In therapeutic practice, doctors often prescribe antacids to patients. These drugs have the ability to reduce the acidity of the environment. The most widely used drugs are in the treatment of diseases of the digestive system (hyperacid gastritis, gastroesophageal reflux disease). What are the indications, contraindications and what is the mechanism of action of these drugs?
Antacids are medicines that are used for acid-related illnesses.This group of drugs has been known for a very long time. The first antacids were used in medicine over 100 years ago. Medicines from this group have the following features:
- able to neutralize hydrochloric acid, normalizing pH;
- have a cytoprotective effect, protecting cells from the aggressive effects of acids;
- able to absorb bile acids;
- have an enveloping effect.
In most cases, antacids are an adjunct to the main treatment. These are drugs for symptomatic therapy. Unlike other drugs that correct acidity, antacids have a faster and more pronounced effect. The therapeutic effect is achieved due to the presence of magnesium, aluminum or calcium compounds in their composition.
Classification of antacids
The list of antacids used today is very wide. There are 2 large groups of antacids: non-absorbable and absorbed. The second group includes such agents as baking soda, burnt magnesia, magnesium carbonate, Rennie, Tams, calcium carbonate.
Representatives of this group have a quick effect, but it is short-lived. In the process of neutralizing the acid, carbon dioxide is released, which often leads to bloating (flatulence) and belching. Absorbable antacids are not used to treat gastroesophageal reflux disease. A possible side effect of these drugs is the rebound phenomenon, in which a secondary increase in acidity occurs.
The most effective are nonabsorbable antacids. This group includes "Fosfalugel", "Almagel", "Maalox", "Topalkan", "Gastracid", "Gaviskon". There are antacids that combine the main active ingredient with auxiliary components. Most of the nonabsorbable antacids are combined. They are poorly absorbed in the gastrointestinal tract.
These medicines neutralize hydrochloric acid and pepsin, envelop the gastric mucosa, protecting it from the effects of hydrochloric acid, and inhibit the activity of Helicobacter pylori bacteria.
The therapeutic effect lasts up to 4 hours. Neutralization begins a few minutes after taking the medicine. Antacids can be treated on an outpatient basis.
They need to be taken 1-1.5 hours after a meal. Most often, treatment involves taking the drug 4 times a day. It is not advisable to take antacids together with other medicines.
Indications and contraindications for use
Antacids are taken orally as gels, suspensions, or tablets. This group of drugs is used for the following pathological conditions:
- dyspepsia;
- gastroesophageal reflux;
- gastric ulcer during an exacerbation;
- duodenal ulcer during an exacerbation;
- duodenitis;
- enteritis;
- hernia of the esophageal opening of the diaphragm;
- inflammation of the esophageal mucosa against the background of gastric reflux;
- functional disorders of the intestine;
- discomfort in the epigastric region after drinking alcohol.
Antacids can be used prophylactically to prevent stomach inflammation associated with the use of drugs from the NSAID group. "Almagel A" can be included in the complex scheme of diabetes mellitus treatment. Absorbable drugs are practically not used. Antacids are well tolerated, however, there are some limitations in their use.
An antacid such as Almagel is contraindicated in Alzheimer's disease, impaired renal excretory function and individual intolerance. The drug is not prescribed for children under 1 month of age. "Gaviscon" should not be taken by persons who have hypersensitivity to the main components of the drug.
Antacid preparation "Maalox" should not be used in the following conditions:
- severe renal failure;
- hypophosphatemia;
- deficiency of sucrose;
- intolerance to fructose.
Maalox is suitable only for people over 15 years old. Contraindications to taking "Fosfalugel" are individual intolerance and renal failure.
Possible adverse reactions
Subject to the treatment regimen prescribed by the doctor, side effects when taking antacids are very rare. They are possible with the uncontrolled use of drugs. Magnesium-based antacids can cause diarrhea. In case of an overdose, they may impair renal function and a decrease in heart rate. Aluminum-based antacids can cause hypophosphatemia. If medications are taken in the presence of renal failure, then encephalopathy and softening of the bones are possible. With prolonged use of drugs based on magnesium against the background of urolithiasis, the patient's condition may worsen and the formation of stones may increase.
These are common unwanted effects. Reception of "Phosphalugel" in rare cases can lead to constipation. This is most often seen in the elderly. When using "Gaviscon", the development of allergic reactions is possible.
