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Antacids for dessert
Stuck with a sensitive stomach? You can indulge in your favorite favorite food vices -- like a slice of spicy pepperoni pizza -- and minimize your chances of painful gastric upset by using an over-the-counter antacid. Nonprescription antacid liquids and tablets are the most popular antacids for easing burning sensations in the upper abdomen, behind the chest, and in the throat. Antacids neutralize excess gastric acid, which the stomach releases to digest food. If you want to be proactive about indigestion, consider beating it to the punch by trying H2 blockers. Or better yet, avoid indigestion altogether by avoiding the foods that you know can provoke it.
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Neutralize Stomach Acid Without Getting Burned
- Antacid tablets should be chewed thoroughly and washed down with a glass of water for maximum benefit.
- Antacid liquids are generally faster-acting than tablets, when similar doses are compared.
- Do not take antacids for more than two weeks. If symptoms persist this long, it's time to consult a physician.
- If you have renal or cardiac problems, avoid products containing aluminum and magnesium.
- If you are watching your sodium intake, request antacids with a low sodium content.
- If you suspect an ulcer, don't self-medicate -- contact your physician.
- Antacids can interact with many other drugs. Make sure your physician knows that you are using them.
- For children under age 12, consult your physician before administrating antacids.
Other Basic Advice
Some changes to your daily life may also help you avoid heartburn and indigestion. In addition to avoiding the foods which perpetually cause you problems, you might try following some of this advice:
- If you're prone to indigestion it's best to avoid alcohol, chocolate, coffee, cola, peppermint, and fatty foods, since they can worsen the problem for some people.
- Don't overeat, and stay away from nighttime snacks.
- Stop smoking, as it causes acid to travel up the esophagus.
- Simply loosening your clothes can reduce some heartburn. A tight waistline can squeeze the stomach and cause acid to flow up the esophagus.
- Raise your torso while sleeping by placing a block under your bed's legs (at the head end) or by sleeping with an extra pillow. This keeps excess stomach acid from traveling up your esophagus. But avoid any position that will cause you to bend at the waist during sleep. This might increase the pressure on your stomach.
That Pain in Your Upper Abdomen Might Be a Heart Attack
Heart attacks (myocardial infarctions) could be mistaken for indigestion or heartburn. Myocardial infarctions often produce intense, crushing pain centered on the chest.
However, they can also produce a deep pain near the end of the sternum. The pain's location, compounded with denial, lead many to avoid seeking medical attention for a condition they think is heartburn. It might be a myocardial infarction if you have heartburn-like pain accompanied by following symptoms:- Nausea
- Vomiting
- Confusion
- Anxiety
- Excessive sweating
If you are experiencing these symptoms with heartburn pain, don't take chances -- seek medical attention before it's too late.
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Aluminum compounds
Aluminum antacids are available in many salt forms (hydroxide, carbonate, phosphate, or aminoacetate). These agents neutralize the stomach acid and may also be used to help lower phosphate levels in the body. Be aware that the most common side effect of aluminum antacids is constipation. Aluminum antacids are often paired with magnesium antacids for just this reason, since magnesium has a laxative effect. If you have kidney problems, use aluminum products with caution, since your kidneys cannot remove aluminum well.
Bicarbonate compounds
Bicarbonate compounds such as sodium bicarbonate are strong antacids which quickly neutralize stomach acid. Sodium bicarbonate is a primary component of effervescent antacids; it produces the famous bubbles. This agent differs from other classes of acid neutralizers in that it can affect the body's pH balance. If you have kidney problems, use bicarbonate antacids with caution, as they can drastically alter your body's pH.
Bismuth compounds
Bismuth compounds are often used for acid indigestion as well as nausea, diarrhea, and ulcers, usually along with other prescription-only drugs. Bismuth compounds appear to have some acid-neutralizing activity useful in eliminating excess stomach acid. So contrary to popular belief, they do not work by coating your stomach.
Calcium compounds
Calcium antacids are available as calcium carbonate. This potent agent neutralizes stomach acid more slowly than sodium bicarbonate but has longer-lasting effects. Still, calcium carbonate is a fairly fast-acting antacid. Calcium antacids have a constipating effect, though, and may form calcium kidney stones. Also be aware that chronic use of calcium carbonate, especially with milk products or sodium bicarbonate, can result in milk-alkali syndrome, a state of excess calcium in the body.
