Maalox Dosing for Adults
For symptomatic relief of heartburn and indigestion, adults should take Maalox TC (therapeutic concentrate) 2-4 tablets four times daily, taken between meals and at bedtime, with a maximum of 16 tablets per day.
Standard Dosing Regimens
Acute Symptom Relief
- Maalox TC: 2-4 tablets four times daily (between meals and at bedtime) for treatment of active duodenal ulcer 1, 2
- This provides approximately 54-108 mmol of acid-neutralizing capacity per day 1
Maintenance Therapy
- Maalox TC: 3 tablets twice daily (morning and bedtime) for duodenal ulcer relapse prevention 1, 3
- This regimen (162 mmol total daily) has demonstrated efficacy comparable to cimetidine 400 mg at bedtime 1
- Alternative lower-dose maintenance: 3 tablets at bedtime only (81 mmol), though less effective than twice-daily dosing 1
Important Timing Considerations with Other Medications
Critical drug interactions require careful timing of Maalox administration:
Fluoroquinolone Antibiotics
- Moxifloxacin, trovafloxacin, and other fluoroquinolones have significantly reduced absorption when taken with Maalox 4, 5, 6
- Administer Maalox at least 4 hours after fluoroquinolone administration to avoid clinically significant reduction in antibiotic bioavailability 6
- Taking Maalox 2 hours before or 2 hours after fluoroquinolones still causes 17-29% reduction in drug absorption 5, 6
Safety Considerations
Adverse Effects
- Diarrhea is the most common side effect, occurring more frequently with higher doses (twice-daily regimen) 1, 2
- Approximately 12 patients per treatment group experienced diarrhea with Maalox TC twice-daily dosing in clinical trials 1
Special Populations
- Elderly patients may require dose reduction due to increased risk of side effects with aluminum-containing antacids 7
- Patients with renal impairment should use caution, as aluminum can accumulate in the body with chronic use 7
- Long-term use without medical supervision may lead to phosphate depletion in susceptible patients 7
Monitoring
- Serum magnesium levels remain stable with chronic Maalox use 1
- Serum aluminum concentrations may increase slightly but typically remain within acceptable ranges during maintenance therapy 1
Clinical Efficacy Context
Maalox TC demonstrates comparable efficacy to H2-receptor antagonists:
- Three tablets twice daily provides duodenal ulcer relapse prevention equivalent to cimetidine 400 mg at bedtime (23% vs 25% relapse rate at one year) 1
- Four tablets four times daily achieves duodenal ulcer healing rates of 78% at 4 weeks and 89% at 6 weeks, comparable to ranitidine 150 mg twice daily 2