Reception of "Maalox" in rare cases can cause nausea, vomiting, stool disturbance and taste sensitivity. Thus, the most effective are nonabsorbable antacids. They are widely used to treat adults and children who are acidic.
Antacids are a pharmacological group of drugs that are used for diseases accompanied by increased gastric acidity. To date, the list of drugs in the antacid group is quite wide.
They may differ in cost and mechanism of action, but the therapeutic effect is similar.
Group description
Antacids are substances that are widely used in the treatment of gastroenterological diseases. The main indications for their use are:
- Gastritis. Some forms of gastritis are accompanied by the production of excess gastric juice. This leads to the appearance of such an unpleasant symptom as heartburn. Hyperacid gastritis is quite common, as there are many reasons for its appearance. It is this form of gastritis that is considered the most common gastrointestinal pathology.
- Peptic ulcer disease. The treatment regimen for gastric ulcer or duodenal ulcer necessarily includes antacid drugs. These drugs help prevent complications from developing. This is extremely important, since perforation or malignancy of the ulcer, as well as the development of gastrointestinal bleeding, are extremely dangerous conditions that require urgent medical attention.
- GERD. Gastroesophageal reflux disease is a pathology in which gastric contents are thrown into the lower esophagus. This condition is accompanied by the appearance of painful sensations. This is due to the fact that hydrochloric acid has a destructive effect on the esophageal mucosa.
- Postoperative period after interventions on the stomach or duodenum. Operations that are carried out for the purpose of surgical treatment of various pathologies of the upper gastrointestinal tract require a decrease in the negative effects of pepsin and acid on the wound surface. The duration of taking antacids for this indication depends on the volume of the operation.
- Diseases of the biliary tract and pancreas. These diseases can also affect stomach acidity. In such diseases, treatment is combined with the use of enzymes.
In addition, antacids are used for heartburn, which occurs against the background of inaccuracies in nutrition, pregnancy, physical exertion after eating, or under the influence of diseases not related to the digestive tract.
Separately occurring heartburn is a common occurrence. Such a manifestation may not be a sign of an illness.
Antacids are only symptomatic therapy. They are prescribed exclusively to eliminate the symptoms of diseases, since they do not affect the etiological factor.
Almost always, antacids are prescribed in combination with other drugs, such as prokinetics, enzyme substances. For the treatment of acute forms of the disease, more serious means or surgical treatment can be used.
Classification
The mechanism of action of antacids is that when interacting with gastric juice, they neutralize hydrochloric acid. As a result of this chemical reaction, various compounds can be formed. Some of them are absorbed into the bloodstream, while others are not.
The classification of antacids is based on this feature. Today, such drugs can have a combined effect. This is possible due to the fact that the composition of the new generation of drugs includes anesthetics or excipients with an enveloping effect.
The anesthetic effect allows you to stop the vivid pain syndrome that is observed in peptic ulcer disease, and thanks to the enveloping effect, these drugs protect the gastric mucosa from the negative effects of acid.
Absorbable
A feature of absorbed antacids is that the products of their interaction with hydrochloric acid are absorbed into the blood. This feature makes it impossible to use them during pregnancy, lactation, and also in childhood.
A high concentration of such substances can cause intoxication, which entails disruption of the work of various organs.
The advantage of absorbable antacids is that they create a therapeutic effect extremely quickly. Most drugs take effect 5 minutes after they are taken.
In this case, the action lasts a fairly short period of time. It is most advisable to take such antacids in order to relieve heartburn attacks that are not associated with serious illnesses.
In addition, these medications must be taken after a meal, as they neutralize most of the acid.
Lack of gastric juice, which occurs if this rule is not followed, can cause food to rot in the intestines. Such a process is dangerous in that toxins will be absorbed into the blood, causing poisoning.
Almost all representatives of this group contain sodium, which ensures the absorption of the products of a chemical reaction. The largest list of antacids containing aluminum.
One of the most common drugs, which belongs to the absorbed antacids, is the usual one. It is often used at home to combat heartburn or acidity.
Large amounts of baking soda are not recommended. This is due to the fact that the reaction products that are formed in the stomach have a detrimental effect on the mucous membrane. Baking soda can be temporary until another drug is prescribed.
