1. Carbonate: regular high doses may cause alkalosis, which in turn may result in altered excretion of other drugs, and kidney stones. A chemical reaction between the carbonate and hydrochloric acid may produce carbon dioxide gas. This causes gastric distension which may not be well tolerated. Carbon dioxide formation can also lead to headaches and decreased muscle flexibility.
2. Aluminum hydroxide: may lead to the formation of insoluble aluminium-phosphate-complexes, with a risk for hypophosphatemia and osteomalacia. Although aluminium has a low gastrointestinal absorption, accumulation may occur in the presence of renal insufficiency. Aluminium-containing drugs may cause constipation.
3. Magnesium hydroxide: has laxative properties. Magnesium may accumulate in patients with renal failure leading to hypermagnesemia, with cardiovascular and neurological complications.
4. Sodium: increased intake of sodium may be deleterious for arterial hypertension, heart failure and many renal diseases.
Interactions
Altered pH or complex formation may alter the bioavailability of other drugs, such as tetracycline. Urinary excretion of certain drugs may also be affected.
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