Aluminium hydroxide for kidney disease

Also called Alu-tab

Key points about aluminium hydroxide for kidney disease

  • Aluminium hydroxide is sometimes used for people with kidney failure who have high phosphate levels.
  • Aluminium hydroxide is also called Alu-Tab.
  • Find out how to take it and possible side effects.
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Kidney disease can cause phosphate to accumulate. Uncontrolled high phosphate levels may lead to weakening of the bones and may also increase the risk of a heart attack and stroke.

Aluminium hydroxide helps to reduce too much phosphate accumulating in your body. It works by reducing the amount of phosphate your body absorbs from the food you eat. Aluminium hydroxide combines with phosphate in your stomach and this is then removed in your poo (faeces) instead of being absorbed. 

Note: Aluminium hydroxide is also found in a variety of antacids. The information on this page is about aluminium as a phosphate binder for people with kidney disease. For information about antacids, see Antacids

Your doctor will tell you how many tablets to take each day. Aluminium hydroxide (Alu-Tab) is available as tablets (600mg).

  • As a phosphate binder, the usual adult dose is 1 or 2 tablets three times a day with meals. 
  • If you have missed a meal, don't take your dose of Alu-Tab.
  • Depending on your blood phosphate levels, your doctor may adjust your dose.
  • Always take your Alu-Tab exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

  • Timing: To work effectively as a phosphate binder, Alu-Tab must be swallowed whole 10 to 15 minutes before meals or immediately before you start eating. 
  • If you are taking other medicines: Aluminium hydroxide can interfere with other medicines taken at the same time and can prevent them from working. Discuss the timing of your medicines with your doctor or pharmacist. 
  • Missed dose: If you forget your dose before or with your meal, wait for your next meal to take your usual dose. Don't take double the dose and don't take the tablets without meals. 

Here are some things to know when you're taking Alu-tab. Other things may be important as well, so ask your healthcare provider what you should know about.

Talk to your healthcare team about all the medicines you are taking including vitamins, herbal or complementary products and medicines you can buy without a prescription. Alu-Tabs may interact with some medicines and herbal supplements, so check with your doctor or pharmacist before starting any new medicines. 

Like all medicines, aluminium hydroxide can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Constipation (trouble passing faeces, poo)
  • Tell your doctor if this bothers you
  • Signs of low phosphate such as unusual tiredness, muscle weakness and confusion 
  • Tell your doctor immediately or ring Healthline 0800 611 116.
Did you know that you can report a medicine side effect to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)


  1. Aluminium hydroxide dried(external link) New Zealand Formulary

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Reviewed by: Angela Lambie, Pharmacist, Auckland

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