Other representatives of this group are:
- Bourget mix.
- Magnesia.
- Vikair.
Use
The main feature of the use of absorbed antacids is that when they are used, the so-called acid ricochet is observed. This process is an undesirable effect, but it is almost impossible to eliminate it.
Its essence lies in the fact that after the end of the antacid effect in patients, an increase in the production of hydrochloric acid is observed. This is due to the fact that a large amount of carbon dioxide is generated during a chemical reaction.
This gas stretches the walls of the stomach, which stimulates the receptors responsible for the production of gastric juice. Some medical specialists also put forward the theory that the body is compensating for the lack of gastric juice caused by taking antacids.
Perhaps the best representative of these drugs is Rennie. This drug, which belongs to antacids, practically does not form compounds that could cause systemic reactions. The use of this drug is allowed to patients even during the period of bearing a child or breastfeeding.
In addition, due to the peculiarities of the composition, this drug is almost completely free from the phenomenon of acid ricochet.
Non-absorbable
Non-absorbable antacids are more popular today. The main representatives are aluminum-containing antacids. The action of such drugs is limited exclusively to the lumen of the digestive tract, since the reaction products are not absorbed into the blood.
In addition, it is to the nonabsorbable antacids that the combination preparations are, which contain auxiliary agents to achieve an analgesic and enveloping effect.
These include:
- Maalox.
- Alumag.
These antacids have a fairly large list of analogues that differ in trade name, but have an identical composition.
In general, the main active ingredients of non-absorbable antacids are compounds of aluminum, magnesium and calcium.
Most medicines contain only one type of substance, but preparations have begun to be produced that contain magnesium, aluminum, and calcium. For example, Gastal contains aluminum hydroxide and magnesium hydroxide.
Due to the presence of metal components, insoluble compounds are formed, which are excreted from the body exclusively through the intestines.
The advantage of non-absorbable antacids such as Almagel, Maalox or Gastal is that almost everyone is allowed to use them. The list of contraindications for the use of these drugs is extremely small.
The most common antacid drug is Almagel. It is this substance that is most often prescribed for diseases of the digestive tract with high acidity.
Take non-absorbable antacids before meals for 10-15 minutes. During this time, a protective layer is formed on the mucous membrane, and part of the acid is also neutralized. As a result, the normal process of digestion is not disturbed, and the negative effect on the gastric mucosa is practically minimized.
During the use of these pharmaceuticals, side effects from the digestive tract may occur. So, for those preparations that contain aluminum, the development of constipation and bloating is characteristic.
Medicines containing magnesium have the opposite effect, causing diarrhea or loose stools. The drugs of the latest generation, which contain several substances, have practically no side effects, since the side effect of one substance is neutralized by another component.
Application
If the patient is prescribed non-absorbable drugs, then he should unconditionally follow the rules for their intake. This is due to the fact that these drugs have a therapeutic effect after a fairly long period of time, and also reduce the effectiveness of many drugs used in the combination therapy of diseases of the digestive tract.
So, in most cases, the appointment of antacids is carried out for a fairly long period. When combined with other drugs, it is necessary to take into account the presence of an enveloping effect, which prevents the absorption of other drugs.
In addition, preparations containing aluminum must be combined with laxatives, since persistent constipation may occur with prolonged use. Laxatives help avoid these effects.
Contraindications for the use of antacids are:
- Conditions that are accompanied by a lack of hydrochloric acid. Taking antacids against the background of such pathologies can cause serious consequences. This is due to the fact that a significant lack of gastric juice leads to the fact that food will not be sufficiently digested. As a result, it will rot and ferment in the intestinal lumen, which will cause toxins to enter the bloodstream.
- Pregnancy. During pregnancy, it is not recommended to take the absorbed form of the drug. The same restriction applies to women who are breastfeeding.
- Age up to 6 years. Antacids should not be given to children under 6 years of age. Special care should be taken when prescribing antacids for children under 12 years of age. This is due to the fact that the child's digestive system is not perfect, and dyspeptic disorders can cause disruption of other organs and systems. In particular, diarrhea in a child can lead to dehydration.
- Individual sensitivity to drug components. If a person is allergic to the substances that make up the composition, then this can manifest itself as a rash on the skin or Quincke's edema. Sometimes an allergic cough may appear, but this is not typical for food allergens and depends on the characteristics of the person's immune system.
