In humans, antacids are commonly used for the prevention and treatment of stomach ulcers and esophageal reflux (heartburn).
Some require a prescription
Use caution in pregnant or lactating animals; calcium carbonate may be given post-partum to prevent or treat eclampsia (low blood calcium levels)
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)
Acid reflux, gastric ulceration, hyperphosphatemia
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 There is an outdated belief that antacids are effective because they increase gastric pH, but this action is unlikely, or only temporary, because these agents do not exhibit strong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.
Powders, suspensions and capsules should be stored at room temperature unless otherwise specified by the manufacturer.
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 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.
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.
Do not use calcium carbonate as a phosphorus binder; it may be used for eclampsia in post-partum dogs.
Electrolyte changes may be seen on blood work in animals taking antacids.
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
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