For patients taking the chewable tablet form of this medicine:

• Chew the tablets well before swallowing. This is to allow the medicine to work faster and be more effective.

For patients taking this medicine for a stomach or duodenal ulcer:

• Take it exactly as directed and for the full time of treatment as ordered by your doctor, to obtain maximum relief of your symptoms.
• Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.

For patients taking aluminum carbonate or aluminum hydroxide to prevent kidney stones:

• Drink plenty of fluids for best results, unless otherwise directed by your doctor.

For patients taking aluminum carbonate or aluminum hydroxide for hyperphosphatemia (too much phosphate in the blood):

• Your doctor may want you to follow a low-phosphate diet. If you have any questions about this, check with your doctor.

Dosing

The dose of an antacid will be different for different patients. Follow your doctor's orders or the directions on the label.

Missed dose

If your doctor has told you to take this medicine on a regular schedule and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule, tablet, or lozenge form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid or gel form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For antacids, the following should be considered:

Allergies Tell your health care professional if you have ever had any unusual or allergic reaction to aluminum-, calcium-, magnesium-, simethicone-, or sodium bicarbonatecontaining medicines. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet Make certain your health care professional knows if you are on a low-sodium diet. Some antacids contain large amounts of sodium.

Pregnancy Studies on effects in pregnancy have not been done in either humans or animals. However, there have been reports of antacids causing side effects in babies whose mothers took antacids for a long time, especially in high doses during pregnancy. Also, sodium-containing medicines should be avoided if you tend to retain (keep) body water.

Breast-feeding Some aluminum-, calcium-, or magnesium-containing antacids may pass into breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Children Antacids should not be given to young children (under 6 years of age) unless ordered by their doctor. Since children cannot usually describe their symptoms very well, a doctor should first check the child. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse. In addition, aluminum- or magnesium-containing medicines should not be given to premature or very young children because they may cause serious side effects, especially when given to children who have kidney disease or who are dehydrated.

Older adults Aluminum-containing antacids should not be used by elderly persons with bone problems or with Alzheimer's disease. The aluminum may cause their condition to get worse.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking antacids, it is especially important that your health care professional know if you are taking any of the following:

• Cellulose sodium phosphate (e.g., Calcibind) Calcium-containing antacids may decrease the effects of cellulose sodium phosphate; use with magnesium-containing antacids may prevent either medicine from working properly; antacids should not be taken within 1 hour of cellulose sodium phosphate

• Fluoroquinolones (medicine for infection) Antacids may decrease the effects of these medicines

• Isoniazid taken by mouth (e.g., INH) Aluminum-containing antacids may decrease the effects of isoniazid; isoniazid should be taken at least 1 hour before or after the antacid

• Ketoconazole (e.g., Nizoral) or
• Methenamine (e.g., Mandelamine) Antacids may decrease the effects of ketoconazole or methenamine; these medicines should be taken 3 hours before the antacid

• Mecamylamine (e.g., Inversine) Antacids may increase the effects and possibly the side effects of mecamylamine

• Sodium polystyrene sulfonate resin (SPSR) (e.g., Kayexalate) This medicine may decrease the effects of antacids

• Tetracyclines (medicine for infection) taken by mouth Use with antacids may decrease the effects of both medicines; antacids should not be taken within 3 to 4 hours of tetracyclines

• Alzheimer's disease (for aluminum-containing antacids only) or
• Appendicitis (or signs of) or
• Bone fractures or
• Colitis or
• Constipation (severe and continuing) or
• Hemorrhoids or
• Intestinal blockage or
• Intestinal or rectal bleeding Antacids may make these conditions worse

• Colostomy or
• Ileostomy or
• Inflamed bowel Use of antacids may cause the body to retain (keep) water and electrolytes such as sodium and/or potassium

• Diarrhea (continuing) Aluminum-containing antacids may cause the body to lose too much phosphorus; magnesium-containing antacids may make diarrhea worse

• Edema (swelling of feet or lower legs) or
• Heart disease or
• Liver disease or
• Toxemia of pregnancy Use of sodium-containing antacids may cause the body to retain (keep) water

• Kidney disease Antacids may cause higher blood levels of aluminum, calcium, or magnesium, which may increase the risk of serious side effects

• Sarcoidosis Use of calcium-containing antacids may cause kidney problems or too much calcium in the blood

• Underactive parathyroid glands Use with calcium-containing antacids may cause too much calcium in the blood