Hydrotalcite
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Drugs List
Therapeutic Indications
Uses
For the symptomatic relief of dyspepsia, peptic ulceration, hyperacidity, gastritis, heartburn especially associated with reflux oesophagitis or hiatus hernia and heartburn in pregnancy.
Dosage
Adults
Elderly
No dosage adjustment necessary (see 'Adult' dose)
Children
Children 6-12 years
5ml between meals and at bedtime.
Children under 6 years
Not recommended.
Contraindications
Children under 6 years
Precautions and Warnings
Pregnancy (see ' Pregnancy' section)
Breast feeding (see 'Lactation' section)
Patient should contact their doctor if symptoms persist despite treatment.
This preparation contains sorbitol and is unsuitable for patients with hereditary fructose intolerance.
Pregnancy and Lactation
Pregnancy
There is consensus that antacids as a class are safe to use during all phases of pregnancy and have been widely prescribed without evidence of adverse effects at normal therapeutic use (Schaefer, Peters and Miller, 2007 and Lee, 2000). Unrestricted and long term use of antacids during pregnancy should however be avoided (Schaefer, Peters and Miller, 2007). The data regarding the safety of the drugs used in the treatment of heartburn are limited and mainly been derived from observational studies and case reports.Hydrotalcite has very limited systemic absorption following oral administration and Schaefer considers that the aluminium-magnesium complexes such as hydrotalcite lead to less aluminium absorption in comparison to other aluminium containing antacids.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Lactation
Because oral absorption of aluminium and magnesium is poor most reviewers consider antacid use to be safe during breast feeding (LactMed via ToxNet).
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Side Effects
Diarrhoea
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Reference Sources
British National Formulary, 62nd Edition (2011) Pharmaceutical Press, London.
BNF for Children (2011-2012) Pharmaceutical Press, London.
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.
Summary of Product Characteristics: Hydrotalcite Suspension. Peckforton Pharmaceuticals Ltd. Revised November 2002
Therapeutics in Pregnancy and Lactation (2000) Lee, A., Inch, S. and Finnigan, D. Radcliffe Medical Press, Abingdon.
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Antacids, Oral. Last revised: February 5 , 2008
Last accessed: March 8, 2012
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