A fixed-dose combination antacid and antiflatulent used for symptomatic relief of hyperacidity, dyspepsia, and associated gas-related discomfort. Aluminium hydroxide neutralizes gastric acid and provides mucosal protection, magnesium hydroxide provides rapid acid neutralization and mild laxative effect, and simethicone acts as an antifoaming agent to relieve bloating and flatulence.
Adult: 1-2 tablets or 5-10 ml of suspension, 4 times a day, preferably 1 hour after meals and at bedtime, or as directed by the physician. Maximum: 8 doses in 24 hours.
Note: Chew tablets thoroughly before swallowing or allow to dissolve in the mouth. Follow with a half glass of water. Liquid formulations should be shaken well before use. For best effect, take 1 hour after meals and at bedtime. Do not take within 2 hours of other medications (especially tetracyclines, fluoroquinolones, iron supplements, bisphosphonates, levothyroxine).
1. **Aluminium Hydroxide:** Reacts with hydrochloric acid in the stomach to form aluminium chloride and water. It also adsorbs pepsin and bile salts, providing a mild cytoprotective effect. 2. **Magnesium Hydroxide:** Reacts rapidly with gastric acid to form magnesium chloride and water. It has an osmotic effect in the intestines, drawing water into the lumen. 3. **Simethicone:** A physiologically inert organosilicon polymer that lowers the surface tension of gas bubbles in the GI tract, causing them to coalesce. This allows for easier expulsion of gas via belching or flatus, relieving pressure and bloating.
Pregnancy: Category C (US FDA). Generally considered safe for short-term, intermittent use during pregnancy as systemic absorption is minimal. However, use should be limited to symptomatic relief and under medical advice. High doses of magnesium should be avoided near term due to theoretical risk of affecting uterine contractions.
Driving: No known effects on driving ability.
| Tetracycline antibiotics (Doxycycline, Tetracycline) | Forms insoluble complexes, drastically reducing antibiotic absorption. | Major |
| Fluoroquinolone antibiotics (Ciprofloxacin, Levofloxacin) | Chelation reduces absorption and efficacy. | Major |
| Iron supplements (Ferrous sulfate) | Reduces iron absorption. | Moderate |
| Bisphosphonates (Alendronate) | Severely reduces absorption. Must be taken at least 2 hours apart. | Major |
| Levothyroxine | Reduces absorption of thyroid hormone. | Moderate |
| Digoxin | Altered GI motility may affect digoxin absorption. Risk of toxicity if diarrhoea causes hypokalaemia. | Moderate |
| H2 Blockers (Ranitidine, Famotidine) or PPIs (Omeprazole, Pantoprazole) | Concurrent use is generally not recommended as antacids can reduce absorption of these drugs. Administer at least 2 hours apart. | Moderate |
| Enteric-coated tablets | Increased gastric pH may cause premature dissolution in stomach. | Moderate |
| Ketoconazole, Itraconazole | Increased gastric pH reduces absorption of these antifungals. | Major |