Magaldrat Ratiopharm (Magaldrate)

Magaldrate is indicated for conditions related to excess gastric acidity within the gastrointestinal tract.

• Heartburn: provides rapid relief of burning sensation by neutralising stomach acid.
• Acid reflux (gastro‑oesophageal reflux disease): reduces acid exposure to the oesophagus, easing discomfort.
• Dyspepsia: alleviates indigestion symptoms such as fullness and bloating.
• Gastric ulcer: creates a less acidic environment to support ulcer healing.
• Peptic ulcer disease: assists in symptom control and promotes mucosal protection.

• Magaldrate acts as a dual‑acting antacid. In the acidic gastric lumen it reacts with hydrochloric acid to form magnesium chloride, aluminum hydroxide and water, thereby raising the gastric pH. The increase in pH reduces irritation of the gastric mucosa and creates conditions favorable for ulcer healing, while the aluminum and magnesium components provide a sustained buffering effect.

Adverse reactions may occur with magaldrate use and are reported in clinical practice.

Common Side Effects

• Constipation: reduced bowel motility associated with aluminum content.
• Diarrhoea: osmotic effect of magnesium salts.
• Nausea or mild stomach discomfort.
• Metallic taste in the mouth.
• Flatulence or abdominal bloating.

Serious or Rare Side Effects

• Electrolyte imbalance: hypermagnesemia or hypercalcaemia with excessive use.
• Metabolic alkalosis: prolonged high gastric pH leading to systemic alkalosis.
• Renal impairment exacerbation: accumulation of magnesium/aluminum in patients with reduced kidney function.
• Severe allergic reactions: rash, itching or angioedema.
• Hypersensitivity pneumonitis (very rare).

Before initiating therapy, consider the following safety measures.

• Renal function assessment: avoid or adjust use in patients with severe renal impairment.
• Cardiac status: monitor fluid and electrolyte balance in heart‑failure patients.
• Concomitant medications: be aware of potential absorption interactions with other oral drugs.
• Duration of therapy: limit long‑term use without medical supervision to prevent electrolyte disturbances.
• Pregnancy and lactation: safety data are limited; use only if clearly needed and prescribed.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Magaldrate may affect the absorption or action of several medicines.

Major Interactions (Avoid)

• Tetracycline antibiotics: antacid binding reduces tetracycline absorption.
• Fluoroquinolone antibiotics (e.g., ciprofloxacin): chelation decreases bioavailability.
• Iron salts: concurrent intake markedly lowers iron absorption.
• Digoxin: altered gastric pH can affect digoxin levels.
• Warfarin: changes in absorption may modify anticoagulant effect.

Moderate Interactions (Monitor Closely)

• Levothyroxine: antacid may reduce thyroid hormone absorption; separate dosing by at least 4 hours.
• Lithium: altered renal excretion may increase lithium levels.
• Other antacids or acid‑reducing agents: additive effect on gastric pH and electrolyte balance.