How Over-the-Counter Antacids Are Messing With Your Body?

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side effects of antacids

Marissa got up with a start. Her throat was burning. And she thought she would throw up. She got up and rushed to the kitchen. She flicked on the light and filled a glass of water. She gulped it down praying that the hot bile be washed away. The burning did not stop. She searched frantically in the kitchen drawers for something that would relieve her of pain. She found a bottle of the liquid antacid she was desperately looking for. She gulped a couple spoonful of the soothing liquid. Relief came almost instantly. She would sleep. For tonight. But, she dreaded to think of the morning. And the night after.

Marissa had been taking over the counter antacids since a month now. But instead of relieving her symptoms, the antacid seemed to be making her acidity even worse.

For someone who never had any tummy troubles, Marissa started having trouble with her bowel movements. Her acid reflux seemed to have given her another health issue – constipation. She was fighting at two fronts now, and she was scared a third front may open up soon.

Marissa is a classic example of someone who is suffering from the side effects of heartburn medicine, or over the counter antacids, that have become a regular part of the daily lives of millions of Americans.

Rebound hyperacidity, diarrhea, constipation and weak bones are some of the side effects of the seemingly innocuous fruity, and minty flavored tablets and liquids.

Most Prescribed Brands of OTC Antacids

While the term “antacid” technically means any drug that blocks stomach acids by any means, we will restrict ourselves in this article to acid neutralizing antacids. We’ve already talked about proton pump inhibitors (like Nexium) and histamine antagonists (or H2 antagonists like Zantac and Pepcid) in earlier articles.

The most common and popular brands of over the counter heartburn medicines are:

Alka-Seltzer, Gaviscon, Gelusil, Maalox, Mylanta, Rolaids, Tums, Pepto-Bismol, Alternagel, Amphojel and Milk of Magnesia.

How Do Antacids Work Inside the Body?

OTC antacids provide relief from symptoms of heartburn by neutralizing the acid in the stomach. Heartburn happens when acidic contents of the stomach reflux back into the esophagus and inflame its sensitive lining. This leads to a burning sensation in the esophagus. Antacids contain alkaline chemicals that will neutralize the acid. Some antacids also contain anti-flatulent activity, meaning that a chemical in the antacid eliminates excess gas formation.

How Should You Use OTC Antacids?

Liquid forms of antacids work faster than tablets. Antacids should be taken for heartburn that occurs once in a while. It should be taken 1 hour after a meal or when you experience symptoms. If you experience heartburn at night, take the antacid just before going to bed.

If you are taking a tablet, chew it slowly. Do not gulp down the whole tablet with water. If you are taking liquid, it is advisable to take it undiluted or with very little water.

Short Term Side Effects of Antacids

Side effects that can happen immediately after you start taking antacids include:

  • Headache
  • Nausea
  • Constipation (caused by aluminum-containing antacids) or
  • Diarrhea (caused by magnesium-containing antacids).

Apart from these side effects that can be taken care of relatively easily, antacids can also cause a potentially fatal side effect called “milk-alkali syndrome.” This condition is characterized by high blood calcium and absorbable alkali. High calcium and alkali can come either from calcium supplements to treat osteoporosis or from antacids. In the beginning, the condition usually has no symptoms (asymptomatic). However, it can lead to the following symptoms.

Symptoms of “milk-alkali syndrome”

  • Back pain especially in the middle and low back, in the kidney area (related to kidney stones)
  • Confusion, strange behavior
  • Constipation
  • Depression
  • Excessive urination
  • Fatigue
  • Irregular heartbeat (arrhythmia)
  • Nausea or vomiting

Untreated milk-alkali syndrome may result in kidney failure and death.

Should You Be Taking Antacids For A Long Time?

side effects of antacids

Experts advise taking antacids to treat occasional heartburn. In fact, it is not advisable to take antacids for more than six weeks straight.

But we often tend to disregard these instructions and use antacids indiscriminately, because (a) we want immediate symptomatic relief, and (b) we do not understand the real cause of acid reflux and do not know how to treat it at the root.

Taking antacids for more than the prescribed duration can cause what is known as “rebound hyperacidity.” Here the body tries to compensate for the constant neutralization of its stomach acid by producing more amounts of acid, thereby making your acid reflux even worse. This creates a vicious cycle where overuse of antacids makes your heartburn worse and you take more antacids to get relief. This causes dependence on antacids that may have precarious consequences in the future.

Antacids that contain aluminum can cause a variety of health complications including constipation, osteomalacia and hypophosphatemia.

Magnesium-containing antacids can cause diarrhea due to their laxative effect. In people with kidney failure, these antacids can cause severe problems of hypermagnesia (increased magnesium levels in the blood) due to the reduced ability of kidneys to clear excessive magnesium from the blood.

Long-Term Side Effects of Antacids

Long-term side effects of antacids vary, depending on what is included in them. Listed below are common side effects of antacids, based on their ingredients.

Aluminum Hydroxide

Aluminum hydroxide-containing antacids may cause side effects like:

  • Constipation
  • Loss of appetite
  • Unusual tiredness
  • Muscle weakness
  • Confusion

These side effects are a result of depletion of vital nutrients like:

  • Calcium
  • Phosphorous
  • Zinc
  • Vitamin B12
  • Vitamin D

Magnesium Carbonate

Magnesium carbonate-containing antacids may cause gastrointestinal side effects like flatulence and diarrhea. These side effects are also a result of depletion of vital nutrients mentioned above.

