Can Maalox Chewable Tablets Be Given via PEG Tube?
Maalox chewable tablets can be crushed and administered through a PEG tube, but this requires proper technique including flushing with at least 30 mL of water before and after administration, and consultation with a pharmacist is strongly recommended before crushing any medication. 1, 2
Key Administration Requirements
Before crushing Maalox tablets for PEG administration, you must confirm the appropriateness of this route considering the site of drug delivery and potential interactions with enteral formula. 1, 2 While magnesium-aluminum hydroxide antacids like Maalox are soluble in the acidic gastric environment, crushing tablets carries inherent risks that must be carefully managed. 2
Critical Technical Steps
Flush the PEG tube with at least 30 mL of water immediately before administering the crushed medication to ensure tube patency and prevent occlusion. 1, 2, 3
Crush the tablet thoroughly and mix with water to create a suspension that can pass through the tube without causing blockage, as PEG tubes with adequate lumen size (at least 15 Charrière) are still susceptible to clogging with crushed solid dosage forms. 4, 1
Administer the medication individually - never mix Maalox with other medications or enteral formula, as this increases the risk of tube occlusion and drug interactions. 1, 2, 3
Flush again with at least 30 mL of water after administration to clear any residual medication from the tube. 1, 2, 3
Important Safety Considerations
Use ENFit-standard syringes and connectors to prevent potentially fatal misconnection errors between enteral and intravenous systems. 1, 2, 3
Consult a pharmacist before crushing to verify there are no contraindications specific to the patient's medication regimen or clinical situation. 1, 2
Do not shake ENFit syringes to remove residual medication as this exposes healthcare workers to the drug and alters the delivered dose. 1, 2, 3
Clinical Pitfalls to Avoid
The most common complication when administering crushed medications through PEG tubes is tube occlusion, which occurs more frequently with crushed solid dosage forms compared to liquid formulations. 4, 1 Inadequate flushing is the primary cause of this preventable complication. 4
Hyperosmolar medications can cause gastrointestinal disturbances including diarrhea, nausea, and abdominal cramping, though standard Maalox formulations are generally well-tolerated. 4, 3
Preferred Alternative
Liquid Maalox formulation is strongly preferred over crushed tablets when available, as it eliminates the risks associated with crushing and reduces the likelihood of tube occlusion. 1, 2 Liquid antacids have demonstrated equivalent efficacy to tablet formulations in clinical studies. 5, 6
Drug Interaction Warning
If the patient is receiving fluoroquinolone antibiotics through the PEG tube, separate Maalox administration by at least 4 hours as magnesium-aluminum antacids substantially reduce quinolone absorption when given concurrently. 7