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Antacids - Interactions and Warnings

Sparfloxacin is a broad-spectrum oral fluoroquinolone antimicrobial agent with a long elimination half-life. Concurrent treatment with antacids has demonstrated a reduction in the oral absorption of many quinolones.
- Clin Ther 1998 Nov-Dec;20(6):1149-58 -- Effect of Maalox on the oral absorption of sparfloxacin. -- Johnson RD, Dorr MB, Talbot GH, Caille G.

Antacids may reduce zinc and iron absorption due to the inhibition of gastric acid secretion.
- J Am Coll Nutr 1991 Aug;10(4):372-5 -- Inhibition of gastric acid secretion reduces zinc absorption in man. -- Sturniolo GC, Montino MC, Rossetto L, Martin A, D'Inca R, D'Odorico A, Naccarato R.

Possible effects of antacids and acid-lowering drugs on the pH of the proximal small intestine. Both cimetidine and an antacid containing aluminum and magnesium hydroxide reduced folate absorption from a liquid formula meal. Although the effects of these drugs on reducing folic acid absorption were relatively small, such reductions could become clinically significant in chronic antacid or H2 receptor antagonist use or intensive antacid or H2 receptor antagonist use by individuals eating diets that are marginal in folate content.
- J Lab Clin Med 1988 Oct;112(4):458-63 -- Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. -- Russell RM, Golner BB, Krasinski SD, Sadowski JA, Suter PM, Braun CL.

The effect of small doses of four commercially available aluminum-containing antacids on calcium and phosphorus metabolism was investigated in adult males in 20 studies. During the use of these doses of antacids, urinary and fecal calcium increased significantly during a low calcium intake averaging 252 mg/day, and the calcium balances became distinctly more negative. There was a reversal of the normal pattern of phosphorus excretions, namely, the fecal phosphorus was high and the urinary phosphorus was low. During a normal calcium intake of 800 mg/day, these doses of antacids did not result in significant changes of the calcium excretions or balance. In three patients who received large therapeutic doses of antacids, 240 to 450 ml/day, the changes of calcium and phosphorus metabolism were intensified.
- Am J Clin Nutr 1982 Jul;36(1):32-40 -- Effect of small doses of aluminum-containing antacids on calcium and phosphorus metabolism. -- Spencer H, Kramer L, Norris C, Osis D.

Following all doses of antacid, a significant increase in 24 h urinary excretion of aluminium was seen. The estimated absorption of aluminium was 8 and 50 times higher when antacids were taken with orange juice or with citric acid, respectively, than when taken with water. Thus, measurable quantities of aluminium are absorbed from single oral doses of antacids. The absorption is substantially enhanced by concomitant ingestion of citric acid.
- Eur J Clin Invest 1986 Oct;16(5):428-32 -- Gastrointestinal absorption of aluminium from single doses of aluminium containing antacids in man. -- Weberg R, Berstad A.

Two infants presented with growth failure and were found to have generalized osteomalacia (rickets) due to phosphate depletion from prolonged administration of an aluminum-containing antacid given for the symptoms of colic. One of the infants developed bilateral proptosis due to craniosynostosis related to the underlying metabolic bone disease. The chronic use of aluminum-containing antacids in infants has potential risk for the growing skeleton and is not innocuous. Therefore, antacid therapy should be used in low doses and very cautiously, with routine monitoring of serum calcium and phosphorus in children taking medications which reduce gastrointestinal phosphate absorption.
- Clin Pediatr (Phila) 1995 Feb;34(2):73-8 -- Rickets secondary to phosphate depletion. A sequela of antacid use in infancy. -- Pivnick EK, Kerr NC, Kaufman RA, Jones DP, Chesney RW.

last update: November 2008

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