Antacid treatment is carried out only as directed by a doctor. Self-use of such drugs can worsen the condition. If you have any symptoms of the disease, you should consult a doctor. This is necessary not only in order to obtain prescriptions for medicines, but also for the examination.
An effective treatment regimen can be prescribed only after undergoing a full examination, which must necessarily include gastroscopy and X-ray of the abdominal organs.
The list of antacid drugs is quite large. The choice of a specific drug is carried out purely individually, taking into account the patient's condition, as well as his financial capabilities.
Before the advent of the group of H 2 -histamine receptor blockers, antacids were the first line of treatment for peptic ulcer disease. Today, these over-the-counter heartburn medications are inexpensive, affordable, highly effective and well tolerated by most patients.
However, antacids don't just reduce the acidity of gastric contents: does pH neutralization have another effect? a decrease in the proteolytic activity of the enzyme pepsin, which is active in an acidic environment and is capable of aggressively affecting the gastric mucosa and causing esophagitis. In addition, bile acids can also be involved in the pathogenesis of the development of esophagitis, which can be thrown into the stomach cavity. Antacids based on compounds of aluminum, calcium and magnesium are able to adsorb and remove bile acids; At the same time, the results of a number of studies have shown that calcium / magnesium- and aluminum-containing antacids most actively adsorb on themselves just the majority of lipophilic and toxic bile acids (Torres VE, Velosa JA, Holley KE et al., 1991; H nsel W., Herzog T., 1998). Thus, antacids provide rational treatment and effective relief of the majority of patients with gastroesophageal reflux disease, without the need to resort to systemic agents.
It is hardly worth dwelling on what is the mechanism of action of drugs that save us from sour belching and heartburn. We all also know the classification of antacids, which divides them according to their composition (magnesium preparations, aluminum preparations, calcium preparations and combinations of aluminum, calcium and / or magnesium preparations), as well as absorbed and non-absorbed.
Antacids: Terra Incognita?
However, despite the long experience of use and the seemingly comprehensive study of antacids, do we really know everything about this group of drugs? This is especially true for the safety profile of these drugs. Moreover, it should be borne in mind that most patients with the appearance of gastrointestinal disorders do not go to the doctor, but use OTC drugs. According to a survey of 500 Russian patients who experienced heartburn, a feeling of heaviness and fullness in the stomach, as well as pain in the epigastric region, only 44% of them had previously consulted a doctor. To relieve symptoms, 78% of the respondents took antacids on their own (Moiseev S.V., 2006). The continued popularity of antacids is confirmed by the growing volumes of pharmacy sales of drugs in this group.
All this prompted us to investigate in more detail the market of antacids, the features of their effectiveness and safety.
Aluminum-containing antacids
As noted above, aluminum compounds are one of the components of antacids. The ingredient most commonly used in such antacids is aluminum hydroxide; among other widely used aluminum compounds? aluminum oxide, aluminum hydroxide hydrate, aluminum phosphate, dihydroxyaluminum sodium carbonate, aluminum acetoacetate, aloglutamol, aluminum glycinate.
Aluminum is found not only in many antacids, but in general is widespread in the environment, we often encounter it in everyday life. It? one of the most common elements of the earth's crust; is it a metal used in a wide variety of industries? from aircraft construction to simple beverage cans and kitchen foil. And yet, despite its high abundance, this element does not perform any important biological functions, unlike other metals such as iron or copper. The daily consumption of aluminum is negligible. However, taking aluminum-containing antacids, the patient can consume up to several grams of aluminum per day.
The use of aluminum in antacids has a long history and dates back to the 1920s, when it was believed that this element was not absorbed in our body. However, the results obtained not so long ago indicate the opposite? aluminum can be adsorbed. So, the use of certain drinks, such as wine, orange juice, coffee or soda, against the background of the use of antacids containing aluminum compounds, increases the intake of this element several times. When taking antacids based on aluminum compounds in high doses or with enviable regularity, this element gradually accumulates in the bone and brain tissues, which leads to fragility of bones and neurological disorders characterized by impairment of memory and speech functions (Lauwerys RR, Hoet P., 2001; Friesen MS, Purssell RA, Gair RD, 2006).