Magnesium compounds
Magnesium antacids are available in many salt forms (hydroxide, chloride, carbonate, oxide, and trilicate); they work by neutralizing stomach acid. Less potent than calcium or sodium bicarbonates, their most common side effect is diarrhea. Therefore, they are often combined with aluminum or calcium compounds, which have a tendency to cause constipation. If you have kidney problems, use magnesium products only under a physician's supervision, since your kidneys cannot remove magnesium as efficiently as healthy kidneys.
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FDA-Approved Uses
Antacids alone
- Temporarily alleviates heartburn, sour stomach, and acid indigestion.
Antacids with aspirin
- For the temporary relief of minor aches and pains associated with heartburn, sour stomach, acid indigestion, and upset stomach, or for hangover and/or overindulgence in food and drink. May also be used for the temporary relief of minor aches and pains associated with the common cold, sore throat, headache, toothache, muscular aches, backache, premenstrual and menstrual cramps (dysmenorrhea), and arthritis. Can reduce fever.
Antacids with acetaminophen
- For the temporary relief of minor aches and pains associated with heartburn, sour stomach, acid indigestion, and upset stomach, or for hangover and/or overindulgence in food and drink. May also be used for the temporary relief of minor aches and pains associated with the common cold, sore throat, headache, toothache, muscular aches, backache, premenstrual and menstrual cramps (dysmenorrhea), and arthritis. Can reduce fever.
Fast-Acting- Fast-acting antacids like sodium bicarbonate and calcium carbonate dissolve easily to neutralize stomach acid rapidly.
- Liquid antacids are also fast-acting.
Slow-Acting- Antacids like aluminum hydroxide dissolve more slowly in the stomach, taking longer to neutralize stomach acids. They may take between 10 to 30 minutes to neutralize any significant amounts of acid.
- Magnesium hydroxide is faster acting than aluminum hydroxide, but not as fast as sodium bicarbonate or calcium carbonate.
Liquid vs. Solid- Because they are more easily dissolved, liquids neutralize acids better than tablets do. However, many people prefer the ease of carrying around tablets compared to bottles of liquids.
Optimizing Your Antacids- Antacids should not be taken on an empty stomach because their neutralizing effects will only last 15 minutes.
- The optimal time to take antacids is about one hour after a meal. The acid neutralizing effects will last longer (two to three hours).
- If you are also using H2 Blockers (Axid, Pepsid, Tagamet, or Zantac) to treat stomach upset, take them two hours before or two hours after taking the antacids, since antacids decrease the absorption of H2 blockers.
Recommended Dosage
| Bicarbonate | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Sodium Bicarbonate | 0.3 to 2 grams as needed | Up to 4 doses | Consult a physician | Consult a physician | Consult a physician | | | Bismuth Subsalicylate | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Bismuth Subsalicylate | 525 mg every 30 to 60 minutes | Up to 8 doses | Consult a physician | Consult a physician | Consult a physician | | Calcium Compounds | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under 6 | Max. Daily |
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| Calcium Carbonate | 0.5 to 1.5 grams as needed | 8 grams | Consult a physician | Consult a physician | Consult a physician | | Magnesium Compounds | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Magnesium Hydroxide | 650 to 1300 mg as needed | Up to 4 doses | Consult a physician | Consult a physician | Consult a physician | | Magnesium Oxide | 140 mg (capsules)or 400-800 mg tablets as needed | Capsules: Up to 4 doses, Tablets: 800mg daily | Consult a physician | Consult a physician | Consult a physician | | Aluminum Compounds | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under age 6 | Max. Daily |
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| Aluminum Hydroxide Gel | 0.5 to 1.5 grams as needed | Up to 6 doses | Consult a physician | Consult a physician | Consult a physician | | Aluminum Carbonate Gel | 0.5 to 1 gram as needed | Up to 12 doses | Consult a physician | Consult a physician | Consult a physician |
