Antacids are medicines that neutralise stomach acid, used for fast relief of heartburn, indigestion and stomach discomfort. They are effective for occasional symptoms, but can reduce the absorption of other medicines if taken at the same time.
Also known as: Hidróxido de alumínio, Hidróxido de magnésio
DailyMed/FDA (NIH/NLM) — approved Antacids label (aluminium and magnesium hydroxide + dimethicone): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=23539e7e-a723-460f-892f-dac5bbbb9b16 — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012) — Group 6.2.1 Antacids (OTC DailyMed antacid labels do not include section 12 Clinical Pharmacology)
Markedly reduced Ciprofloxacin absorption. Divalent cations (aluminium, magnesium, calcium, iron) chelate the fluoroquinolone.
Ciprofloxacin forms insoluble chelates with di- and trivalent cations (aluminium, magnesium, calcium) present in antacids, reducing oral bioavailability by up to 90% and risking therapeutic failure in serious infections (e.g., febrile neutropenia, complicated urinary tract infections). The ciprofloxacin label recommends administering the antibiotic 2 hours before or 6 hours after antacids containing magnesium or aluminium; the same care applies to calcium, iron and zinc supplements and to sucralfate. In hospitalised patients, check the administration schedule of both.
Antacids + ciprofloxacin: cations (Al, Mg, Ca) chelate ciprofloxacin and reduce absorption by up to ~90%. Administer ciprofloxacin 2 hours before or 6 hours after antacids.
Chelation between the antibiotic and cations in the gastrointestinal lumen.
Watch antibiotic efficacy (fever, unresolved infection signs).
Persistent fever, worsening symptoms or a new infection focus.
Give the antacid 2 hours after (or 6 hours before) Ciprofloxacin.
DailyMed/FDA (NIH/NLM) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb ; approved Ciprofloxacin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14c3bc33-201d-492e-9aee-a4d84c813a3d
Antacids reduce Chloroquine absorption, which may lower its efficacy.
Antacids containing kaolin, magnesium or aluminium adsorb chloroquine in the gastrointestinal lumen and reduce its absorption, potentially lowering plasma concentrations and compromising antimalarial treatment or prophylaxis. The chloroquine label recommends separating administration by at least 4 hours when an antacid is needed. This precaution is especially relevant in patients on malaria prophylaxis or treatment of autoimmune diseases (lupus, rheumatoid arthritis), where adherence and efficacy are critical.
Antacids + chloroquine: antacids (kaolin, magnesium, aluminium) reduce chloroquine absorption. Separate administration by at least 4 hours.
Chelation and changes in gastric pH reduce Chloroquine solubility and absorption.
Clinical response; reassess if therapeutic failure.
Lack of response to treatment.
Separate doses by 2–4 hours (antacids after Chloroquine).
DailyMed/FDA (NIH/NLM) — approved Chloroquine label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06c69e2b-211b-4746-9f3a-f86d36520570 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb
Antacids, H2-blockers, proton-pump inhibitors and sucralfate markedly reduce Itraconazole absorption.
Itraconazole capsules require an acidic gastric medium to dissolve and absorb the drug; antacids, by raising the pH, reduce itraconazole plasma concentrations and can compromise the treatment of systemic fungal infections or prophylaxis in immunocompromised patients. The itraconazole label recommends taking the capsules after a full meal (which promotes acidity) and separating from antacids by at least 2 hours. Alternatively, consider oral solution formulations of itraconazole (less pH-dependent) under medical guidance.
Antacids + itraconazole (capsules): absorption depends on acidic pH; antacids reduce it. Separate by at least 2 hours and, if possible, avoid the combination.
Itraconazole (capsule) absorption depends on gastric acidity; agents that raise gastric pH reduce absorption.
Clinical response; signs of antifungal failure.
Persistent or worsening fungal infection.
Give itraconazole at least 2 h before antacids/PPIs; consider the oral solution (less pH-dependent absorption).
DailyMed/FDA (NIH/NLM) — approved Itraconazole label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a4d555fa-787c-40fb-bb7d-b0d4f7318fd0 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Combining Atazanavir with Antacids reduces Atazanavir absorption, with a risk of reduced efficacy.
