Antacid (aluminium magnesium hydroxide carbonate)
ATC code: A02AD02 (Almagate)
Aluminium and magnesium hydroxide carbonate in crystalline form. Neutralizes gastric acid with fast onset (5–10 minutes) and up to 3 hours' duration on an empty stomach. Not absorbed – acts only in the gastric lumen. Compared with other antacids, the balanced aluminium-to-magnesium ratio causes less constipation (from aluminium) and less diarrhea (from magnesium). In Spain it is among the most popular over-the-counter antacids under the brand Almax by Almirall.
Adjunct
Symptomatic relief of epigastric pain and discomfort in functional dyspepsia. Per Rome IV and the Spanish AEG 2024 consensus, first-line depends on subtype: PPIs for epigastric pain syndrome; prokinetics for postprandial distress. Antacids give quick relief but do not modify disease course.
Sources
Adjunct
Symptomatic relief in moderate heartburn and acid reflux. 2022 and the Spanish AEG 2024 consensus set proton pump inhibitors (omeprazole, pantoprazole, esomeprazole) and lifestyle change as first-line in GERD. Antacids including almagate are quick symptomatic relief used before or together with a PPI, especially in episodic heartburn. Not used as monotherapy in erosive esophagitis.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Almagate is an antacid (an aluminum and magnesium hydroxide complex), approved by AEMPS. It rapidly neutralizes acid and relieves heartburn and discomfort in mild, occasional dyspepsia. It is an on-demand symptomatic option: for frequent or persistent symptoms, proton pump inhibitors are more effective and a workup is needed. The profile is mild: bowel changes are possible; use with caution in renal impairment.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Direct links to regulator labels. Open in a new tab.
Acceptable in pregnancy for short-term heartburn relief. Systemic bioavailability is essentially nil.
Compatible with breastfeeding. Essentially does not pass into milk.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Almagate is evaluated for the following indications with varying evidence strength: Antacid therapy for mild dyspepsia (evidence tier B), Functional dyspepsia (evidence tier C), Gastroesophageal reflux disease (evidence tier C). See the full indication matrix with dosing and citations above on this page.
Common side effects of Almagate (≥ 1 in 100): Constipation or diarrhea (individual response), Nausea, Taste alteration, Flatulence. See the Safety section for uncommon and serious reactions.
FDA category B. Acceptable in pregnancy for short-term heartburn relief. Systemic bioavailability is essentially nil.
Compatible with breastfeeding. Essentially does not pass into milk.
Almagate is contraindicated in: Hypersensitivity to components; Severe renal impairment (eGFR under 30) – hypermagnesemia risk; Hypophosphatemia; Alzheimer's disease (theoretical aluminium accumulation risk); Age under 6. Full list in the Safety section.