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Warnings
Aluminum compounds
Consult a physician before using or do not use if you have:
- Allergy to any aluminum compounds
- Congestive heart failure
- Edema
- Gastrointestinal hemorrhage
- Kidney impairment
- Liver impairment
Or if you:
- Are pregnant or nursing
- Are age 65 or older; you may require a lower dosage
- Are administering to a child under age 12
- Are on a low-salt diet
- Have abdominal pain, cramps, nausea, or vomiting
- Have had irregular bowel movements for two days or more
- Plan to use for prolonged periods; increases the likelihood of experiencing hypophosphatemia
Or if you are taking:
- Allopurinol (Zyloprim): may decrease allopurinol effects
- Benzodiazepines, such as:
- Alprazolam (Xanax): may decrease alprazolam effects
- Lorazepam (Ativan): may decrease lorazepam effects
- Corticosteroids, such as:
- Methylprednisolone (Medrol): may decrease methylprednisolone effects
- Prednisone (Orasone): may decrease prednisone effects
- Digoxin (Lanoxin): may decrease digoxin effects
- Fluoroquinoiones, such as:
- Ciprofloxacin (Cipro): if taken at the same time, will decrease ciprofloxacin absorption
- Norfloxacin (Noroxin): if taken at the same time, will decrease norfloxacin absorption
- Indomethacin (Indocin): may decrease indomethacin effects
- Iron: may decrease iron effects
- Isoniazid (Nydrazid): may decrease isoniazid effects
- Itraconazole (Sporanox): may decrease itraconazole effects
- Ketoconazole (Nizoral): may decrease ketoconazole effects
- Levodopa (Dopar): may increase levodopa effects
- Penicillamine (Cuprimine): may decrease penicillamine effects
- Ranitidine (Zantac): may decrease ranitidine effects
- Tetracycline (Sumycin): may decrease tetracycline effects
Bismuth compounds
Consult a physician before using or do not use if you have:
- Allergy to aspirin, salicylates, or any NSAIDs
- Allergy to any bismuth compounds
- Kidney impairment
- Stomach ulcers
Or if you:
- Are a child or teenager with a viral illness (due to the risk of Reye's syndrome)
- Are pregnant or nursing
- Are age 65 or older; you may require a lower dosage
- Have symptoms that do not improve after two days
Or if you are taking:
- Aspirin (Ecotrin): may increase the risk for aspirin toxicity
- Fluoroquinoiones, such as:
- Ciprofloxacin (Cipro): if taken at the same time, will decrease ciprofloxacin absorption
- Norfloxacin (Noroxin): if taken at the same time, will decrease norfloxacin absorption
- Tetracycline (Sumycin): may decrease tetracycline absorption and effects
- Warfarin (Coumadin): may increase the risk of bleeding
Calcium compounds
Consult a physician before using or do not use if you have:
- Diabetes
- Heart disease
- High calcium levels in the blood
- Kidney impairment
- Kidney stones
Or if you:
- Are pregnant or nursing
- Are administering to a child under age 12
- Are also taking sodium bicarbonate antacids; increases the chance of milk-alkali syndrome, with symptoms including headache, nausea, irritability, and weakness.
- Are administering to an infant
- Are debilitated; there is an increased chance of fecal impaction
Or if you are taking:
- Calcium channel blockers, such as:
- Diltiazem (Cardizem): may decrease the effects of diltiazem
- Nifedipine (Adalat): may decrease the effects of nifedipine
- Fluoroquinoiones, such as:
- Ciprofloxacin (Cipro): if taken at the same time, will decrease ciprofloxacin absorption
- Norfloxacin (Noroxin): if taken at the same time, will decrease norfloxacin absorption
- Iron: may decrease iron effects
- Sodium bicarbonate (Neut): if taken at the same time, will increase the risk for the milk-alkali syndrome
- Tetracycline (Sumycin): if taken at the same time, will decrease tetracyline absorption and effects
Sodium bicarbonate compounds
Consult a physician before using or do not use if you have:
- Heart disease
- High sodium levels in the blood
- Hypertension
- Kidney impairment
- Liver impairment
- Severe constipation
Or if you:
- Are pregnant or nursing
- Are age 65 years or older; you may require a lower dosage
- Are administering to a child under age 12
- Are on a low-salt diet
- Plan to take for longer than two days
- Take with calcium carbonate; increases the chance of the milk-alkali syndrome with symptoms including headache, nausea, irritability, and weakness.
