Mylanta Maximum Strength (magnesium hydroxide/aluminum hydroxide/simethicone)

The usual dosage of simethicone for adults and children older than 12 years of age is 40-125 mg 4 times daily after meals and at bedtime. The drug also may be taken as necessary or as directed by a physician; higher than usual dosages have been used. For self-medication, total dosage should not exceed 500 mg daily. A simethicone dosage of 20 mg 4 times daily after meals and at bedtime (with a maximum dosage for self-medication of 120 mg daily) is recommended for children younger than 2 years of age, and a dosage of 40 mg 4 times daily after meals and at bedtime (with a maximum dosage for self-medication of 240 mg daily) is recommended for children 2-12 years of age.

Prior to gastroscopy or radiography of the intestine, adults have been given a single dose of 67 mg of simethicone as the oral suspension, in 2.5 mL of water.

Antacids are administered orally. The dose of antacids should be expressed in terms of mEq of acid neutralizing capacity. Dose and frequency of administration depend on the acid secretory rate of the stomach, gastric emptying time, and the disorder being treated. The duration of action of antacids is determined principally by gastric emptying time. In fasting subjects, antacids have a duration of action of 20-60 minutes. However, if the drugs are administered 1 hour after meals, acid neutralizing effects may persist up to 3 hours. Sodium bicarbonate generally has a shorter duration of action than other antacids. Antacids should be used for longer than 2-week periods only under the management of a physician and as part of a carefully planned therapeutic regimen.

There is considerable variation in in vivo acid neutralizing capacity of equal volumes of different antacids and antacid products. Since suspensions are more rapidly and effectively solubilized than powders or tablets, antacid suspensions have a greater ability to react with and neutralize gastric acid. Antacid suspensions have a smaller particle size than do tablets and drying of antacid suspensions to prepare powders and tablets causes substantial loss of ability to neutralize acid. In general, an antacid suspension is preferable to a tablet or powder; tablets should be reserved for chronic use in patients who refuse suspensions because they are inconvenient or unpalatable. Tablets should be thoroughly chewed before swallowing.

The US Food and Drug Administration (FDA) requires that antacids have a minimum in vitro acid neutralizing capacity of 5 mEq per dose and that antacid labeling contain the in vitro acid neutralizing capacity; however, this FDA in vitro test does not correlate with in vivo acid neutralizing capacity.

For peptic ulcer disease, dosages of antacids are empirical and various antacid dosages have been used. In patients with uncomplicated duodenal ulcers or gastric ulcers, an antacid is administered 1 and 3 hours postprandially and at bedtime. In patients with duodenal ulcers, antacids are usually given for 4-6 weeks, and in patients with gastric ulcers, antacids are administered until healing is complete. If symptoms of duodenal ulcer recur, some clinicians recommend that antacids be administered 1 and 3 hours postprandially and at bedtime for 1 week and, if pain is relieved, less frequently for an additional 1-2 weeks; these patients should consult their physicians if pain worsens or is not relieved after the first week of therapy. Additional doses of antacids may be administered to relieve ulcer pain which occurs between regularly scheduled doses.

For the acute management of moderate or severe esophageal reflux, an antacid suspension is administered every hour; if symptoms persist, antacids may be given every 30 minutes. For long-term therapy of esophageal reflux, antacids are administered 1 and 3 hours postprandially and at bedtime and whenever symptoms recur.

In the management of GI bleeding and stress ulceration, antacids are usually administered every hour and, for GI bleeding, the antacid dosage should be titrated to maintain the nasogastric aspirate above pH 3.5. For severe symptoms, antacid suspensions may be diluted with water or milk and given by continuous intragastric infusion.

To reduce the risk of anesthesia-induced gastric acid aspiration, an antacid suspension has been given 30 minutes before anesthesia.

In conjunction with dietary phosphate restriction in the management of hyperphosphatemia, 30-40 mL of aluminum hydroxide or aluminum carbonate suspension is administered 3 or 4 times daily.

Simethicone is administered orally. Simethicone chewable tablets should be chewed thoroughly before swallowing. Simethicone liquid-filled capsules should not be chewed.

No dosing information is available for this tab.

No dosing information is available for this tab.

All antacids potentially may increase or decrease the rate and/or extent of absorption of concomitantly administered oral drugs by changing GI transit time or by binding or chelating the drug. In vitro studies indicate that magnesium hydroxide or trisilicate has the greatest potential for drug binding and aluminum hydroxide and calcium carbonate are intermediate. Antacid-induced increases in GI pH may affect the disintegration, dissolution, solubility, or ionization of enteric-coated preparations and weakly acidic or basic drugs.

Simultaneous administration of aluminum-, calcium-, or magnesium-containing antacids with orally administered tetracyclines reduces the absorption of the tetracycline, probably because of chelation of these antacids by the tetracycline. Therefore, doses of tetracyclines should be spaced 1-2 hours from doses of antacids.

Concurrent administration of antacids and orally administered digoxin, indomethacin, or iron salts may decrease the absorption of these drugs. Doses of these drugs should be spaced as far apart as possible from doses of antacids. Concurrent administration of isoniazid and aluminum hydroxide gel may decrease the absorption of isoniazid; therefore, isoniazid should be administered at least 1 hour before aluminum-containing antacids. Absorption of buffered or enteric-coated aspirin is increased by simultaneous administration of antacids. Antacid-induced changes in urine pH increase urinary excretion and decrease blood concentrations of salicylates. Concurrent administration of dicumarol and an aluminum and magnesium hydroxides preparation reportedly increases the absorption of dicumarol; patients receiving antacids and oral anticoagulants should probably use warfarin rather than dicumarol. Concurrent administration of aluminum hydroxide and pseudoephedrine or diazepam increases the rate of absorption of the latter drugs. Administration of a magnesium and aluminum hydroxide preparation with chlordiazepoxide decreases the rate of chlordiazepoxide absorption. Administration of sodium bicarbonate with naproxen increases the rate of naproxen absorption, while concurrent administration of magnesium oxide or aluminum hydroxide with naproxen decreases the rate of naproxen absorption.

Antacid-induced increases in urine pH may decrease excretion of weakly basic drugs and increase excretion of weakly acidic drugs. Urinary excretion of amphetamines and quinidine are markedly decreased in patients whose urine is alkalinized with sodium bicarbonate and patients receiving these drugs concomitantly may have increased amphetamine or quinidine effects.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.