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Antacid Pregnancy: SPC section 4.6: For Mucogel no clinical data on exposed pregnancies are available. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development. Caution should be exercised when prescribing to pregnant women.

Co-magaldrox (Aluminium and Magnesium Hydroxide)

Brand names: Mucogel

Co-magaldrox is an antacid combining aluminium hydroxide and magnesium hydroxide, used for the symptomatic relief of dyspepsia, heartburn and acid-related upper gastrointestinal discomfort.

Adult dose

Dose: Antacid therapy in gastric and duodenal ulcer, gastritis, heartburn, gastric hyperacidity; treatment of indigestion; relief of symptoms of heartburn and dyspepsia associated with gastric reflux in hiatus hernia, reflux oesophagitis and similar conditions (adults, elderly and children aged 12 years and older): 10-20 ml of Mucogel suspension three times daily
Route: Oral (suspension)
Frequency: Three times daily, 20 minutes to one hour after meals, and at bedtime, or as required
PRODUCT (SPC section 2): MUCOGEL SUSPENSION (PL004270287, Rosemont Pharmaceuticals Ltd) - 'Each ml contains 44 mg dried aluminium hydroxide and 39 mg magnesium hydroxide'. READING OF THE DOSE FIGURE: the SPC's PDF text layer prints section 4.2 as 'Adults, elderly and children aged 12 years and older 10 20 ml three times daily 20 minutes to one hour after meals, and at bedtime, or as required' - the dash between 10 and 20 is missing from the text layer. Per the batch rule, the MHRA-approved patient leaflet for the SAME product and licence holder (PL004270287, Rosemont; in the bundle as mhra_pil) was used ONLY to read this figure as a range: it prints 'Take 10-20 ml three times a day, 20-60 minutes after meals and at bedtime, or as required'. Every other figure here comes from the SPC. No maximum dose is printed in the SPC, so none is written. Section 4.1: 'Mucogel is indicated in adults and children aged 12 years and older.' Children less than 12 years of age: 'Mucogel should not be used in children less than 12 years of age' (section 4.2). Method of administration: oral use (section 4.2). Section 4.3: should not be used in patients who are severely debilitated or suffering from kidney failure. Section 4.5: antacids inhibit the absorption of tetracyclines and vitamins and should not be taken concomitantly. Contains sorbitol (E 420) 8.75 mg per ml (not for hereditary fructose intolerance) and methyl and propyl parahydroxybenzoates (section 4.4).

Paediatric dose

Dose: Children aged 12 years and older: the same as the adult dose - 10-20 ml three times daily. Mucogel should not be used in children less than 12 years of age.
Route: Oral (suspension)
Frequency: Three times daily, 20 minutes to one hour after meals, and at bedtime, or as required
THE LABEL'S OWN STATEMENT, NOT SCALED. Section 4.2 prints one dose for 'Adults, elderly and children aged 12 years and older' and states 'Children less than 12 years of age Mucogel should not be used in children less than 12 years of age.' No weight-based figure and no separate paediatric maximum is printed. See the adult notes for the reading of '10 20 ml' as 10-20 ml (MHRA patient leaflet corroboration). Section 4.4: in young children the use of magnesium hydroxide can produce a hypermagnesaemia, especially if they present with renal impairment or dehydration. Verify against a children's formulary before use.

Dose adjustments

Renal

Section 4.3: should not be used in patients who are severely debilitated or suffering from kidney failure. Section 4.8: hypermagnesaemia has been observed after prolonged administration of magnesium hydroxide to patients with renal impairment (very rare). No numeric renal dose adjustment is printed.

Hepatic

No hepatic dose adjustment is printed in the retrieved SPC sections.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substances or to any of the excipients (section 4.3)
  • Patients who are severely debilitated or suffering from kidney failure (section 4.3)
  • Children less than 12 years of age (section 4.2: should not be used)
  • Hereditary fructose intolerance (HFI) - contains sorbitol (E 420) 8.75 mg per ml (section 4.4)

Side effects

  • Gastrointestinal side-effects are uncommon; this formulation minimises the problems of diarrhoea and constipation (section 4.8)
  • Hypermagnesaemia - very rare; observed after prolonged administration of magnesium hydroxide to patients with renal impairment (section 4.8)
  • Abdominal pain - frequency not known (section 4.8)
  • Methyl and propyl parahydroxybenzoates may cause allergic reactions (possibly delayed) (section 4.4)

Interactions

  • Tetracyclines and vitamins - antacids inhibit their absorption and should not be taken concomitantly (section 4.5)
  • Drugs whose excretion is altered by urine alkalinisation (secondary to magnesium hydroxide) - increased excretion of salicylates has been seen (section 4.5)

Monitoring

  • In young children magnesium hydroxide can produce hypermagnesaemia, especially with renal impairment or dehydration (section 4.4)
  • Hypermagnesaemia after prolonged administration in renal impairment (section 4.8)

Clinical monograph

How it works

The constituent hydroxides neutralise gastric acid, raising intragastric pH; pairing aluminium and magnesium salts balances their opposing effects on bowel transit.

Prescribing in practice

  • Use with caution in renal impairment, where aluminium and magnesium can accumulate and cause toxicity, and avoid in hypophosphataemia.
  • Separate dosing from other oral medicines because antacids reduce the absorption of many drugs, including certain antibiotics, bisphosphonates and iron.
  • Be aware the preparation contains sodium and may cause altered bowel habit, with magnesium tending to loosen and aluminium to constipate.

Monitoring

Routine monitoring is not generally required for short-term use, but consider renal function and electrolytes in patients with renal impairment or prolonged use.

Counselling the patient

  • Take after meals and at bedtime, or when symptoms occur.
  • Leave a gap between this and your other medicines.
  • See a doctor if symptoms persist or worsen.

Evidence & guidelines

Antacid efficacy for symptomatic acid-related dyspepsia is well established and reflected in current prescribing references and the SPC.

Reference: SPC Mucogel; NICE CG17 Dyspepsia; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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