Atazanavir is an HIV protease inhibitor whose absorption depends on an acidic gastric pH: antacids, by neutralising the acid, reduce the drug solubility and plasma concentration, with a risk of loss of antiretroviral efficacy and viral resistance. The atazanavir label recommends administering the drug 2 hours before or 1 hour after antacids (and buffered medications). In patients on antiretroviral therapy, any drug that raises gastric pH (antacids, H2 antagonists, proton pump inhibitors) must be managed with caution and with the recommended spacing.
Antacids + atazanavir: raised gastric pH reduces atazanavir solubility and absorption. Administer atazanavir 2 hours before or 1 hour after antacids.
Antacids (aluminium/magnesium hydroxide) raise gastric pH and may chelate Atazanavir, lowering its bioavailability.
Monitor the virological response to the antiretroviral regimen.
Detectable viral load with regular antacid use requires reassessment of the regimen.
Separate administration: take antacids at least 2 hours before or after Atazanavir.
DailyMed/FDA (NIH/NLM) — approved Atazanavir label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=165cff62-b284-4a27-a65d-9ec8a5bfcdd8 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Bisphosphonate + antacids: marked reduction of alendronate absorption.
Antacids containing calcium, magnesium or aluminium form insoluble chelates with oral bisphosphonates such as alendronate, markedly reducing their absorption and efficacy (risk of therapeutic failure in osteoporosis). Alendronate should be taken on an empty stomach, with water, at least 30 minutes before the first food or medicine of the day. When an antacid is needed, administration should be separated as much as possible (ideally 2 hours), and the patient should be instructed to keep the usual alendronate schedule so adherence is not compromised.
Alendronate + antacids: cations (calcium, magnesium, aluminium) chelate alendronate and reduce its absorption. Separate administration by at least 30 minutes, ideally 2 hours.
Calcium, aluminium and magnesium in antacids chelate alendronate in the GI tract, preventing absorption.
Confirm adherence to the correct dosing schedule.
Lack of therapeutic effect; persisting osteoporosis/bone pain.
Separate administration by at least 2 hours (alendronate on an empty stomach, with plain water).
DailyMed (FDA) — approved Alendronate label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c7e470d6-508e-466e-a78d-060bbbc9745c ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f — additional reference: Prontuário Terapêutico do INFARMED (11th ed., 2012)
Reduced Doxycycline absorption through cation chelation.
Doxycycline, like other tetracyclines, forms insoluble chelates with di- and trivalent cations (calcium, magnesium, aluminium, iron, zinc), reducing its oral absorption and plasma concentrations — with a risk of therapeutic failure in infections such as brucellosis, rickettsioses, Lyme disease or severe acne. The doxycycline label and the Portuguese Prontuário Terapêutico recommend separating antacids (and calcium/iron supplements and dairy products) by at least 2–3 hours. Warn the patient not to take the antibiotic with milk or with the antacid.
Antacids + doxycycline: cations (Al, Mg, Ca) chelate tetracyclines and reduce absorption. Separate administration by at least 2–3 hours.
Chelation of the tetracycline with aluminium, magnesium, calcium and iron in the gut.
Antibiotic efficacy.
Persistent fever, pain or discharge — infection possibly uncontrolled.
Separate the antacid dose from Doxycycline by 2–3 hours.
DailyMed/FDA (NIH/NLM) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb ; approved Doxycycline label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cf95b2ca-2cf8-49a8-8e3a-f9b0f5b2072c
Antacids, H2-blockers, proton-pump inhibitors and sucralfate markedly reduce Ketoconazole absorption, compromising efficacy.
Ketoconazole (tablet) is an azole antifungal whose oral absorption is strongly dependent on an acidic gastric pH — the drug is a weak base that only dissolves well in an acidic medium. Antacids, by raising the pH, can reduce ketoconazole plasma concentrations in a clinically significant way, compromising the treatment of systemic fungal infections. The ketoconazole label and the Portuguese Prontuário Terapêutico recommend avoiding the combination or separating administration by at least 2 hours (ideally more), and considering monitoring the clinical response to the antifungal.
