Dosing and uses of AlternaGEL, Amphojel (aluminum hydroxide)
Adult dosage forms and strengths
oral suspension
- 320mg/5mL
Antacid
5-30 mL PO between meals & HS or as directed
Peptic Ulcer Disease
5-30 mL between meals & HS or as directed
Hyperphosphatemia
300-600 mg PO 3 times/day between meals and Hs
Administration
Follow dosing with water
Pediatric dosage forms and strengths
oral suspension
- 320mg/5mL
Hyperphosphatemia
50-150 mg/kg/day divided q4-6hr PO; titrate dose to keep phosphorus within normal range
AlternaGEL, Amphojel (aluminum hydroxide) adverse (side) effects
Frequency not defined
Nausea
Vomiting
Rebound hyperacidity
Aluminum-intoxication
Hypophosphatemia
Chalky taste
Constipation
Fecal impaction
Stomach cramps
Milk-alkali syndrome
Osteomalacia
Warnings
Contraindications
Hypersensitivity to aluminum salts
Cautions
Aluminum toxicity may occur in renal failure patients
Hypophosphatemia may occur
Use caution in patients with heart failure, cirrhosis, edema, or renal failure
Will bind calcium if given at same time
Elderly may be predisposed to fecal impaction
Use caution in patients who have recently suffered massive gastrointestinal hemorrhage
Pregnancy and lactation
Pregnancy category: C
Lactation: Not known whether aluminum hydroxide is excreted in breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of AlternaGEL, Amphojel (aluminum hydroxide)
Mechanism of action
Antacid: Neutralizes HCl in the stomach to form soluble aluminum chloride
Phosphate binder: binds phosphate in the GI tract to form insoluble complexes and reduces phosphate absorption
Pharmacokinetics
Excretion
- Absorbed aluminum is eliminated in the urine (0.1-0.5 mg of Al in aluminum-containing antacid is absorbed from standard daily doses of antacid)
- Insoluble, poorly absorbed Al salts in the intestines: hydroxides, carbonates, phosphates and fatty acid derivatives, are excreted in feces
