ALternaGEL, Alu-Cap, Alugel, Alu-Tab, Amphojel, Dialume
Classifications: gastrointestinal agent; antacid; adsorbent
Pregnancy Category: C


Aluminum Hydroxide 300 mg, 400 mg, 500 mg, 600 mg tablets; 300 mg, 400 mg, 500 mg, 600 mg capsules; 320 mg/5 mL, 450 mg/5 mL, 600 mg/5 mL, 675 mg/5 mL suspension

Aluminum Carbonate, Basic 608 mg tablets; 608 mg capsules; 400 mg/5 mL suspension

Aluminum Phosphate 608 mg tablets; 608 mg capsules; 400 mg/5 mL suspension


Nonsystemic antacid with moderate neutralizing action. Decreases rate of gastric emptying and has demulcent, adsorbent, and mild astringent properties. Reduces acid concentration and pepsin activity by raising pH of gastric and intraesophageal secretions.

Therapeutic Effects

Reduces gastric acidity by neutralizing the stomach acid content. Aluminum carbonate lowers serum phosphate by binding dietary phosphate to form insoluble aluminum phosphate, which is excreted in feces.


Symptomatic relief of gastric hyperacidity associated with gastritis, esophageal reflux, and hiatal hernia; adjunct in treatment of gastric and duodenal ulcer. More commonly used in combination with other antacids. Aluminum carbonate is used primarily in conjunction with a low phosphate diet to reduce hyperphosphatemia in patients with renal insufficiency and for prophylaxis and treatment of phosphatic renal calculi.


Prolonged use of high doses in presence of low serum phosphate; pregnancy (category C).

Cautious Use

Renal impairment; gastric outlet obstruction; older adults; decreased bowel activity (e.g., patients receiving anticholinergic, antidiarrheal, or antispasmodic agents); patients who are dehydrated or on fluid restriction.

Route & Dosage

Antacid (hydroxide & phosphate)
Adult: PO 600 mg t.i.d. or q.i.d.

Antacid (carbonate)
Adult: PO 10–30 mL of regular suspension or 5–15 mL of extra strength suspension or 2 capsules or tablets q2h

Phosphate Lowering (carbonate)
Adult: PO 10–30 mL of regular suspension or 5–15 mL of extra strength suspension or 2–6 capsules or tablets 1h p.c. and h.s.



Adverse Effects (1%)

GI: Constipation, fecal impaction, intestinal obstruction. CNS: Dialysis dementia (thought to be due to aluminum intoxication). Metabolic: Hypophosphatemia, hypomagnesemia.


Drug: Aluminum will decrease absorption of chloroquine, cimetidine, ciprofloxacin, digoxin, isoniazid, iron salts, nsaids, norfloxacin, ofloxacin, phenytoin, phenothiazines, quinidine, tetracycline, thyroxine. Sodium polystyrene sulfonate may cause systemic alkalosis.


Absorption: Minimal absorption. Peak: Slow onset. Duration: 2 h when taken with food; 3 h when taken 1 h after food. Elimination: Excreted in feces as insoluble phosphates.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug