Maalox Dosing for Heartburn and Indigestion
For immediate relief of heartburn and indigestion, take 20-30 mL of liquid Maalox (Extra Strength) or 2-4 tablets as needed, which provides rapid symptom relief within minutes and maintains effectiveness for 30-70 minutes. 1, 2
Standard Dosing Regimens
Acute Symptom Relief (PRN Use)
- Liquid formulation: 20-30 mL taken as needed for breakthrough symptoms 2
- Tablet formulation (Maalox TC): 2-4 tablets as needed 3
- Onset of action occurs rapidly, with esophageal pH increasing to 7.0-7.4 within minutes 2
- Duration of effect: 30-70 minutes for esophageal pH control 2
Maintenance Therapy (If Prescribed)
- For duodenal ulcer prevention: 3 tablets of Maalox TC twice daily (morning and bedtime), providing 162 mmol acid-neutralizing capacity 3
- This regimen is as effective as cimetidine 400 mg at bedtime for preventing ulcer relapse 3
- Alternative regimen: 3 tablets at bedtime only (81 mmol), though less effective than twice-daily dosing 3
Optimal Timing and Administration
Take Maalox 1-3 hours after meals and at bedtime for maximum effectiveness when used as maintenance therapy 4. For acute heartburn relief as a PRN medication, it can be taken immediately when symptoms occur 1.
Critical Timing Considerations
- Drug interactions: If taking fluoroquinolone antibiotics (like trovafloxacin), take Maalox at least 2 hours AFTER the antibiotic to avoid reducing antibiotic absorption by 66% 4
- The primary site of action is the lower esophagus, not the stomach, which explains the rapid symptom relief despite modest changes in gastric pH 2
Integration with PPI Therapy
Alginate-containing antacids (which include some Maalox formulations) are the preferred first-line PRN option for breakthrough GERD symptoms in patients already taking morning PPI therapy 1.
- Use as-needed for post-prandial symptoms, nighttime symptoms, or breakthrough symptoms despite PPI therapy 1
- Before adding Maalox PRN, ensure your PPI is taken correctly (30-60 minutes before first meal) and consider escalating to twice-daily PPI if symptoms persist 1
- Do not rely on antacids as monotherapy when PPIs are indicated for chronic GERD 5
Common Pitfalls to Avoid
- Diarrhea risk: Approximately 12% of patients taking Maalox TC twice daily develop diarrhea, compared to 8% with once-daily dosing 3
- Aluminum accumulation: While serum aluminum concentrations may increase slightly with chronic use, this is generally not clinically significant in patients with normal renal function 3
- Not a substitute for definitive therapy: Antacids provide rapid but temporary relief; they do not heal erosive esophagitis as effectively as PPIs 5