluminum and magnesium are excreted in the urine. Fluid replacement and forced diuresis are performed. Patients with renal insufficiency require hemodialysis or peritoneal dialysis.

Interaction

With simultaneous use with quinidine, an increase in serum concentrations of quinidine and the development of an overdose of quinidine are possible.

When taken simultaneously with Maalox®, absorption from the gastrointestinal tract of the following drugs is reduced: histamine H 2 receptor blockers, propranolol, atenolol, cefdinir, cefpodoxime, metoprolol, chloroquine, prostacyclins, diflunisal, digoxin, bisphosphonates, ethambutol, isoniazid, fluoroquinolones, sodium fluoride , GCS (described for prednisolone and dexamethasone), indomethacin, ketoconazole, lincosamides, neuroleptics, phenothiazine derivatives, penicillamine, rosuvastatin, iron salts, sodium levothyroxine. In the case of a 2-hour interval between taking these drugs and Maalox ® and a 4-hour interval between taking fluoroquinolones and Maalox ®, in most cases this undesirable interaction can be avoided.

When using Maalox® with polystyrene sulfonate (kayexalate), caution should be exercised because of the possible risk of reducing the efficiency of potassium binding by the resin and the development of metabolic alkalosis in patients with renal insufficiency (for aluminum hydroxide and magnesium hydroxide) and intestinal obstruction (for aluminum hydroxide).

When aluminum hydroxide is combined with citrates, an increase in plasma concentrations of aluminum is possible, especially in patients with renal insufficiency.

Side effects

Determination of the frequency of undesirable effects (according to WHO classification): infrequently (≥0.1% and<1%); частота неизвестна (по имеющимся данным оценить частоту возникновения не представляется возможным).

From the immune system: the frequency is unknown - hypersensitivity reactions, anaphylactic reactions.

Allergic reactions: the frequency is unknown - itching, urticaria, angioedema.

From the digestive system: infrequently - diarrhea, constipation.

From the side of metabolism: the frequency is unknown - hypermagnesemia, hyperaluminemia, hypophosphatemia (with long-term treatment or high doses, or when taken in standard doses with a low phosphate content in food), which can lead to increased bone resorption, hypercalciuria, osteomalacia.

Indications

peptic ulcer of the stomach and duodenum in the acute phase;
acute gastroduodenitis;
chronic gastroduodenitis with normal or increased secretory function in the acute phase;
hiatal hernia;
reflux esophagitis;
dyspeptic phenomena such as discomfort or pain in the epigastrium, heartburn, sour eructation after errors in the diet, excessive consumption of ethanol, coffee, nicotine, etc.;
dyspeptic phenomena, such as discomfort or pain in the epigastrium, heartburn, acid belching (and their prevention), resulting from the use of certain drugs (including NSAIDs, corticosteroids).

Contraindications

severe renal failure;
hypersensitivity to active substances and other components of the drug;
hypophosphatemia;
fructose intolerance (due to the presence of sorbitol in the preparation);
glucose-galactose malabsorption syndrome, sucrase / isomaltase deficiency, (due to the presence of sucrose in the preparation) (for chewable tablets);
intolerance to maltitol (for chewable tablets (without sugar));
children and adolescents up to 15 years of age.

The drug should be used with caution in patients with porphyria who are on hemodialysis; with Alzheimer's disease; during pregnancy; for chewable tablets - for diabetes mellitus (due to the presence of sucrose in the preparation).

Application features

Use during pregnancy and lactation

At the moment, no specific teratogenic effects have been identified when using the drug Maalox ® during pregnancy, however, due to the lack of clinical experience with its use in pregnancy, the appointment is possible only if the potential benefit of therapy for the mother justifies the potential risk to the fetus.

When using the drug in accordance with the dosing regimen, the absorption of combinations of aluminum hydroxide and magnesium salts in the mother's body is limited, therefore Maalox ® is recognized as compatible with breastfeeding.

In preclinical studies in animals, there are no clear indications of the presence of a teratogenic effect in aluminum hydroxide and magnesium hydroxide.

Application for violations of kidney function

Contraindicated in severe renal impairment.

Use in children

Use in children and adolescents under the age of 15 is contraindicated.

special instructions

Aluminum hydroxide can cause constipation, an overdose of magnesium salts can lead to a weakening of intestinal motility; in patients at high risk (patients with renal insufficiency, the elderly), taking high doses of the drug may cause or exacerbate intestinal obstruction and intestinal obstruction.

Aluminum hydroxide is poorly absorbed from the gastrointestinal tract, so systemic exposure is rare in patients with normal renal function. However, prolonged treatment, the use of the drug in excessively high doses, or the use of the drug in usual doses against the background of a decrease in phosphate intake from food can lead to phosphate deficiency (due to the binding of aluminum to phosphate), which is accompanied by increased bone resorption and hypercalciuria with the risk of developing osteomalacia. Treatment of patients at risk of developing phosphate deficiency or long-term use of the drug should be carried out under medical supervision.

In violation of renal failure, an increase in plasma concentrations of magnesium and aluminum is possible. In these patients, with prolonged use of the drug Maalox ® in high doses, encephalopathy, dementia, microcytic anemia or aggravation of osteomalacia caused by dialysis may develop.

A 2-hour interval should be observed between the use of Maalox ® and other drugs.

Long-term use of Maalox ® in renal failure should be avoided.

Aluminum hydroxide with a low content of phosphates in food can lead to the development of phosphorus deficiency in the body. Therefore, when using it, especially for a long time, it is necessary to ensure sufficient intake of phosphates from food.

The preparation is permeable to x-rays.

When using the drug in patients with diabetes, the presence of sucrose in the composition of Maalox ® chewable tablets should be taken into account.

Influence on the ability to drive vehicles and control mechanisms

The drug does not affect the ability to drive vehicles and work with mechanisms.