Also, remember that the main side effect of aluminum salt antacids is constipation. This is particularly important for patients at risk, such as pregnant women, patients taking opioids, and elderly patients with limited fluid intake or dehydration.
Antacids containing aluminum: Handle with care!
However, aluminum can harm not only those who directly take drugs containing this metal, but also future generations, many scientists believe.
Heartburn often accompanies a condition such as pregnancy. That is why pregnant women are often forced to take antacids regularly; thus, pregnancy is a typical example where antacids can be used regularly and for a long time, especially given the fact that heartburn tends to worsen with the course of pregnancy. At the same time, animal experiments indicate that aluminum crosses the placenta and accumulates in fetal tissues, causing various developmental disorders, including death. in utero, defects, delayed skeletal ossification, growth retardation, etc. (Bennet R., Persaud T., Moore K., 1975; Domingo J., Gomez M., Colomina M., 2000). The possibility of aluminum intoxication with its oral administration largely depends on the bioavailability of the drug used and the presence in food of other substances that enhance the absorption of aluminum. These facts are important from a practical point of view. On the one hand, the frequency of heartburn associated with gastroesophageal reflux in pregnant women reaches 85%, and about 30-50% of them use antacids (Broussard C., Riechter J., 1998). On the other hand, the fetus and newborn may be more sensitive to the toxic effects of aluminum. A case of the development of a severe neurodegenerative disease in a girl was described, whose mother during pregnancy took antacids in extremely high doses (up to 15 g of aluminum per day) (Gibert-Barnes E., Barness L., Wolff J. et al., 1998). Of course, this example cannot be extrapolated to common practice, but it is worth considering the fact that for a developing fetus, significant and significantly smaller doses of aluminum may be significant.
Some researchers have found aluminum in breast milk in women, which indicates the possibility of its entry into the body of breastfed newborns (Mandic M., Grgic J., Grgic Z. et al., 1995).
In many European countries, there are certain restrictions on the use of aluminum-containing antacids in pregnant and lactating women. For example, in Austria, France, Italy, Spain and Switzerland, the package leaflets indicate that antacids containing aluminum should be used during pregnancy and lactation only on the advice of a doctor or pharmacist (Maton P., Burto V., 1999).
The most complete information on the possible undesirable effects of aluminum-containing antacids is presented in the instructions for use and promotional materials in Germany. So, they clearly indicate that the simultaneous use of these drugs with drinks containing acids, for example, fruit juice or wine, leads to an undesirable increase in the absorption of aluminum in the intestine, and in order to avoid aluminum intoxication in a child, during pregnancy, the drug can be taken only during short term, it is also especially noted that aluminum compounds penetrate into breast milk (Maton P., Burto V., 1999).
Continuation of the story about antacids
drugs? in the next rooms
"Weekly Pharmacy"
Antacids are a group of medicinal substances that neutralize the acid produced by the human stomach. There are many trade names for antacids that are marketed as tablets and suspensions.
When can antacids be used?
Most often, antacid drugs are used to relieve chest pain and heartburn - symptoms of reflux esophagitis, a disease in which caustic stomach contents enter the esophagus and cause inflammation of its mucous membrane. Also, antacids can reduce the intensity of painful sensations in gastric ulcer and duodenal ulcer. They are also used when it is required to temporarily neutralize stomach acid, for example, with functional dyspepsia.
For a long time, antacids have been widely used to treat diseases of the digestive system. However, with the advent of more modern drugs such as proton pump inhibitors and H2 receptor blockers, it seemed that the era of antacids would be over. Modern medicines are more effective - they reduce the amount of acid produced by the stomach, while antacid medicines simply neutralize the acidic environment in the stomach for a short period of time.
However, antacids have their own niche in modern medicine. The strong point of antacid drugs is the speed of action and, accordingly, the therapeutic effect that comes earlier. And, unlike proton pump inhibitors and H2 receptor blockers, antacid drugs are generally cheaper.
How do antacids work?
To digest food and kill pathogenic bacteria with it, the human stomach produces acid. Gastric juice is so pungent that the inner surface of the stomach is equipped with a natural mucous barrier that protects the surface of the organ from acids and erosion.
