Aluminum Hydroxide

Reviewed on 9/3/2021

What Is Aluminum Hydroxide ( Vasostrict, ADH) and How Does It Work?

Aluminum Hydroxide is an over-the-counter (OTC) product used as an antacid, and to treat peptic ulcer disease and hyperphosphatemia.

  • Aluminum hydroxide is available under the following different brand names: AlternaGEL, Amphojel, and Nephrox.

What Are Dosages of Aluminum Hydroxide?

Dosages of Aluminum Hydroxide:

Dosage Forms and Strengths

Oral suspension

  • 329mg/5mL
Dosage Considerations – Should be Given as Follows: Antacid
  • 5-30 mL orally between meals and at bedtime or as directed
Peptic Ulcer Disease
  • 5-30 mL between meals and at bedtime or as directed
  • Adult: 300-600 mg orally 3 times/day between meals and at bedtime
  • Pediatric: 50-150 mg/kg/day orally divided every 4-6 hours; titrate dose to keep phosphorus within normal range


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What Are Side Effects Associated with Using Aluminum Hydroxide (AlternaGEL)?

Common side effects or health problems may include:

  • Nausea
  • Vomiting
  • Rebound hyperacidity
  • Aluminum-intoxication
  • Low blood phosphates (hypophosphatemia)
  • Chalky taste
  • Constipation (this could lead to hemorrhoids or bowel obstruction)
  • Fecal impaction
  • Stomach cramps
  • Milk-alkali syndrome
  • Softening of the bones

Serious side effects of aluminum hydroxide include::

  • Black/tarry stools
  • Mental/mood changes (e.g., confusion, deep sleep)
  • Pain with urination
  • Stomach/abdominal pain
  • Vomit that looks like coffee grounds

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Aluminum Hydroxide?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Aluminum Hydroxide?


  • This medication contains aluminum hydroxide. Do not take AlternaGEL, Amphojel, or Nephrox if you are allergic to aluminum hydroxide or any ingredients contained in this drug.
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.


  • Hypersensitivity to aluminum salts

Effects of Drug Abuse

  • No information available

Short-Term Effects

  • See "What Are Side Effects Associated with Using Aluminum Hydroxide?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Aluminum Hydroxide?"


  • Aluminum toxicity may occur in renal failure patients.
  • Low blood phosphate levels (hypophosphatemia) may occur.
  • Use caution in patients with heart failure, cirrhosis, edema, or renal failure.
  • Will bind calcium if given at same time.
  • Elderly may be predisposed to fecal impaction.
  • Use caution in patients who have recently suffered massive gastrointestinal hemorrhage.

Pregnancy and Lactation

  • Use aluminum hydroxide with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
  • It is not known whether aluminum hydroxide is excreted in breast milk. Consult your doctor.


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Medscape. Aluminum Hydroxide.
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