MOXAL SUSP 200ML

Indications

Approved Uses

Symptomatic relief of heartburn, acid indigestion/dyspepsia, and gastric hyperacidity (sour stomach/upset stomach related to excess acid).

Dosage & Administration

Dosing by Condition

Adults and ≥12 years (typical OTC antacid use): 10-20 mL after meals and at bedtime, up to 4 times daily as needed; do not use continuously >14 days without medical advice.

Initial Dose

10ml (2 teaspoons) after meals and at bedtime

Maintenance Dose

10-20 mL as needed after meals and at bedtime.

Maximum Dose

80ml (16 teaspoons) per day in adults

Dose Adjustment Notes

Renal impairment: use with caution and avoid prolonged/high-dose use; in severe renal failure/dialysis generally avoid unless specifically directed due to aluminum/magnesium accumulation and toxicity risk.

How to Take

Shake well before each use; measure with a calibrated device. Take orally preferably 20-60 minutes after meals and at bedtime. Separate from other oral medicines by at least 2 hours (4 hours for levothyroxine). May be taken with water; milk is optional.

How to Prepare

Ready-to-use oral suspension. Shake well before each dose. No reconstitution required.

Side Effects

Common Side Effects

Constipation, diarrhea, nausea, abdominal discomfort/cramps, and chalky taste (less commonly vomiting).

Side Effect Frequency

Common: constipation (aluminum) and diarrhea (magnesium); other GI effects such as nausea/chalky taste may occur. Uncommon/with prolonged use or renal impairment: hypophosphatemia, hypermagnesemia, and aluminum accumulation/toxicity.

Safety & Warnings

Contraindications

Hypersensitivity to components; severe renal impairment/renal failure; hypophosphatemia (or conditions predisposing to phosphate depletion).

Warnings & Precautions

Do not use for prolonged periods without medical advice; use caution/avoid in renal impairment; prolonged/high-dose use may cause hypophosphatemia; separate from other oral medicines by at least 2 hours (longer for some interacting drugs); seek medical review if symptoms persist/are recurrent.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Reduces absorption of many oral drugs via chelation/adsorption or pH effects (notably tetracyclines, fluoroquinolones, iron, levothyroxine, bisphosphonates, azole antifungals, digoxin); separate by at least 2 hours (4 hours for tetracyclines/fluoroquinolones/levothyroxine/bisphosphonates when feasible).

Interaction Severity

MAJOR/clinically significant: tetracyclines and fluoroquinolones (chelation markedly reduces absorption-separate by at least 2-6 hours per specific antibiotic). MODERATE: levothyroxine (separate by 4 hours), iron salts, digoxin, azole antifungals (ketoconazole/itraconazole), and other drugs with pH-/adsorption-dependent absorption (separate by ≥2 hours).

Food Interaction

No clinically significant food interaction; taking 20-60 minutes after meals and at bedtime can improve duration of symptom relief.

Special Populations

Pregnancy

Consult Doctor

Kidney Impairment

Mild-moderate renal impairment: use with caution, lowest effective dose, avoid prolonged/frequent use; severe renal impairment/renal failure (e.g., CrCl <30 mL/min or dialysis patients): avoid/contraindicated due to magnesium and aluminum accumulation.

Liver Impairment

No adjustment needed

Storage & Patient Advice

Storage Conditions

Store below 30°C. Do not freeze. Keep bottle tightly closed. Ready-to-use suspension - no reconstitution required.

Preparation Instructions

Ready-to-use oral suspension. Shake well before each dose. No reconstitution required.

Missed Dose

If using on a schedule, take when remembered unless close to the next dose; otherwise skip-do not double. If using as needed, take when symptoms occur.

Stopping the Medicine

Safe to stop anytime when used for occasional symptoms.

Patient Counseling

Shake well; measure doses accurately. Take after meals and at bedtime for best effect; separate other oral medicines by ≥2 hours (levothyroxine 4 hours; follow antibiotic-specific spacing). Do not use continuously for >14 days unless advised by a clinician; seek care for alarm symptoms (GI bleeding, weight loss, persistent vomiting, severe pain). Use caution/seek advice if you have kidney disease.

Monitoring Requirements

No routine monitoring for short-term use. With prolonged use: monitor serum phosphate, magnesium, and aluminum levels, especially in renal impairment.

Pharmacology

Mechanism of Action

Neutralizes gastric acid by reacting with hydrochloric acid to raise intragastric pH and reduce pepsin activity; aluminum hydroxide can bind phosphate, and combining aluminum (constipating) with magnesium (laxative) helps balance bowel effects.

Onset of Action

Rapid-typically within minutes (about 5-15 minutes).

Half-Life

Not applicable/Not clinically meaningful (local GI effect with minimal systemic absorption; no defined systemic half-life for the product’s antacid action).

Bioavailability

Minimal systemic absorption; primarily local action in the stomach/intestine (only small fractions of aluminum and magnesium are absorbed, with higher absorption risk in renal impairment).

Metabolism

Not significantly metabolized; acts locally and reacts chemically with gastric acid to form salts (e.g., aluminum/magnesium salts) that are mostly not absorbed.

Excretion

Primarily excreted in feces as insoluble salts; any absorbed aluminum and magnesium are eliminated renally in urine.

Protein Binding

Not applicable (minimal systemic absorption; protein binding not clinically relevant).

Product Information

Available Dosage Forms

Oral suspension, chewable tablets.

Composition per Dose

Each 5ml: Aluminum hydroxide 405mg + Magnesium hydroxide 100mg

Generic Availability

Yes

OTC Alternatives

Calcium carbonate antacids; sodium bicarbonate; other aluminum/magnesium antacid combinations (e.g., Maalox-type products); alginate-containing antacid/raft-formers (e.g., some Gaviscon formulations).

Gi Condition

Acid Reflux/GERD

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