Or if you are taking:
- Amphetamines, such as:
- Dextroamphetamine (Dexedrine): may increase dextroamphetamine levels or toxicity
- Benzodiazepines, such as:
- Alprazolam (Xanax): may decrease alprazolam effects
- Lorazepam (Ativan): may decrease lorazepam effects
- Calcium carbonate (Tums): if taken at the same time, will increase the risk for the milk-alkali syndrome
- Chlorpropamide (Diabinese): may decrease chlorpropamide levels or effect
- Flecainide (Tambocor): may increase flecainide levels or toxicity
- Ketoconazole (Nizoral): may decrease ketoconazole effects
- Lithium (Lithobid): may decrease lithium levels or effect
- Quinidine (Quinidex): may increase quinidine levels or effect
- Salicylates, such as:
- Aspirin (Ecotrin): may decrease aspirin levels or effect
- Choline salicylate (Arthopan): may decrease choline salicylate levels or effect
- Tetracycline (Sumycin): if taken at the same time, will decrease tetracyline absorption and effects
Magnesium compounds
Consult a physician before using or do not use if you have:
- Heart disease
- Hypertension
- Kidney impairment
- Liver impairment
Or if you:
- Are pregnant or nursing
- Are age 65 or older; you may require a lower dosage
- Are administering to a child under age 12
- Have had irregular bowel movements for two days or more
- Plan to take for longer than seven days
Or if you are taking:
- Benzodiazepines, such as:
- Alprazolam (Xanax): may decrease alprazolam effects
- Lorazepam (Ativan): may decrease lorazepam effects
- Digoxin (Lanoxin): may decrease digoxin effects
- Fluoroquinoiones, such as:
- Ciprofloxacin (Cipro): if taken at the same time, will decrease ciprofloxacin absorption
- Norfloxacin (Noroxin): if taken at the same time, will decrease norfloxacin absorption
- Indomethacin (Indocin): may decrease indomethacin effects
- Iron: may decrease iron effects
- Isoniazid (Nydrazid): may decrease isoniazid effects
- Ketoconazole (Nizoral): may decrease ketoconazole effects
- Levodopa (Dopar): may increase levodopa effects
- Tetracycline (Sumycin): may decrease tetracycline effects
Common Side Effects
Aluminum compounds
- Constipation
- Chalky taste
- Stomach cramps
Bicarbonate compounds
- Abdominal discomfort
- Belching
- Gas
Bismuth compounds
- Black stools
- Darkened tongue
Calcium compounds
Magnesium compounds
Infrequent to Rare Side Effects
Aluminum compounds
- Increased thirst
- Nausea
- Vomiting
- Whitish speckling of stools
Bicarbonate compounds
- Electrolyte imbalances
- Increased thirst
- Stomach cramps
Bismuth compounds
- Confusion
- Headache
- Muscle spasms
- Ringing in ears
- Slurred speech
- Weakness
Calcium compounds
- Constipation
- Diarrhea
- Electrolyte imbalances
- Nausea
- Slow heartbeat
- Tiredness
- Vomiting
Magnesium compounds
- Abdominal cramps
- Low blood pressure
- Muscle weakness
- Slow breathing
Effects of Overdose
Aluminum compounds
- Confusion
- Constipation
- Dry mouth
- Weakness
Bicarbonate compounds
- Severe electrolyte imbalances
- Seizures
Bismuth compounds
- Confusion
- Nervousness
- Persistent ringing in ears
- Rapid breathing
- Seizures
- Severe drowsiness
Calcium compounds
- Coma
- Elevated blood calcium levels
- Extreme tiredness
- Nausea
- Vomiting
Magnesium compounds
- Coma
- Confusion
- Diarrhea
- Muscle pain
- Very slow breathing
What to Do in Case of Overdose
- If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL HELP.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 6/4/74.
- 2. Food & Drug Administration. Federal Register 8/26/93.
- 3. Food & Drug Administration. Federal Register 9/23/93.
- 4. Food & Drug Administration. Federal Register 2/8/96.
- 5. Food & Drug Administration. Federal Register 10/9/97.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S.The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
- 4. Zimmerman, DR. Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
Find more books on health and wellness at  barnesandnoble.com.
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