Under the influence of various factors, this barrier can be damaged in some people, which allows the acid to begin to corrode the inner surface of the stomach, which ultimately leads to an ulcer. In other cases, the annular muscle that separates the stomach from the esophagus may weaken, causing caustic stomach contents to enter the esophagus and eventually cause inflammation of the lining of the esophagus (reflux esophagitis).
Antacid drugs, on the other hand, can neutralize acids because the chemicals they contain are bases (alkalis), the exact opposite of acids. The reaction between acid and base is called neutralization. This chemical reaction makes stomach acid less aggressive, which can help relieve ulcer pain, stomach and esophageal discomfort and heartburn.
What types of antacids are there?
The main active substances in antacids are compounds of calcium, magnesium and aluminum. According to the method of assimilation by the body, antacids are divided into absorbable and non-absorbable.
Absorbable antacids differ from non-absorbable antacids in that either they themselves or the products of the chemical reaction they cause are absorbed by the intestinal walls and dissolve in the blood. Therefore, these drugs act very quickly, but the increased number of complications compared to nonabsorbable antacids makes their use undesirable. Suction antacids include regular baking soda (a folk remedy for heartburn), calcium and magnesium carbonate preparations, etc.
Non-absorbable antacids are more popular. Unlike the previous group, they begin to act more slowly, but the effect of their use is longer. The active substances of these drugs are aluminum and magnesium hydroxides, aluminum phosphate, sometimes in combination with each other. While the aluminum compounds envelop the damaged surface with a protective film, the magnesium compounds help the stomach to rebuild its own mucus barrier. In Russia, non-absorbable antacids are sold under the names Almagel, Fosfalugel, Maalox, Gastal, etc.
Some brands of antacids contain a mixture of the main active ingredient with another drug, which can either help reduce the likelihood of side effects or help treat a disease.
For example, Almagel Neo and other preparations contain simethicone, a substance that helps to reduce flatulence that sometimes occurs when using an antacid. The consequence of the neutralization reaction is the release of carbon dioxide, which causes bloating and flatulence. Antacid drugs, one of the components of which is simethicone, can destroy the formed bubbles of carbon dioxide or remove them naturally.
Some other drugs, along with antacids, include alginic acid and its salts, alginates. The purpose of the alginate supplementation is to protect the inner surface of the esophagus from stomach acids. Sodium alginate and alginic acid are commonly used in medicine from alginates. When these substances enter the stomach, they form a gel, which, as it were, floats on top of the contents of the stomach, preventing it from entering the esophagus and thereby injuring its mucous membrane. These drugs are used to treat reflux esophagitis. One example of such antacids is Gaviscon.
In some cases, an analgesic is added to the antacid medication to relieve pain. One of these drugs is Almagel A.
Do I need a prescription when buying antacids?
Some drugs require a prescription, others don't.
What dosage forms do antacids have?
Antacids are supplied to the pharmaceutical market in the form of tablets and suspensions. The latter can be sold both in the form of a large bottle and in small sachets, each of which contains a single dose of the drug. Suspensions are more beneficial in terms of drug absorption, but they are inconvenient to use at work or while traveling. Therefore, many people prefer to use suspensions at home, and tablets when they come out of it. By the way, tablets are absorbed faster if they are chewed or sucked.
How to take antacids?
Usually, an antacid is taken to relieve or prevent symptoms. Before taking antacids, it is recommended to consult a doctor, and also carefully study the instructions attached to the medicine.
How quickly do antacids take effect? How long should you take antacids?
Absorbable antacids begin to act almost instantly, non-absorbable ones - after 9-15 minutes.
Antacids are usually prescribed for situational treatment - patients should take them only when symptoms appear and stop when they disappear. However, some antacids, especially with additives, can be used for longer treatment or in combination with proton pump inhibitors, for example, to minimize the harm from the nocturnal acid breakthrough that occurs when taking the latter (when during sleep for unknown reasons, the stomach begins to produce acid ).
Who shouldn't take antacids?
The list of contraindications depends on the specific drug and is indicated on the instructions contained in the package.
Can I have side effects when taking antacids?
In some people, the use of antacids can cause side effects. The most common ones are diarrhea, constipation and belching. For a complete list of all side effects for each specific antacid, see the leaflet that came with the medicine.