Antacids + ketoconazole: ketoconazole tablet absorption depends on acidic pH; antacids reduce it dramatically. Avoid simultaneous administration and separate by at least 2 hours.
Ketoconazole absorption depends on gastric acidity; agents that raise gastric pH reduce its dissolution and absorption.
Clinical response; signs of antifungal failure; temporal separation of doses.
Worsening or persistent fungal infection.
Give ketoconazole at least 2 h before antacids/PPIs; otherwise use fluconazole/voriconazole (less pH-dependent).
DailyMed/FDA (NIH/NLM) — approved Ketoconazole label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f162e616-21b4-49b1-b437-15e21001a6f0 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Antacids (aluminium and magnesium) reduce Ethambutol absorption — risk of subtherapeutic levels.
The ethambutol label states that aluminium hydroxide, present in many antacids, reduces ethambutol absorption, potentially lowering plasma concentrations and compromising antituberculosis treatment. Separate ethambutol and antacid administration by at least 4 hours. Adherence and efficacy of the antituberculosis regimen are critical, so this precaution should be passed on to the patient, especially in fixed-dose combination regimens where the schedule is already demanding.
Antacids + ethambutol: aluminium hydroxide reduces ethambutol absorption. Separate administration by at least 4 hours.
Chelation and reduced gastrointestinal absorption.
Clinical TB response; adherence.
Treatment failure.
Separate ethambutol and antacid intake by at least 4 hours.
DailyMed/FDA (NIH/NLM) — approved Ethambutol label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3f6428d6-3745-4337-ad78-ebfff9f49135 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb
Antacids and calcium-containing preparations significantly reduce Fosfomycin absorption, compromising its efficacy in urinary tract infection.
Fosfomycin trometamol, used as a single dose in uncomplicated urinary tract infections, has reduced oral absorption when taken with food; co-administration with antacids or other drugs that change gastric pH or motility can further reduce its bioavailability and compromise efficacy. The label recommends taking the drug on an empty stomach and the Portuguese Prontuário Terapêutico advises separating from antacids. In practice, instruct the patient to take fosfomycin alone, on an empty stomach, and to space any antacid by 2–3 hours.
Antacids + fosfomycin: take fosfomycin on an empty stomach and separate from antacids to avoid reducing its absorption.
Antacids, calcium salts (and also metoclopramide) interfere with oral fosfomycin bioavailability, reducing the concentrations reached in the urinary tract.
Monitor the clinical response and resolution of urinary symptoms.
Persistent urinary tract infection symptoms after concurrent dosing.
Separate fosfomycin dosing from antacids and calcium supplements by several hours and avoid taking it with meals.
DailyMed/FDA (NIH/NLM) — approved Fosfomycin trometamol label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4f206750-8126-99a3-e063-6294a90ade4c ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Antacids with cations (aluminium, magnesium, calcium) and iron/zinc supplements significantly reduce Levofloxacin absorption, compromising its efficacy.
Levofloxacin, like other fluoroquinolones, forms insoluble chelates with di- and trivalent cations (aluminium, magnesium, calcium) of antacids, reducing oral bioavailability and risking therapeutic failure. The levofloxacin label recommends administering the antibiotic at least 2 hours before or 2 hours after antacids containing magnesium or aluminium (the same applies to sucralfate, iron and zinc). This spacing should be checked at prescription and dispensing, especially in outpatients, to ensure antibiotic efficacy.
Antacids + levofloxacin: cations (Al, Mg, Ca) chelate levofloxacin and reduce absorption. Administer levofloxacin 2 hours before or 2 hours after antacids.
Bi/trivalent cations chelate quinolones in the gut, forming insoluble complexes that reduce levofloxacin bioavailability.
Ensure the dosing interval is respected and monitor the clinical response to the antibiotic.
Treatment failure with persistent signs of infection after concurrent dosing.
Give levofloxacin at least 2 hours before or 2–4 hours after antacids, iron/zinc supplements or calcium preparations.
DailyMed/FDA (NIH/NLM) — approved Levofloxacin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c6c117c-9d91-48f4-9aaa-ee70b99218c2 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Antacids (aluminium and magnesium) reduce levothyroxine absorption when taken at the same time.
