ALUMINUM/MAGNESIUM
Place in Therapy
Even to this day, there is an absence of quality randomized-controlled trials proving the effectiveness of magnesium-aluminum antacids in relieving symptoms of GERD. Despite this, a number of small trials have shown some symptomatic relief over that of placebo. Specifically, antacids relieve heartburn and acid regurgitation, usually within 30 minutes of ingestion. Maximum effectiveness is achieved when antacids are administered 1 hour after meals and at bedtime.
Magnesium-aluminum antacids are, for the most part, very safe and well tolerated when used in patients with healthy renal function.
Diarrhea is the most predominant adverse effect and this may be more severe in the elderly population. The support of antacids from expert opinion takes into account the logical mechanism of action, quick onset, reliable safety profile, low cost, ease of accessibility and data supporting benefit, albeit limited. Ultimately, magnesium-aluminum antacids are reasonable as an initial pharmacological option for patients with mild GERD symptoms.
References
1. Armstrong, D.,
Marshall, J.K., Chiba, N., Enns, R., Fallone, C.A., Fass, R., et al. (2005,
January). Canadian consensus conference on the management of gastroesophageal
reflux disease in adults: Update 2004. Canadian Journal of Gastroenterology
19(1), 15-35.
2. DeVault K &
Castell D. Updated Guidelines for the Diagnosis and Treatment of
Gastroesophageal Reflux Disease. American Journal of Gastroenterology. 2005:
190-200.
3. Graham DY &
Patterson DJ. Double-blind comparison of liquid antacid and placebo in the
treatment of symptomatic reflux esophagitis. Dig Dis Sci. 1983
Jun;28(6):559-63.
4. Kitchin L &
Castell D. Rationale and Efficacy of Conservative Therapy forGastroesophageal
Reflux Disease. Arch Intern Med.
1991:151:448-454
5. Weberg R &Berstad
A. Symptomatic Effect of a Low-Dose Antacid Regimen in Reflux
Oesophagitis. Scand J
Gastroenterol. 1989 May;24(4):401-6.
Magnesium-aluminum antacids are, for the most part, very safe and well tolerated when used in patients with healthy renal function.
Diarrhea is the most predominant adverse effect and this may be more severe in the elderly population. The support of antacids from expert opinion takes into account the logical mechanism of action, quick onset, reliable safety profile, low cost, ease of accessibility and data supporting benefit, albeit limited. Ultimately, magnesium-aluminum antacids are reasonable as an initial pharmacological option for patients with mild GERD symptoms.
References
1. Armstrong, D.,
Marshall, J.K., Chiba, N., Enns, R., Fallone, C.A., Fass, R., et al. (2005,
January). Canadian consensus conference on the management of gastroesophageal
reflux disease in adults: Update 2004. Canadian Journal of Gastroenterology
19(1), 15-35.
2. DeVault K &
Castell D. Updated Guidelines for the Diagnosis and Treatment of
Gastroesophageal Reflux Disease. American Journal of Gastroenterology. 2005:
190-200.
3. Graham DY &
Patterson DJ. Double-blind comparison of liquid antacid and placebo in the
treatment of symptomatic reflux esophagitis. Dig Dis Sci. 1983
Jun;28(6):559-63.
4. Kitchin L &
Castell D. Rationale and Efficacy of Conservative Therapy forGastroesophageal
Reflux Disease. Arch Intern Med.
1991:151:448-454
5. Weberg R &Berstad
A. Symptomatic Effect of a Low-Dose Antacid Regimen in Reflux
Oesophagitis. Scand J
Gastroenterol. 1989 May;24(4):401-6.