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What are antacids?
An antacid is a compound that absorbs and neutralizes stomach acid. The use of antacids has declined because of the availability of many very potent drugs that are more effective and much less troublesome to take than antacids. Still, these drugs can be helpful in relieving intermittent, infrequent heartburn and indigestion. If these symptoms occur frequently such as multiple times a day or at night, then the cause should be sought, as a more serious disorder may be present.
Following are some facts about antacids:
- Taken on an empty stomach, they only neutralize acid for 30 to 60 minutes because the antacid quickly leaves the stomach.
- If taken with food, the protective effect may be 2 or 3 hours.
- To get as much acid reduction as prescription medicines produce is expensive as the antacid must be taken frequently during the day and night. It is probably cheaper to take an acid-reducing pill once or twice a day.
- All antacids, but especially calcium carbonate, can result in an acid rebound effect where the stomach acid surges back after the antacid has left the stomach, another reason for long-acting medications.
- Antacids interfere with many drugs. (See below.) Staggering the antacid away from medications is always preferable but again is a nuisance and hard to comply with long-term.
What are antacids used for?
Antacids are useful for the temporary relief of occasional indigestion and heartburn. Frequent, daily or nightly symptoms usually mean a more serious problem. Antacids by themselves do not correct these problems. The medications that are now available to treat acid problems are generally superior to antacids.
How do I take antacids?
It is best to take them with food as the buffering effect in the stomach lasts for 2 to 3 hours. If you have symptoms at night, take the antacids before retiring. However, it is more important not to eat within 2 hours of sleep as eating often promotes reflux of acid into the esophagus. Keep all medications away from children.
What do I do for a missed dose?
This is usually not a problem since most people only use the antacid when they have symptoms. If you miss a physician recommended dose, take it as soon as you remember. However, it is not necessary to double up on the next dose.
Are there interactions with food or beverages?
There are no known interactions between food or alcohol and any of the antacids. However, caffeine and alcohol do stimulate the production of stomach acid and nicotine delays the healing of ulcers.
Are there interactions with other drugs?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. Antacids do interact with or prevent the absorption of many medications. As a general rule it is best to separate antacid use and any other medications by at least 1 hour. When antacids are only taken occasionally, this seldom presents a serious problem. Since there are so many good medications to reduce stomach acid, some of them over-the-counter, it is unusual to require frequent antacid use during the day and night.
Interactions with this antacid may occur with the following:
- allopurinol (Zyloprim)
- benzodiazepine (Valium, Xanax)
- chloroquine (Aralen)
- steroids (prednisone, Deltasone, Medrol)
- digoxin (Lanoxin)
- ethambutol (Myambutol)
- ulcer medications (Tagamet, Zantac, Pepcid, Axid)
- iron (Feosol, ferrous sulfate, Nu-Iron)
- isoniazid (INH)
- penicillamine (Depen, Cuprimine)
- phenothiazines (Thorazine, Stelazine, Compazine)
- tetracycline (Sumycin, Tetracyn)
- thyroid (Synthroid, levothyroxine)
- ticlopidine (Ticlid)
Is there a problem if I have another disorder or disease?
At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. Most antacids do not interfere with any underlying disease or disorder. An exception is the use of sodium bicarbonate when high blood pressure or heart disease is present.
What if I’m pregnant, considering pregnancy or breast-feeding?
Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. Antacids are generally thought to be safe during pregnancy although there are no medical studies that prove it. Calcium carbonate (Tums and others) is probably the safest antacid, since the baby and mother both need calcium to develop properly and maintain health. Heartburn is very common during pregnancy so the woman and her physician should discuss this problem and the best method and antacid that would be helpful.
How long is it safe to take aluminum carbonate?
Antacids can be used indefinitely if they are only taken occasionally. However, when they are necessary several times a day, medical attention is required. Excessive antacid use in the short-term may indicate an underlying disorder that needs different care. The long-term, heavy use of any antacid can produce medical problems and should not be done without a physician’s input.
How about side effects?
Adverse reactions can occur with any drug, even over-the-counter medications. Most antacids produce only minor side effects, especially if they are used infrequently. Minor side effects are usually relieved by reducing the dose or frequency. For major reactions, the patient should contact the physician immediately.
Aluminum carbonate may lead to constipation and, uncommonly, blockage of the bowel. A high fiber diet is often helpful (links below). Excessive or long-term use of aluminum containing antacids can lead to subtle poisoning, mental changes and weak bones. They should not be used long-term or by patients with chronic kidney failure or who are on dialysis without discussion with the physician.
For aluminum carbonate, the following are the observed side effects:
- abdominal discomfort
- severe abdominal pain
- mood or mental changes
- severe weakness
A physician’s comment…
Antacids are one of mankind’s oldest friends. If you develop occasional heartburn or indigestion, you take an antacid and get instant relief. No house should be without an antacid. Yet, if these symptoms occur daily or several times a day and especially at night, then there could be a more serious problem. There may be an ulcer or serious acid injury to the esophagus (food pipe). These conditions are rarely healed by antacids alone. A specific diagnosis must be made by the physician. If an ulcer is being caused by the stomach bacteria, Helicobacter pylori, or if gastroesophageal injury is occurring, specific potent medications are available to heal or control these conditions. Antacids, at best, just temporarily cover up the symptoms. They do not solve the problem.