Maalox Plus Simethicone Suspension

Maalox Plus Simethicone Suspension is a liquid oral antacid product that combines two antacid agents, aluminium hydroxide and magnesium hydroxide, together with simethicone, an anti-foaming agent, in a single suspension. It belongs to the combination antacid product class and is sold in a 250ml bottle. Maalox is manufactured by Sanofi (Opella Healthcare).

The exact strength of each active ingredient per 5ml can vary slightly between the regional formulations of Maalox Plus sold under the Sanofi group worldwide, so the specific milligram amounts of aluminium hydroxide, magnesium hydroxide, and simethicone per dose should always be checked on the printed carton and package insert of the Malaysian pack rather than assumed from a generic figure. What distinguishes Maalox Plus from a plain single-ingredient antacid is the addition of simethicone alongside the two antacid salts within the same suspension.

Maalox Plus Simethicone Suspension is available in Malaysia as an OTC (Over-the-Counter) product and can be purchased at a pharmacy without a doctor’s prescription. It is presented as a ready-to-drink liquid suspension that requires shaking before use, and is distinct from the Maalox Plus chewable tablet, which is a separate solid dosage form of the same brand.

Shake the bottle well before every use, as the suspension can settle at the bottom of the bottle. Measure the dose using the measuring cup or spoon supplied with the product rather than an ordinary household spoon, to ensure an accurate amount is taken. The suspension is generally taken after meals and at bedtime, or exactly as instructed on the pack label.

Because Maalox Plus can reduce the absorption of a number of other oral medicines when taken close together, it is generally recommended to leave a gap of at least two hours between a dose of Maalox Plus and other oral medicines, including antibiotics and iron supplements. If Maalox Plus Simethicone Suspension is being used alongside another antacid, gas-relief, or simethicone-containing product, take care not to exceed the combined recommended daily amount of these ingredients from all products used together.

For adults and children 12 years and above, a common dose is 5-10ml (one to two 5ml measures), taken up to four times a day, generally 20 minutes to one hour after meals and at bedtime, or as directed on the product label. Do not exceed the maximum daily dose stated on the pack. Use in younger children should follow the age-specific guidance printed on the Malaysian pack insert or the advice of a doctor or pharmacist, since dosing recommendations for children can differ between product markets and are not something to estimate independently.

If a dose is missed, simply take the next dose at its scheduled time rather than doubling up. A doctor should be consulted if symptoms do not improve after using Maalox Plus for more than two weeks, if symptoms worsen, or if there is difficulty or pain on swallowing, unexplained weight loss, or black or bloody stools.

Store the bottle below 30°C, away from direct sunlight and excessive heat, and keep it tightly capped and upright between uses. Do not freeze. Keep out of the reach and sight of children.

• Common: Constipation, which is more commonly linked to the aluminium hydroxide component.
• Common: Loose stools or mild diarrhoea, which is more commonly linked to the magnesium hydroxide component.
• Common: A chalky or altered taste in the mouth after dosing.
• Serious: Symptoms of raised magnesium levels in people with impaired kidney function, such as unusual drowsiness, muscle weakness, or an irregular heartbeat — seek medical attention if these occur.
• Serious: Signs of an allergic reaction, including rash, swelling of the face or throat, or difficulty breathing.

• Known hypersensitivity to aluminium hydroxide, magnesium hydroxide, simethicone, or any other ingredient in the suspension.
• Severe kidney impairment or kidney failure, due to the risk of magnesium and aluminium accumulation.
• Hypophosphataemia (abnormally low blood phosphate levels).
• Use in young children below the age stated on the pack, unless directed by a doctor.

• May reduce the absorption of tetracycline and quinolone-class antibiotics if taken at the same time — space doses at least two hours apart.
• May reduce the absorption of oral iron supplements, such as iron polymaltose or ferrous salt products — take at least two hours apart from Maalox Plus.
• May alter the absorption of certain heart medicines such as digoxin, and of some antifungal medicines, by changing stomach acidity — separate dosing times where possible and check with a pharmacist.
• Avoid taking other antacid, gas-relief, or simethicone-containing products at the same time without checking with a pharmacist, to avoid taking more than the recommended daily amount of these ingredients.

• Shake the bottle thoroughly before each and every use.
• Always use the measuring cup or spoon provided rather than a regular kitchen spoon.
• Take doses after meals and at bedtime, or at the times printed on the pack label.
• Leave at least a two-hour gap between this product and other oral medicines you are taking.
• Close the cap tightly and store the bottle upright after use.
• Do not use the suspension beyond its printed expiry date, even if some liquid remains in the bottle.

Precautions: Use Maalox Plus Simethicone Suspension with caution if you have any degree of kidney impairment, are on a low-phosphate or low-magnesium/aluminium diet as advised by a doctor, or are pregnant or breastfeeding, and confirm suitability with a pharmacist first. Because this product can reduce absorption of many other oral medicines, keep track of what else you are taking and the spacing between doses. Keep the bottle out of the reach of children.

When to See a Doctor or Pharmacist: Speak to a doctor or pharmacist if symptoms persist for more than two weeks of regular use, if you notice black or bloody stools, persistent vomiting, unexplained weight loss, or difficulty swallowing, or if you are unsure whether this product is safe to combine with your other medicines or existing kidney condition.