Antacids

Definition
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Medicinal product for the treatment of complaints due to acidosis of the stomach.

For the most important antacids see Table 1.

Indication
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In dermatology, antacids play a role in particular as concomitant medication in systemic therapies with glucocorticoids as well as immunosuppressive or cytostatic therapies.

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Limited indication
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Intestinal stenosis, hypophosphatemia, gastric outlet stenosis, renal insufficiency, constipation.

Undesirable effects
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CNS disorders, anaemia, appetite disorders, constipation, osteomalacia (in dialysis patients), aluminium intoxication in long-term use.

Interactions
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s. Table 2.

Tables
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Overview of the most important antacids and their dosage

Group/Active substance	Dosage	Finished preparation
Aluminium compounds
Aluminium hydroxide	3-4 times/day 2 tbl. p.o. after meals	Tepilta
Magnesium compounds
Magnesium carbonate	If required, chew or suck 1-2 tbl. finely	Palmicol
Aluminium-Magnesium Compounds
Hydrotalcite	1-2 h after the meals 2 tbl. p.o. each	Talcid
Magaldrate	4 times/day after meals 1-2 tbl. or 1 bag p.o.	Riopan
Carbaldrat	1-2 tbl/teel/btl. between meals and before bed	Compensation
Silicates
Aluminium magnesium silicopolyhydrate	Chew 2-3 tbl. intensively several times a day	Ultilac
Aluminium magnesium silicate hydrate	Suck or chew 1-2 tbl. several times a day	Gelusil
Combinations
Aluminium hydroxide-magnesium hydroxide	After the meals 1-2 tbl. or 1-2 bags p.o.	Maaloxan
Magnesium carbonate-calcium carbonate	If required 1-2 tbl., up to 3 times/day p.o.	Rennie
aluminium-magnesium-silicate hydrate + milk powder	Suck or chew 1-2 tbl. several times a day or dissolve and ingest the contents of 1-2 bags in ¼ glass of water	Gelusil-Lac

Significant interactions of antacids

Allopurinol	Allopurinol level ↓, take antacid 3 hours before allopurinol
Atenolol	Atenolol Mirrors ↓
Biphosphonates	Biphosphonate levels ↓
Chenodesoxycholic acid	Chenodesoxycholic acid levels ↓
quinine	quinine levels ↓
Cimetidine	Cimetidine level ↓, take in 2 hours intervals
Ciprofloxacin	Ciprofloxacin levels ↓
Iron	Iron Mirrors ↓
Cardiac glycosides	Glycoside levels ↓
Hydroxychloroquine	Hydroxychloroquine Mirror ↓, to be taken 4 hours apart
Isoniazid	Isoniazid mirror ↓
Itraconazole	Itraconazole level ↓, to be taken 2 hours apart
Ketoconazole	Ketoconazole level ↓, to be taken 2 hours apart
Misoprostol	Misoprostol levels ↓
Food	Fruit juices and wine increase toxicity of Al-containing antacids
Sodium fluoride	Sodium fluoride level ↓, take at intervals of 2 hours
Ofloxacin	Ofloxacin levels ↓
Propanolol	Propanolol levels ↓
Phenytoin	Phenytoin levels ↓
Rifampicin	Rifampicin levels ↓
Tetracyclines	Tetracycline level ↓, to be taken 3 hours apart
Ursodeoxycholic acid	Ursodeoxycholic acid levels ↓