Magaldrate

Magaldrate (magnesium aluminum hydroxide sulfate) is an antacid drug used for the treatment of esophagitis, duodenal and gastric ulcers and gastroesophageal reflux. Oral administration.

After taking aluminum-containing antacids, plasma aluminum values rise from the basal 7 μg/L to 55 μg/L within half an hour and fall back to their previous value 3 hours later. Aluminum and magnesium from antacids are not concentrated in breast milk. The average natural concentration of magnesium in milk is 31 mg/L (15 to 64 mg/L) and is little affected by magnesium ingestion. ^{(Dórea 2000)}

Small amounts of aluminum and magnesium may be excreted in breast milk, but the concentrations reached are not high enough to cause adverse effects in the newborn. Therefore, its use is accepted during breastfeeding, and it is recommended to avoid chronic and/or excessive use. ^{(AEMPS 2009, Broussard 1998)}

Breast milk contains an average of 15 to 50 μg/L of aluminum, an amount 10 to 40 times lower than the 180 to 700 μg/L of commercial infant formulas. ^{(Burrell 2010, Simmer 1990)}

The low oral bioavailability of magaldrate means that there is little passage to infant plasma from ingested breast milk, except in premature infants and the immediate neonatal period, where there may be greater intestinal absorption.

Several medical societies, expert authors and the manufacturer consider safe the use of this medication during breastfeeding. ^{(AEMPS 2009, Mahadevan 2006, Richter 2005, Broussard 1998)}

WHO 2002 essential medicines list: Aluminum and magnesium hydroxides compatible with breastfeeding (WHO 2002). American Academy of Pediatrics: Magnesium sulfate is a medication usually compatible with breastfeeding. ^{(AAP 2001)}