Aluminum phosphate (Aluminii phosphas)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antacids

Included in the formulation
  • Phosphalugel
    gel inwards 
    Astellas Farma Europe BV     Netherlands
    • АТХ:

    A.02.A.B.03   Aluminum phosphate

    Pharmacodynamics:Has acid neutralizationscaling, enveloping, adsorbing action. Reduces the proteolytic activity of pepsin. It does not cause alkalization of the gastric juice, keeping the acidity of the gastric contents at the physiological level. Does not lead to secondary hypersecretion of hydrochloric acid. Forms a protective layer on the mucosa of the gastrointestinal tract. Promotes the removal of toxins, gases and microorganisms throughout the digestive tract, normalizes the passage of contents through the intestine.
    Pharmacokinetics:

    In the stomach for 10 minutes increases the pH to 3.5-5 and reduces the proteolytic activity of pepsin.

    When ingestion has a low absorption. Most aluminum phosphate is insoluble, a small part is precipitated in the intestine in the form of oxides and insoluble carbonates. 15-30% of the salt formed during the neutralization of hydrochloric acid is absorbed. Elimination of the absorbed part by the kidneys, the rest through the gastrointestinal tract.

    Indications:

    Stomach ulcer and duodenal ulcer in the exacerbation phase, chronic gastritis with increased and normal secretory function of the stomach in the exacerbation phase, acute gastritis, acute duodenitis,symptomatic ulcer various genesis, erosion of the gastrointestinal mucosa, reflux esophagitis, hiatal hernia, enterocolitis, sigmoid, proctitis, diverticulitis, diarrhea in patients after gastrectomy, dyspepsia (including neurotic genesis, after errors in diet, medication , chemotherapy), acute pancreatitis, chronic pancreatitis in the phase of exacerbation, poisoning and intoxication.

    For the purpose of prevention to reduce the absorption of radioactive elements.

    ICD-10

    XI.K20-K31.K21.0   Gastroesophageal reflux with esophagitis

    XI.K20-K31.K20   Esophagitis

    XI.K20-K31.K26   Duodenal ulcer

    XI.K20-K31.K25   Stomach ulcer

    XI.K20-K31.K29   Gastritis and duodenitis

    XI.K20-K31.K30   Dyspepsia

    XI.K40-K46.K44   Diaphragmatic hernia

    XI.K55-K63.K57   Diverticular Bowel Disease

    XI.K55-K63.K62.8   Other specified diseases of anus and rectum

    XI.K80-K87.K86.1   Other chronic pancreatitis

    XI.K80-K87.K85   Acute pancreatitis

    XVIII.R10-R19.R12   Heartburn

    Contraindications:Renal failure, Alzheimer's disease, hypophosphatemia, increased sensitivity to aluminum phosphate, pregnancy, breast-feeding.
    Carefully:

    Older age (may increase serum concentrations of Al3 +), children's age (12 years).

    Pregnancy and lactation:

    The category of FDA recommendations is not defined.The use of antacids is considered safe, except for prolonged use in large doses. Adequate and well-controlled studies in humans have not been conducted, but there have been reports of such side effects of antacids as hypercalcemia, hypomagnesemia, hypermagnesia, and an increase in tendon reflexes in the fetus and / or newborns whose mothers have taken aluminum, calcium or magnesium-containing antacids , especially in high doses.

    Lactation: complications in humans are not recorded. Despite the fact that aluminum, calcium and magnesium-containing antacids are able to penetrate into the milk, their concentrations are not enough to have an effect on the newborn. Use with caution!

    Dosing and Administration:

    Dosing regimen is individual. The dose is set depending on the dosage form and indications used.

    Side effects:

    From the digestive system: constipation (especially in elderly and bedridden patients), nausea, vomiting, change in taste sensations.

    From the laboratory indicators: with prolonged use in high doses - hypophosphatemia, hypocalcemia, an increase in the content of aluminum in the blood.

    From the musculoskeletal system: osteomalacia, osteoporosis.

    From the central nervous system: encephalopathy.

    From the urinary system: hypercalciuria, nephrocalcinosis, renal insufficiency.

    Overdose:

    Is manifested by a decrease in intestinal motility. Eliminated by the appointment of laxatives.