Levothyroxine has gastrointestinal absorption that is reduced by several drugs and foods; antacids containing aluminium, magnesium or calcium chelate or adsorb the hormone, decreasing its absorption and potentially destabilising the hypothyroid patient (signs of hypothyroidism, raised TSH). The levothyroxine label recommends separating antacid administration by at least 4 hours. Levothyroxine should always be kept on an empty stomach, 30–60 minutes before breakfast, and the antacid schedule adjusted accordingly, with TSH reassessment if needed.
Antacids + levothyroxine: cations (Al, Mg, Ca) reduce levothyroxine absorption. Separate administration by at least 4 hours.
Chelation/adsorption of levothyroxine by antacid cations.
Monitor TSH and hypothyroidism symptoms.
Decompensated hypothyroidism.
Separate administration times (4 hours) and monitor TSH.
DailyMed (FDA) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f ; approved Levothyroxine label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=55f4c679-86cb-b97f-e063-6294a90ad5ef — additional reference: Prontuário Terapêutico do INFARMED (11th ed., 2012)
Antacids with cations (aluminium, magnesium, calcium) and iron/zinc preparations significantly reduce Moxifloxacin absorption, compromising its efficacy.
Moxifloxacin, a broad-spectrum fluoroquinolone, forms insoluble chelates with di- and trivalent cations (aluminium, magnesium, calcium) present in antacids, reducing oral bioavailability and risking therapeutic failure in respiratory or pelvic infections. The moxifloxacin label recommends administering the antibiotic 4 hours before or 8 hours after antacids containing magnesium or aluminium, sucralfate, iron or zinc. This wide spacing should be clearly explained to the patient, since moxifloxacin is usually taken once daily.
Antacids + moxifloxacin: cations (Al, Mg, Ca) chelate moxifloxacin and reduce absorption. Administer moxifloxacin 4 hours before or 8 hours after antacids.
Bi/trivalent cations chelate moxifloxacin in the gut, forming insoluble complexes that reduce its bioavailability.
Ensure the dosing interval and monitor the clinical response.
Treatment failure/persistent infection after concurrent dosing.
Separate the doses: moxifloxacin at least 4 hours before or 8 hours after antacids and cation-containing preparations.
DailyMed/FDA (NIH/NLM) — approved Moxifloxacin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1ed191f5-7df5-488c-bb72-91ac0b618d9a ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c72f0736-ee20-45b4-baf0-b80f1e3fa9cb — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Antacids may reduce the protective effect of sucralfate when taken together.
Sucralfate is a cytoprotective agent that forms an adhesive barrier over the ulcer, but its polymerisation and activation depend on an acidic gastric medium. Antacids, by neutralising the acid, reduce the formation of that barrier and decrease sucralfate efficacy; additionally, sucralfate can reduce the absorption of co-administered drugs. The sucralfate label recommends not administering antacids within 30 minutes before or after sucralfate. In practice, instruct the patient to space the doses consistently (for example, sucralfate 1 hour before meals and the antacid at a separate time).
Antacids + sucralfate: antacids reduce sucralfate efficacy (pH-dependent activation). Do not administer within 30 minutes before or after sucralfate.
Antacids change gastric pH and may interfere with sucralfate polymerisation.
Monitor symptomatic response (epigastric pain, heartburn).
Recurrence of ulcer symptoms.
Separate sucralfate and antacid administration (30–60 minutes).
DailyMed (FDA) — approved Sucralfate label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1e781cc0-24ec-4028-8262-dcef9873ea1f ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f — additional reference: Prontuário Terapêutico do INFARMED (11th ed., 2012)
Antacids may reduce omeprazole absorption when taken at the same time.
Omeprazole is a proton pump inhibitor (PPI) usually taken on an empty stomach, 30–60 minutes before breakfast. Antacids can be used concomitantly for symptomatic relief, but simultaneous administration can reduce omeprazole absorption (which depends on the enteric coating and the pH of the medium) and decrease its efficacy. The omeprazole label considers the combination acceptable, but in practice it is recommended to separate administration by 1–2 hours. In patients with refractory symptoms, assess adherence and timing before escalating the PPI dose.