The side effects of absorbed antacids include the so-called. acid ricochet - when the body reacts to a sharp change in the environment in the stomach from acidic to alkaline with increased production of acid. Intake of absorbable antacids can stimulate the production of carbon dioxide, which increases the volume of the stomach, stretches its walls, and can provoke gastroesophageal reflux. If the absorbed antacid contains calcium, then prolonged use is fraught with constipation, nausea and vomiting. Calcium-containing antacids can also cause increased formation of kidney stones in patients with urolithiasis.
Antacids should be avoided at the same time as other medicines because antacids can interfere with the absorption of other medicines.
Additional Information
If taking antacids does not bring the desired relief and, conversely, the patient becomes worse, you should consult a doctor - perhaps a serious disorder of the digestive system has begun. Particular attention should be paid to the following symptoms:
- Vomiting of blood. The blood can be either fresh or already clotted. In the latter case, the erupted masses look like coffee grounds - dark and grainy in consistency.
- Blood in the stool. It is both fresh and dark, curdled, and stains the stool black.
- Weight loss if the patient is not on a diet.
- Difficulty swallowing, food stuck in the esophagus.
- Abdominal pain, nausea, or vomiting for a long time.
Almagel is a well-known and widely used drug that eliminates the symptoms of gastritis, duodenitis, gastric and duodenal ulcers, and esophagitis. Almagel also relieves pain in the stomach and heartburn. Yellow Almagel, in addition, has analgesic properties, therefore it is used to eliminate severe pain syndrome in various diseases of the digestive system.
The drug Almagel also has the spelling "Almagel". This confusion is due to the fact that the name of the original is written in Latin letters "Almagel". The letter "l" in the Latin word is usually read softly, like "l". However, it is impossible to accurately convey phonetics and pronunciation in Cyrillic letters, therefore there are variants of spelling the name with both soft "l", or with only one - at the end of the word, as is typical of the Russian language.
Types and forms of release
Today the drug Almagel is available in two main dosage forms:1. Suspension.
2. Pills.
The suspension contains various components that give the drug certain additional properties. The following suspension options are available today:
- Suspension Almagel (contains only the main components - aluminum and magnesium hydroxide gel);
- Suspension Almagel A (together with the main components contains anesthetic benzocaine);
- Suspension Almagel Neo (together with the main components contains the substance simethicone, which eliminates gases);
- Almagel T tablets (contain only the main components).
In connection with such a convenient and unified color of the packaging, the variants of the drug are often called by the color of the box, for example, Almagel green (base, ordinary suspension), Almagel yellow (Almagel A with anesthetic), Almagel red (Almagel Neo). The name "Almagel in sachets" means the release form of Almagel Neo, which is poured into small plastic sachets with a volume of 10 ml.
All Almagel suspensions are available in 170 ml vials with a 5 ml measuring spoon. Almagel Neo is also available in the form of 10 ml sachets. The tablets are sold in packs of 12 and 24.
The Maalox suspension in everyday speech is often called "Maalox sachets", "liquid Maalox" or "Maalox gel". All of these names use some distinctive feature of the dosage form to designate it, which allows both doctors and pharmacists to clearly and quickly understand what the patient means. Therefore, these incorrect and unofficial names are often and widely used. However, it must be remembered that whichever of the listed names a person uses, he means exactly the Maalox suspension.
Composition
Both tablets and suspension of Maalox and Maalox Mini contain as active active ingredients aluminum hydroxide (algeldrat) and magnesium hydroxide... The amount of active substances in each form is slightly different, however, this is necessary so that they all have approximately the same severity and duration of the therapeutic effect. The dosage of active substances of various varieties and forms of Maalox is shown in the table.Wearing uncomfortable clothes and accessories is also important - for example, tight belts and tight pants can also lead to this ailment. Heartburn can occur during pregnancy or as a result of a hiatal hernia.
What to do when heartburn overtook you here and now?
In this case, you can use Rennie's effective remedy, which will relieve you of heartburn without harm to your health.
Rennie - composition
The main components of the drug are calcium carbonate (680 mg) and magnesium carbonate (With 80 mg). Also, the medicine contains excipients.Release form
This popular medicine comes in pill form.Each tablet form contains the same composition of calcium carbonate and magnesium carbonate. The excipients differ depending on the aroma of the preparation (mint, orange, and menthol). All tablets are sold in cardboard boxes.
