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Hyperacidity, gas: Oral (OTC labeling): Maalox® Advanced Maximum Strength: 1-2 tablets as symptoms occur or as directed by healthcare provider (maximum: 8 tablets/24 hours) Titralac® Plus: Two tablets every 2-3 hours as needed (maximum: 19 tablets/24 hours) Dosing: Pediatric

Hyperacidity, gas: Oral (OTC labeling): Children 6-11 years: Maalox® Junior Plus Antigas: Two tablets as symptoms occur or as directed by healthcare provider (maximum: 6 tablets/24 hours) Children ≥12 years: Maalox® Advanced Maximum Strength: Refer to adult dosing. Dosing: Geriatric Refer to adult dosing. Dosage Forms: U.S. Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Tablet, chewable: Gas Ban™: Calcium carbonate 300 mg and simethicone 40 mg Maalox® Advanced Maximum Strength: Calcium carbonate 1000 mg and simethicone 60 mg [equivalent to elemental calcium 400 mg; assorted fruit flavor, lemon flavor, wildberry flavor] Maalox® Junior Plus Antigas: Calcium carbonate 400 mg and simethicone 24 mg [equivalent to elemental calcium 160 mg; wildberry flavor] Titralac® Plus: Calcium carbonate 420 mg and simethicone 21 mg [equivalent to elemental calcium 168 mg; sugar free; spearmint flavor] Generic Equivalent Available: U.S. No Administration Tablets may be chewed, swallowed whole, or allowed to melt in the mouth. Use Relief of acid indigestion, heartburn, bloating, pressure, and discomfort of gas Medication Safety Issues International issues: Remegel Wind Relief [Great Britain] may be confused with Renagel brand name for sevelamer [U.S., Canada, and multiple international markets] Adverse Reactions Significant Frequency not defined: Gastrointestinal: Constipation Warnings/Precautions

Other warnings/precautions: • Self medication (OTC labeling): Prior to self medication patients should contact healthcare provider if they have kidney stones, are on a calcium-restricted diet, or are taking any prescription medications. Patients should discontinue use and contact healthcare provider if symptoms persist for >2 weeks. Patients should not use the maximum dose for >2 weeks unless directed by healthcare provider. Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) ACE Inhibitors: Antacids may decrease the serum concentration of ACE Inhibitors. Management: Separate fosinopril administration from antacids by at least 2 hours. US and Canadian recommendations for use of other ACE- inhibitors with antacids may vary. Consult appropriate labeling. Monitor for decreased therapeutic effects of ACE-inhibitors.

Trientine: Antacids may decrease the absorption of Trientine. Management: Separate trientine dosing from other oral drugs (eg, antacids) by at least 1 hour. Monitor for decreased therapeutic effects of trientine if an antacid is initiated/dose increased, or increased effects if an antacid is discontinued/dose decreased. Risk D: Consider therapy modification Trientine: Calcium Salts may decrease the serum concentration of Trientine. Trientine may decrease the serum concentration of Calcium Salts. Risk D: Consider therapy modification Vismodegib: Antacids may decrease the serum concentration of Vismodegib. Management: Carefully consider the need for any medication that increases the pH of the upper GI tract (PPIs, H2RAs, antacids), as these could significantly reduce vismodegib systemic exposure. Vismodegib dose increases are unlikely to compensate for this effect. Risk D: Consider therapy modification Vitamin D Analogs: Calcium Salts may enhance the adverse/toxic effect of Vitamin D Analogs. Risk C: Monitor therapy Pregnancy Risk Factor C ( show table ) Pregnancy Implications See individual agents. Breast-Feeding Considerations See individual agents. Pricing: U.S. (Medi-Span®)

Chewable (Titralac Plus Oral) 420-21 mg (100): $5.94 Pharmacodynamics/Kinetics See individual agents. Use of UpToDate is subject to the Subscription and License Agreement . Topic 8827 Version 40.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [1104-58.240.98.179-704953041C-S244013.14]