Maalox Dosage for Adults
For symptomatic relief of heartburn and dyspepsia, the standard adult dosage of Maalox is 10-20 mL (or 2-4 tablets) taken four times daily, after meals and at bedtime, though higher doses have been studied for specific indications like ulcer prevention.
Standard Symptomatic Dosing
The typical adult dose is 10-20 mL of liquid Maalox (or 2-4 tablets) taken 1-3 hours after meals and at bedtime for relief of acid-related symptoms 1
Maximum daily dosing should not exceed the equivalent of approximately 80-160 mmol of neutralizing capacity without medical supervision 2
Evidence-Based Dosing for Ulcer Prevention
For patients requiring ulcer prophylaxis (though this is rarely used in modern practice given superior alternatives):
Three Maalox TC tablets twice daily (morning and bedtime) has been shown to be as effective as cimetidine 400 mg at bedtime for preventing duodenal ulcer relapse, with a cumulative relapse rate of 23% at one year versus 25% for cimetidine 2
Three tablets at bedtime alone was less effective (39% relapse rate) than the twice-daily regimen 2
This higher-dose regimen (162 mmol daily) was superior to placebo but associated with increased diarrhea (12 patients versus 8 in other groups) 2
Critical Drug Interactions and Timing
Maalox significantly impairs absorption of fluoroquinolone antibiotics and must be separated by at least 4 hours:
When taken concurrently with trovafloxacin, Maalox reduced bioavailability by 66% and should be avoided 3
Administer Maalox at least 4 hours after fluoroquinolone administration to avoid clinically significant interaction 1, 3
With sparfloxacin, Maalox given 4 hours after the antibiotic was the only regimen that did not significantly reduce absorption 4
Special Population Considerations
Elderly patients and those with renal impairment require special caution:
The American Geriatrics Society recommends dose reduction in elderly patients due to increased risk of side effects with aluminum-containing antacids 1
Patients with renal impairment should use caution, as aluminum can accumulate with chronic use 1
Long-term use without medical supervision may lead to phosphate depletion 5
Common Pitfalls to Avoid
Do not use Maalox concurrently with fluoroquinolones—always separate by at least 4 hours 1, 3
Avoid chronic high-dose use without monitoring renal function and electrolytes, particularly in elderly patients 1
Do not recommend as first-line therapy for ulcer prevention when superior alternatives (PPIs, H2-blockers) are available 2
Be aware that diarrhea is dose-dependent, occurring more frequently with higher doses (twice daily versus once daily regimens) 2