Adult: As chewable tab containing 150 mg alginic acid, 625 mg Ca carbonate, and 73.50 mg heavy Mg carbonate: Chew 2 tabs preferably 1 hour after meals and before bedtime. Max duration: 14 days. As chewable tab containing 200 mg alginic acid, 30 mg dried Al hydroxide gel, and 40 mg light Mg carbonate: Chew 1-3 tab(s) after meals and at bedtime, or as prescribed. Max duration: 14 days. Seek medical advice if symptoms persist after 14 days. Child: >12 years As chewable tab containing 150 mg alginic acid, 625 mg Ca carbonate, and 73.50 mg heavy Mg carbonate: Same as adult dose.
Contraindications
Intestinal obstruction. Chewable tab containing alginic acid, Ca carbonate, and heavy Mg carbonate: Hypercalcaemia or conditions resulting in hypercalcaemia; hypercalciuria, nephrolithiasis (due to calculi-containing Ca deposits), pre-existing hypophosphataemia. Severe renal impairment.
Special Precautions
Patient with fluid retention. Chewable tab containing alginic acid, Ca carbonate, and heavy Mg carbonate: Patient with constipation, haemorrhoids, sarcoidosis. Not indicated for long-term treatment. Renal impairment. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Chewable tab containing alginic acid, Ca carbonate, and heavy Mg carbonate: Hypercalcaemia, hypermagnesaemia, milk alkali syndrome, and increased renal calculi formation (prolonged use); masking of stomach malignancy. Gastrointestinal disorders: Constipation, nausea, vomiting, abdominal distension, diarrhoea, hiccup. Immune system disorders: Rarely, hypersensitivity reactions. Musculoskeletal and connective tissue disorders: Muscle weakness.
Monitoring Parameters
Monitor Ca, phosphate and Mg levels in patients with renal impairment.
Drug Interactions
May hinder the absorption of tetracyclines, quinolones, bisphosphonates, levothyroxine, dolutegravir, eltrombopag, cardiac glycosides (e.g. digoxin, digitoxin).
Action
Description: Mechanism of Action: Alginic acid reacts with the gastric acid to form a viscous gel or “raft” that floats on the surface of stomach contents. This activity acts as a mechanical barrier to reduce reflux or protect the oesophageal mucosa during reflux. Usually combined antacids such as Ca carbonate, Mg carbonate, and Al hydroxide works synergistically with alginic acid by neutralising the excess acid in the stomach. Pharmacokinetics: Absorption: Not converted in the gastrointestinal tract.
Chemical Structure
Alginic acid Source: National Center for Biotechnology Information. PubChem Database. Alginic acid, CID=6850754, https://pubchem.ncbi.nlm.nih.gov/compound/6850754 (accessed on June 29, 2020)
Storage
Store below 30°C. Protect from moisture and direct sunlight.
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