Somewhat less often, aluminum hydroxide is used to eliminate hyperphosphatemia (increased levels of phosphates in the blood) against the background of renal failure. The fact is that aluminum hydroxide binds excess phosphates in the intestine, which, in case of renal failure, are not excreted from the body in a normal volume, thereby, as if helping the kidneys to remove these salts.
In addition, in rare cases, aluminum hydroxide is used externally as an astringent for skin diseases.
Inside, aluminum hydroxide is usually taken in the form of a suspension, which is a powder thoroughly shaken in water. In rare cases, when it is impossible to prepare a suspension, aluminum hydroxide is taken orally directly in the form of a powder.
Outwardly, aluminum hydroxide is used only in powder, sprinkling it on the affected areas of the skin.
Medicinal products containing aluminum hydroxide
In the CIS countries, there are only two medicinal products containing aluminum hydroxide as an active substance - these are Rokzhel (Rokgel) and Aluminum hydroxide-Rivopharm. In Europe and the USA, there is a much wider range of medicines with aluminum hydroxide as the only active substance, such as Alternagel, Amphojel, Aloh-Gel, etc. There are significantly more drugs that contain algeldrat as one of the active ingredients on the market of the CIS countries, since they are more effective, safe and modern. To facilitate orientation, we present a list of antacid preparations present on the pharmaceutical market of the CIS countries, containing algeldrat as an active substance:
- Agiflux (algeldrat + magnesium hydroxide) tablets;
- Almagel, Almagel A and Almagel Neo (algeldrat + magnesium hydroxide) - suspension;
- Altacid (algeldrat + magnesium hydroxide) - suspension and chewable tablets;
- Alumag (algeldrat + magnesium hydroxide) tablets;
- Gastracid (algeldrat + magnesium hydroxide) tablets;
- Maalox and Maalox mini (algeldrat + magnesium hydroxide) tablets and suspension;
- Palmagel (algeldrat + magnesium hydroxide) oral gel;
- Simalgel VM (algeldrat + magnesium hydroxide + simethicone) suspension for oral administration.
Therapeutic action
Aluminum hydroxide has three main pharmacological properties:- Antacid action;
- Absorbent action;
- Enveloping action.
In the intestine, aluminum is not absorbed, but forms insoluble salts - phosphates, which provoke constipation. Therefore, when using only aluminum hydroxide as an antacid, laxatives should be taken. Constipation can be eliminated by a complex intake of aluminum hydroxide in combination with magnesium hydroxide, which, as a rule, is successfully done.
Absorbent property aluminum hydroxide lies in its ability to bind hydrochloric acid molecules and thereby neutralize them, enhancing the antacid effect based on a chemical reaction.
Enveloping property aluminum hydroxide lies in its ability to be evenly distributed over the gastric mucosa, forming a thin protective film on it, which protects against the damaging effects of both hydrochloric acid and some types of food.
Thus, aluminum hydroxide is used as a symptomatic agent to eliminate various unpleasant sensations caused by increased gastric acidity. Since the acidity of gastric juice can be increased not only in severe serious diseases, but also against the background of functional disorders, aluminum hydroxide cannot be considered a drug only for the treatment of pathology, since it can be used exclusively as a symptomatic agent to eliminate discomfort.
Separately, it should be said about another property of aluminum hydroxide, which is also used in medical practice. So, this substance, getting from the stomach into the intestines, binds phosphates, forming insoluble salts with them and removing them from the body along with feces. The ability of aluminum hydroxide to remove phosphates from the body is used in the complex therapy of renal failure, in which, on the contrary, these salts accumulate and cause various disorders. After all, phosphates are normally excreted mainly by the kidneys, and in case of renal failure, accordingly, these salts are not removed from the body in the required volume and accumulate. The use of aluminum hydroxide allows you to remove excess phosphates from the body and, thereby, improve the well-being of a person suffering from renal failure.
Indications for use
Aluminum hydroxide is indicated for use in the complex therapy of the following diseases, as well as for the elimination of dyspeptic symptoms: - Esophagitis;
- Reflux esophagitis;
- Acute gastritis;
- Chronic gastritis with increased acidity of gastric juice;
- Acute duodenitis;
- Peptic ulcer of the stomach or duodenum during an exacerbation;
- Symptomatic ulcers or erosion on the mucous membranes of the digestive tract;