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(Gaviscon®-type formulation)
Symptomatic treatment of:
Heartburn • Acid regurgitation • Indigestion
Gastro-oesophageal reflux disease (GORD)
Reflux oesophagitis (mild-moderate)
Dual Mechanism of Action:
| Component | Action | Onset |
|---|---|---|
| Sodium Alginate | Reacts with gastric acid → forms viscous gel "raft" → floats on stomach contents → physical barrier against reflux | Rapid (3-5 min) |
| Potassium Bicarbonate | Neutralizes gastric acid → rapid symptom relief • Provides potassium ions for electrolyte balance | Immediate |
| Form | Dose | Frequency | Timing |
|---|---|---|---|
| Tablet | 1-2 tablets | 4× daily | After meals + before bedtime |
| Suspension | 5-10 mL (1-2 tsp) | 4× daily | After meals + before bedtime |
| Age | Form | Dose | Max Daily |
|---|---|---|---|
| 6-12 years | Tablet | 1 tablet | 4 tablets |
| Suspension | 2.5-5 mL (½-1 tsp) | 20 mL | |
| 2-6 years | Suspension* | 2.5 mL (½ tsp) | 10 mL |
*Tablets not recommended <6 years
Contraindicated in children <2 years
Hypersensitivity to alginates or bicarbonates
Severe renal impairment (eGFR <30 mL/min)
Addison's disease
Hyperkalemia
Common (≤10%):
GI: Nausea • Constipation* • Diarrhea
Neurologic: Headache
*Alginate-related
Serious (Monitor):
Hyperkalemia (muscle weakness, arrhythmias) in at-risk patients
Metabolic alkalosis (prolonged high-dose use)
Renal Impairment:
Avoid if eGFR <60 mL/min → risk of hyperkalemia
Cardiac Conditions:
Caution in heart failure • Concurrent ACEi/ARB use
Electrolyte Imbalance:
Monitor K⁺ if used >14 days
Special Populations:
Pregnancy: Safe (Category B)
Elderly: Screen for renal impairment
| Concomitant Drug | Risk | Management |
|---|---|---|
| Potassium-sparing diuretics | ↑ Hyperkalemia | Avoid combination |
| ACE inhibitors | ↑ Hyperkalemia | Monitor K⁺ levels |
| Anticholinergics | ↓ Alginate efficacy | Separate dosing by 2 hours |
Symptoms: Alkalosis (confusion, tremors) • Hyperkalemia (ECG changes)
Treatment:
Calcium gluconate IV for cardiac hyperkalemia
Insulin-dextrose for K⁺ >6.5 mmol/L
Gastric lavage if recent ingestion
Antacid / Reflux Suppressant
Suspension: Shake well • Do not freeze
Tablets: Store below 30°C • Protect from moisture
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