Antacids + omeprazole: generally compatible, but separate administration (at least 1–2 hours) to avoid reducing omeprazole absorption.
Gastric pH change and altered dissolution of gastro-resistant capsules by the antacid.
Monitor response to antacid/anti-ulcer therapy.
Insufficient symptom control.
Separate administration times (2 hours).
DailyMed (FDA) — approved Omeprazole label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6ea9a6f3-b756-4cdf-b3db-f666a2c17d66 ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f — additional reference: Prontuário Terapêutico do INFARMED (11th ed., 2012)
Antacids containing magnesium trisilicate reduce nitrofurantoin absorption and may decrease antibiotic effectiveness.
The nitrofurantoin SmPC documents decreased absorption with magnesium trisilicate (present in some antacids). Reduced absorption may compromise antibacterial efficacy in a urinary infection. Advise separating doses or avoiding antacids during treatment.
Absorption: magnesium trisilicate decreases nitrofurantoin absorption. Separate the doses (at least 2–3 h) or avoid the combination during treatment.
Chelation/adsorption of the drug by the antacid in the gastrointestinal tract.
Clinical response to antibiotic therapy.
Persisting urinary infection symptoms.
Separate the doses (minimum 2–3 h) or stop the antacid during treatment.
EMC-UK (MHRA) — approved Nitrofurantoin SmPC: https://www.medicines.org.uk/emc/product/100018/smpc ; PubMed — https://pubmed.ncbi.nlm.nih.gov/6995091/ ; Prontuário Terapêutico do INFARMED (11th ed., 2012)
Antacids work most effectively after meals and at bedtime.
Take 1–2 hours after meals and at bedtime.
DailyMed (FDA) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f
Aluminium and magnesium cations from antacids may accumulate in renal impairment.
Avoid prolonged use or high doses in severe renal impairment.
DailyMed (FDA) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f
Aluminium and magnesium antacids are considered safe in pregnancy at usual doses and short term.
Can be used in all trimesters; avoid prolonged high doses (aluminium accumulation).
Excreted into breast milk in small amounts; compatible with breastfeeding.
No specific additional contraception.
DailyMed (FDA) — approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5e346dc0-69ce-4cc5-bb5d-bfa833e11c1f
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Antacids neutralise the hydrochloric acid of the gastric contents, relieving pain; in amounts sufficient to raise gastric pH markedly they inhibit peptic activity, since pepsin is inactivated between pH 7 and 8. Liquid or powder preparations are more effective than tablets, probably because they disperse more rapidly. They may be systemic (sodium bicarbonate, calcium carbonate — absorbed, with risk of metabolic alkalosis and milk-alkali syndrome) or non-systemic (aluminium and magnesium salts — forming insoluble, non-absorbable basic compounds).
They act by direct neutralisation of gastric acid (acid-base reaction) and by inhibition of pepsin activity when the pH rises to 7 to 8. Alkalinisation of the gastric contents decreases the absorption of weak acids and increases that of basic compounds; antacids containing calcium, magnesium and aluminium can adsorb other drugs (e.g. tetracyclines, chlorpromazine, anticholinergics).
They act locally in the stomach, without needing absorption for the effect; the most effective (sodium bicarbonate, calcium carbonate) have the described limitations (alkalosis, milk-alkali syndrome, renal lithiasis). Magnesium oxide and hydroxide act rapidly but can cause diarrhoea; magnesium trisilicate, aluminium hydroxide gel and bismuth salts are less effective but also cause fewer unwanted effects.
Magnesium salts act rapidly but can cause diarrhoea; aluminium salts cause constipation. Systemic antacids (e.g. sodium bicarbonate) are absorbed and can disturb acid-base balance (metabolic alkalosis); under homeostatic conditions excess bicarbonate is excreted by the kidney, alkalinising the urine. With simultaneous calcium intake (milk, calcium-containing antacid) the milk-alkali syndrome may occur.
The effect is short-lived — administration is recommended 1 to 3 hours after meals and at bedtime, or according to symptoms. Chronic calcium intake can increase the incidence of renal stones and phosphate lithiasis is favoured by persistent urine alkalinisation; silica stones may occur with magnesium silicate.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
