# GORD in pregnancy (gastro-oesophageal reflux in pregnancy) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - Gastrointestinal Tract 2025 · ACG Clinical Guideline: Management of GERD 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) · MSF Essential Drugs 2024 (aluminium hydroxide/magnesium hydroxide oral monograph, page 31): "Adult: 1 to 2 tablets 3 times daily 20 minutes to one hour after meals, or 1 tablet during painful attacks", of the "400 mg aluminium hydroxide/400 mg magnesium hydroxide chewable tablet" · GORD - disease-level clinical article (gerd-full.txt) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) - MSF Essential Drugs 2024 (aluminium hydroxide/magnesium hydroxide oral monograph, page 31): "Adult: 1 to 2 tablets 3 times daily 20 minutes to one hour after meals, or 1 tablet during painful attacks", of the "400 mg aluminium hydroxide/400 mg magnesium hydroxide chewable tablet" - GORD - disease-level clinical article (gerd-full.txt) ## Treatment metadata - Aluminium hydroxide + Magnesium hydroxide — 800 mg — oral.solid - Famotidine — 20 mg — oral.solid ## Complete treatment card ```text GORD IN PREGNANCY (GASTRO-OESOPHAGEAL REFLUX IN PREGNANCY) Sources: Egyptian National Drug Formulary - Gastrointestinal Tract 2025 · ACG Clinical Guideline: Management of GERD 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) · MSF Essential Drugs 2024 (aluminium hydroxide/magnesium hydroxide oral monograph, page 31): "Adult: 1 to 2 tablets 3 times daily 20 minutes to one hour after meals, or 1 tablet during painful attacks", of the "400 mg aluminium hydroxide/400 mg magnesium hydroxide chewable tablet" · GORD - disease-level clinical article (gerd- full.txt) Review status: REVIEWED against 3 sources listed above (2026-08) 1. ALUMINIUM HYDROXIDE + MAGNESIUM HYDROXIDE [1st line] Adult 1 to 2 tablets (400 mg + 400 mg) three times daily, 20 minutes to one hour after meals; or 1 tablet during an attack - According to clinical response Peds Adult-only condition - paediatric section not applicable Source MSF Essential Drugs 2024 (aluminium hydroxide/magnesium hydroxide oral monograph, page 31): "Adult: 1 to 2 tablets 3 times daily 20 minutes to one hour after meals, or 1 tablet during painful attacks", of the "400 mg aluminium hydroxide/400 mg magnesium hydroxide chewable tablet" Why The first step for reflux in pregnancy, and the one to try before an acid suppressant. The GORD article's indication is that antacids are taken as and when they are needed, for the symptoms of dyspepsia or reflux, heartburn among them. The amount and the pregnancy position come from MSF Essential Drugs 2024, which records this tablet as carrying no contra-indication in pregnancy and none in breast-feeding - a plainer statement than the formulary manages for the H2 blocker that follows it. Caution MSF Essential Drugs 2024 is explicit on both counts: there is no contra-indication in pregnancy, and none during breast-feeding. CHEW THE TABLETS - the monograph's own administration instruction. IT BLOCKS THE ABSORPTION OF OTHER DRUGS, and this is the caution that matters most in practice. Plenty of medicines are taken up less well from the gut while it is on board, and these must NOT go down at the same time as it: iron salts and levothyroxine, digoxin, doxycycline, gabapentin, itraconazole, chloroquine and atazanavir - leave at least 2 hours between them. Iron and levothyroxine are the two a pregnant woman is most likely to be taking already. Separate the quinolones and the antivirals further still. Ciprofloxacin goes either 2 hours before the antacid or 4 hours after it; dolutegravir needs 2 hours ahead of it, or 6 hours after; velpatasvir wants 4 hours' clearance either way. Egyptian antacid products are commonly aluminium + magnesium WITH simeticone, and several substitute magnesium oxide, trisilicate or carbonate for the hydroxide. The dose above is the one the monograph states for the 400/400 mg tablet; a different salt or a suspension is a different presentation and its own label governs. The monograph gives no antenatal-specific dose and states none for children under 5; over 5 it says the drug is seldom called for. Egypt FRITZU 20 ORAL SUSP. SACHET PHARCO 80.00 EGP -> ? strength differs, ? different route - not oral solid 2. FAMOTIDINE [2nd line] Adult 20 mg orally twice daily x for 6 weeks (may extend further 6 weeks if not healed) Peds Adult-only condition - paediatric section not applicable Source Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) Why Histamine H2-receptor antagonist, stepped up when antacids alone are not controlling the reflux in pregnancy. The Egyptian formulary does not call it safe: its own position is that famotidine is not recommended in pregnancy and should be given only where the need is clear. Prescribe it on that footing - a considered decision when symptoms warrant it, not a routine first step. Caution Reduce dose in moderate-to-severe renal impairment. No adequate and well-controlled human data. Famotidine is not recommended for use in pregnancy and should be used only if clearly needed. Egypt FAMOTAK 20MG 20 F.C.TAB. SEDICO 28.00 EGP (1.40/unit) GASTRODOMINA 20MG 20 TAB. MUP > ALMIRAL... 28.00 EGP (1.40/unit) ANTODINE 20 MG 30 F.C.TABS. AMOUN 60.00 EGP (2.00/unit) FAMOTIN 20MG 20TAB. MEMPHIS 40.00 EGP (2.00/unit) RANI-F 20MG 6 SACHETS PHARCO 42.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)