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Antacids for Pets: Acid Reflux, Gastric Ulcers, Hyperphosphatemia
In humans, antacids are commonly used for the prevention and treatment of stomach ulcers and esophageal reflux (heartburn).
Summary
Used For:
Acid reflux, gastric ulcers, hyperphosphatemia
Brands:
AlternaGEL, Amphojel, Maalox, Phos-Ex, PhosLo, Tums, Milk of Magnesia
Species:
Dogs, cats, cattle, horses
Drug type:
Gastrointestinal
Prescription required:
Some require a prescription
Pregnancy and lactation:
Use caution in pregnant or lactating animals; calcium carbonate may be given post-partum to prevent or treat eclampsia (low blood calcium levels)
Side effects:
Lack of appetite, constipation or diarrhea, electrolyte imbalances
General description
Antacids are the oldest of the gastrointestinal (GI) protectants and comprise a group of inorganic, relatively insoluble salts of aluminum hydroxide, calcium carbonate, and magnesium hydroxide.
In humans, antacids are commonly used for the prevention and treatment of stomach ulcers and esophageal reflux (heartburn). Insufficient evidence is available to recommend antacids for treatment of ulcers and/or reflux in dogs and cats. Other longer acting and more effective acid-suppressing agents are available.
Aluminum hydroxide and calcium acetate may be used for the reduction of hyperphosphatemia (increased amount of phosphorus in the blood) in patients with kidney failure; use of calcium carbonate should not be utilized due to potential for hypercalcemia (increased amount of calcium in the blood).
Calcium carbonate may be given post-partum to prevent or treat eclampsia (low blood calcium levels)
Uses
Acid reflux, gastric ulceration, hyperphosphatemia
How it works
Antacids also may be beneficial by decreasing pepsin activity, binding to bile acids in the stomach, and stimulating local prostaglandin synthesis. There is an outdated belief that antacids are effective because they increase gastric pH, but this action is unlikely, or only temporary, because these agents do not exhibit strong enough buffer ing capacity.
Antacids bind phosphorus in the bloodstream to lower the levels present. Calcium carbonate may increase blood calcium levels.
Dosage
Consult your veterinarian.
Forms
Most antacids are available in tablet, liquid and capsule forms. Pets generally do not like the taste, making it difficult to get the pet to take the products.
Storage information & handling
Powders, suspensions and capsules should be stored at room temperature unless otherwise specified by the manufacturer.
What results can I expect?
Depending on what the antacid is being used for, results are usually seen within 2-3 days of treatment.
Missed Dosage
Long-term use of these antacids is not recommended for GI ulcers and/or reflux. When used as a phosphorous binder, continue treatment at the next scheduled dosing time.
Overdose / acute toxicity
Overdose rarely causes problems. If overdose occurs, consult your veterinarian. With overdose, electrolyte imbalances can cause weakness and heart arrhythmias. Long-term use of aluminum-containing products can cause muscle weakness, thinning of the bones and aluminum toxicity. Long-term use of other products can damage the kidneys.
Side effects
May include:
- Lack of appetite
- Constipation
- Diarrhea
- Electrolyte imbalances in some patients due to the levels of magnesium, aluminum, sodium and potassium in the products
Contraindications
*Do not use magnesium-containing products or calcium carbonate (Tums) in animals with kidney failure.
*Use with caution in patients who need restricted amounts of sodium or potassium in their diets.
*Use aluminum-containing products with caution in patients with an obstruction in the stomach, emptying disorders or obstruction of the small intestines.
*Use caution in pregnant or nursing animals, though calcium carbonate may be used for eclampsia in post-partum dogs.
Drug interactions
Due to changes in the acidity of the stomach, emptying time of the stomach or by chelation of the drugs, all oral medications may be affected. If multiple medications must be administered, separate dosages by at least 2 hours.
Tetracycline antibiotics may not be absorbed if given with antacids.
Antacids may decrease the absorption or effects of:
- Chlordiazepoxide
- Captopril
- Chloroquine
- Cimetidine
- Corticosteroids
- Digoxin
- Iron salts
- Indomethacin
- Isoniazid
- Ketoconazole
- Nitrofurantoin
- Pancreatic enzymes
- Penicillamine
- Phenothiazines
- Phenytoin
- Ranitidine
- Valproic acid
Antacids may increase the absorption or effects of:
- Aspirin
- Dicumarol
- Flecainide
- Quinidine
- Sympathomimetics like ephedrine
Do not use calcium-containing products in patients using digoxin/digitalis as abnormal heart rhythms may result.
If using to decrease high blood phosphorus levels, give with meals.
Precaution
Do not use calcium carbonate as a phosphorus binder; it may be used for eclampsia in post-partum dogs.
Laboratory considerations
Electrolyte changes may be seen on blood work in animals taking antacids.
Sources
- Saunders Handbook of Veterinary Drugs
- Plumb’s Veterinary Formulary
- Sparkes, A. H., Caney, S., Chalhoub, S., Elliott, J., Finch, N., Gajanayake, I., Langston, C., Lefebvre, H. P., White, J., & Quimby, J. (2016). ISFM Consensus Guidelines on the diagnosis and management of feline chronic kidney disease. Journal of Feline Medicine and Surgery, 18(3), 219–239. https://doi.org/10.1177/1098612X16631234
- Marks, S. L., Kook, P. H., Papich, M. G., Tolbert, M. K., & Willard, M. D. (2018). ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats. Journal of Veterinary Internal Medicine, 32(6), 1823–1840. https://doi.org/10.1111/jvim.15337
Disclaimer
The information contained on this page is for educational purposes only. This medication should only be given under the advice of a veterinarian who has examined your pet under the laws applicable to your state of residence.