Magnesium Hydroxide

Magnesium hydroxide-containing antacids may cause gastrointestinal side effects like:

  • Stomach cramps
  • Upset stomach
  • Vomiting
  • Diarrhea

These side effects are also a result of depletion of vital nutrients like calcium, phosphorus and vitamin D.

Magnesium Trisilicate

Occasionally, people who have taken this medicine have experienced digestive symptoms such as mild diarrhea, stomach cramps and belching. This compound depletes nutrients like Calcium, Phosphorous, Zinc, Vitamin B12, Vitamin D from the body.

Magnesium Oxide

Magnesium oxide may cause side effects like:

  • Cramping
  • Diarrhea
  • Rash or hives
  • Itching
  • Dizziness or lightheadedness
  • Mood or mental changes
  • Unusual tiredness
  • Weakness
  • Nausea
  • Vomiting

These side effects are a result of depletion of nutrients like Phosphorous, Zinc, Vitamin B12, Vitamin D and Calcium.

Magnesium Sulfate

Magnesium sulfate-containing antacids may cause side effects such as:

  • Confusion
  • Dizziness or lightheadedness
  • Fast, slow, or irregular heartbeat
  • Low blood pressure
  • Muscle weakness
  • Skin infection after soaking
  • Sleepiness

This drug depletes nutrients like Calcium, Phosphorous, Zinc, Vitamin B12, Vitamin D.

Calcium Carbonate

Calcium carbonate-containing antacids may cause side effects such as:

  • Upset stomach
  • Vomiting
  • Stomach pain
  • Belching
  • Constipation
  • Dry mouth
  • Increased urination
  • Loss of appetite
  • Metallic taste

Overuse of this antacid may cause severe accumulation of calcium in the blood, called hypercalcemia.

To prevent health complications due to nutrient depletion, you must replenish your body with the lost nutrients. You can start with the following dosages in consultation with your physician.

  • Calcium – 1000-1200 mg
  • Folic acid – 400 mcg
  • Phosphorous – 700 mg
  • Vitamin B12 – 200 mcg
  • Vitamin D – 600-1000 IU
  • Zinc – 25-50 mg

How Do Antacids Interact With Other Medication?

Since antacids are essentially alkaline in nature, they shouldn’t be taken along with acidic medicines like digoxin, phenytoin and chlorpromazine. They cause reduction in the absorption of these drugs leading to reduced effect of these drugs on the body.

Antacids taken with drugs like pseudoephedrine and levodopa cause increased absorption of these drugs and can cause drug toxicity or adverse effects of drug overdose.

Magnesium-containing antacids can bind to antibiotics such as tetracycline and reduce its absorption and thus, its efficacy.

Antacids containing sodium bicarbonate affect the acidity of the urine, thereby affecting the elimination of certain drugs (like quinidines and amphetamines) by the kidneys. Antacids also increase the excretion of acidic drugs like aspirin.

How Should You Store Antacids?

side effects of antacids

Always store your medicines in a cool, dry place so as not to affect their efficacy. Keep medicines out of reach of children. Never keep medicines in the bathroom as it is hot and humid and may affect the potency of the medicines. Always use medicines within their expiration dates. All expired medicines should be disposed of safely to avoid their misuse. Most pharmacies will take back expired medicines and ensure their safe disposal.

Dietary Considerations while on Antacids

Avoid acidic, spicy, fried foods if you suffer from heartburn. There are some foods,  such as grains, meat, alcohol, etc. that will make your heartburn worse. It will be wise to keep away from them.

Final Verdict

Acid Reflux is a common health condition and is often brushed aside as a minor irritant. The majority of sufferers simply pop an antacid tablet or gulp a teaspoonful of the antacid and go about their jobs. However, heartburn is a far more ominous sign with serious complications than just a burning sensation in the throat.

Over the counter antacids are meant for relieving symptoms of the occasional acid reflux. If your acid reflux persists, there might be a problem within your gut that you need to look at seriously.

Antacids cause a wide variety of short term and long-term side effects that range from minor to potentially life-threatening.

Acid reflux should be treated at its very roots and antacids are definitely not an answer to it.  There are far gentler options to treat heartburn symptoms effectively. Try them.

Jitendra Rathod

Jitendra Rathod

Microbiologist and Science Writer
Jitendra is a microbiologist and a passionate student of the human body. He is a firm believer in the power of alternative and holistic medicine. He believes nature holds the key to restore us back to health and balance.

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2. https://medlineplus.gov/ency/article/000332.htm

3. https://medlineplus.gov/ency/patientinstructions/000198.htm

4. http://www.sciencedirect.com/science/article/pii/S0735109785804666

5.  http://www.jpharmsci.org/article/S0022-3549(15)38531-2/pdf

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7. http://www.tandfonline.com/doi/abs/10.3109/03602537909046431?journalCode=idmr20

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9. https://books.google.co.in/books id=AgNrZzBFjQsC&pg=PA252&lpg=PA252&dq=antacid+drug+interactions+levodopa&source=bl&ots=DsQXWIKg3L&sig=vZYb6cjhXIt6ifJXQY3bM-rooLw&hl=en&sa=X&ved=0ahUKEwid_cOq-I3UAhUWS48KHZUwD304ChDoAQgpMAE#v=onepage&q=antacid%20drug%20interactions%20levodopa&f=false

10.  http://www.tandfonline.com/doi/abs/10.3109/03602537909046431?journalCode=idmr20

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This article is intended for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Sepalika.com strongly recommends that you consult a medical practitioner for implementing any of the above. Results may vary from person to person.

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