From the Guidelines
Maalox (aluminum hydroxide) should be used with caution and only for short-term therapy (4 weeks) in patients with serum phosphorus levels greater than 7.0 mg/dL (2.26 mmol/L), due to the potential risk of aluminum toxicity and osteomalacia. The use of aluminum hydroxide as a phosphate binder is generally not recommended due to the potential for neurotoxicity and osteomalacia 1. However, in certain situations, such as in patients with serum phosphorus levels greater than 7.0 mg/dL (2.26 mmol/L), aluminum-based phosphate binders may be used as a short-term therapy (4 weeks) to control serum phosphorus levels 1.
Some key points to consider when using Maalox (aluminum hydroxide) include:
- The standard adult dose is 2-4 teaspoons (10-20 mL) taken by mouth as needed, up to 4 times daily, but do not exceed 16 teaspoons (80 mL) in 24 hours.
- Maalox contains aluminum hydroxide and magnesium hydroxide, which work by neutralizing stomach acid.
- The liquid form is generally more effective than tablets because it coats the esophagus and stomach more thoroughly.
- For best results, take Maalox between meals or before bedtime, and shake the bottle well before use.
- If symptoms persist for more than two weeks or worsen, consult a healthcare provider as this may indicate a more serious condition.
- Be aware that Maalox can interact with other medications by altering their absorption, so wait at least 2 hours before or after taking other oral medications.
- People with kidney problems should consult a doctor before using Maalox regularly, as it can affect electrolyte balance 1.
It is essential to weigh the benefits and risks of using aluminum hydroxide, considering the potential for aluminum toxicity and osteomalacia, and to monitor patients closely for any adverse effects 1.
From the Research
Use of Maalox (aluminum hydroxide)
- Maalox is used to treat symptomatic reflux esophagitis, as shown in a double-blind comparison of liquid antacid and placebo in 32 patients with chronic heartburn 2.
- The antacid properties of Maalox have been studied and compared to other antacids, such as Almagel, in patients with duodenal ulcer, gastric ulcer, erosive gastroduodenitis, and erosive reflux-esophagitis 3.
- Maalox has been shown to increase esophageal pH and provide relief from heartburn symptoms, with its effects being rapid and prolonged 4.
- The gastric emptying of Maalox has been investigated using scintigraphy, and it was found to empty faster than another antacid, magaldrate 5.
- Maalox has been used in the treatment of peptic ulcers, and its efficacy has been explained by its ability to neutralize gastric acid and provide symptomatic relief 6.
Conditions Treated with Maalox
- Symptomatic reflux esophagitis
- Duodenal ulcer
- Gastric ulcer
- Erosive gastroduodenitis
- Erosive reflux-esophagitis
- Peptic ulcers
- Heartburn symptoms
Mechanism of Action
- Neutralization of gastric acid
- Increase in esophageal pH
- Rapid and prolonged relief from heartburn symptoms
- Faster gastric emptying compared to other antacids 5