    Chronic overdose (Newcastle bone disease) with application of the drug for more than 2 weeks: hypophosphatemia (malaise, myasthenia gravis, osteomalacia, osteoporosis), development of renal insufficiency (or its aggravation), aluminum encephalopathy (dysarthria, apraxia, convulsions, dementia).

    Interaction:Aluminum preparations that are used as antacids interact with most drugs for oral administration by changing the pH of the gastric juice and quickly emptying the stomach, and by adsorption to form complexes that are not absorbed. With the simultaneous use of citrates, ascorbic acid increase the absorption of aluminum from the digestive tract.

    Antibiotics: azithromycin, cefpodoxime, pivampticillin, rifampicin, isoniazid, tetracyclines: decrease and slowdown of their absorption.

    Indirect anticoagulants: decrease and slowdown of their absorption.

    Barbiturates: decrease and slowdown of their absorption.

    Fexofenadine: decrease and slowdown of their absorption.

    Dipyridamole: decrease and slowdown of their absorption.

    Zalcitabine: decrease and slowdown of their absorption.

    Bile acids (chenodeoxycholic, ursodeoxycholic): decrease and slowdown of their absorption.

    Lansoprazole: decrease and slowdown of their absorption.

    Amphetamine, quinidine: in doses that alkalinize urine - suppressing their renal excretion with increased toxicity; correction of the dose with the simultaneous administration of antacids, dose changes or their cancellation.

    Ketoconazole: decrease and decrease of absorption.

    Chenodiol: decrease and decrease of absorption.

    Cardiac glycosides: decrease and decrease of absorption.

    Penicillamine: decrease and decrease of absorption.

    Phenothiazines: decrease and decrease of absorption.

    Quinine: decrease and slowing down of absorption.

    H2-receptor blockers: decrease and decrease of absorption.

    Sodium Fluoride: Decrease and retardation of absorption.

    Iron preparations: decrease and decrease of absorption.

    Mekilamin - decrease in the rate of absorption, prolongation of its effect; simultaneous reception is not recommended.

    Methenamine - the effectiveness decreases, since its transformation is inhibited formaldehyde alkalization of urine; simultaneous reception is not recommended.

    Salicylates - an increase in their renal excretion and a decrease in their serum concentration due to urine alkalinization; It is necessary to correct the dose of salicylates with prolonged intake of antacids in large doses or to cancel them, especially in patients receiving large doses of salicylates (for example, in rheumatoid arthritis or rheumatic fever).

    Means in the enteric coating, for example, bisacodyl - earlier dissolution of the membrane and irritation of the mucous membrane of the stomach and duodenum.

    Means, acidifying urine (ammonium chloride, ascorbic acid, potassium or sodium phosphate, racemetionine) - weakening of action. Patients who receive drugs that create an acidic urine reaction should not often take antacids, especially in large doses.

    Sucralfate - can bind to the mucosa; it is recommended to take an antacid at least half an hour before or after taking sucralfate; simultaneous administration can cause aluminum intoxication, especially in chronic kidney failure.

    Folic acid - a decrease in its absorption in the small intestine due to the increase in pH during long-term use of antacids; antacids are taken no earlier than 2 hours after taking folic acid.

    Fluoroquinolones - alkalization of urine reduces the solubility in it of ciprofloxacin and norfloxacin, especially at a pH of> 7; with simultaneous admission, it is necessary to exclude crystalluria and signs of nephrotoxicity; reduces the absorption of fluoroquinolones and their serum concentration, which is why it is undesirable to use them simultaneously; with forced simultaneous appointment, it is recommended to take enoxacin at least 2 hours before or 8 hours after, ciprofloxacin and lomefloxacin - 2 hours before or 6 hours after, norfloxacin and ofloxacin - at least 2 hours before or 2 hours after taking the antacid.

    Holinoblokatory, other means with cholinoblocking activity - decrease in their absorption, decrease in efficiency, decrease in renal excretion of cholinoblockers, intensification of their side effects; take 1 hour after antacids.

    Citrate - increased absorption of aluminum, systemic alkalosis and aluminum intoxication, especially in renal failure.

    Special instructions:

    Use with caution in high doses in elderly patients and in patients with impaired renal function (due to the possible risk of cumulation of aluminum phosphate leading to constipation).

    In patients with concomitant renal failure, thirst, a decrease in blood pressure, a decrease in reflexes are possible.

    When interacting with other drugs leading to a violation of absorption, the interval in taking medications should be 1-3 hours.

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