A quadruple-action oral suspension for the symptomatic management of hyperacidity, gastroesophageal reflux disease (GERD), and associated dyspepsia. It combines a potent local anesthetic (oxetacaine) for rapid pain relief, two antacids (aluminium hydroxide and magnesium hydroxide) for acid neutralization, and an antiflatulent (simethicone) for gas relief. It is a first-line therapy for immediate relief of acid-peptic symptoms in the Indian outpatient setting.
Adult: 10-20 ml (2-4 teaspoonfuls) orally, 3-4 times a day, 20-60 minutes after meals and at bedtime, or as directed by the physician. Do not exceed 80 ml (16 teaspoonfuls) in 24 hours.
Note: Shake the bottle well before use. Use the measuring cup/spoon provided. To be taken undiluted or with a small amount of water. Do not take with other liquids like milk. Maintain an upright position for 1-2 minutes after administration. Allow at least 2 hours gap between taking this suspension and other oral medications (especially tetracyclines, fluoroquinolones, iron supplements, levothyroxine, azole antifungals, etc.) to avoid adsorption and reduced absorption.
1. Oxetacaine: A potent surface anesthetic that blocks sodium channels in the neuronal membrane of the esophageal and gastric mucosa, providing rapid relief from pain and burning sensation. 2. Aluminium Hydroxide & Magnesium Hydroxide: Non-systemic antacids that react with and neutralize hydrochloric acid in the gastric lumen, raising the pH. They also adsorb pepsin and bile salts. 3. Simethicone: A physiologically inert antifoaming agent that reduces the surface tension of gas bubbles in the GI tract, causing them to coalesce and be more easily expelled via belching or flatus.
Pregnancy: Category C (US FDA). No well-controlled studies. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Oxetacaine absorption is minimal. Antacids are generally considered safe for short-term, intermittent use in pregnancy for heartburn, but high doses should be avoided. Magnesium hydroxide is preferred over aluminium-containing antacids.
Driving: Unlikely to affect driving ability. However, if dizziness or headache occurs as a side effect, caution is advised.
| Tetracyclines (Doxycycline, Tetracycline) | Markedly decreased absorption due to chelation with Al & Mg cations. | Major |
| Fluoroquinolones (Ciprofloxacin, Levofloxacin) | Markedly decreased absorption due to chelation. | Major |
| Iron Supplements (Ferrous sulfate) | Decreased absorption of iron. | Moderate |
| Levothyroxine | Decreased absorption of levothyroxine. | Moderate |
| Azole Antifungals (Ketoconazole, Itraconazole) | Decreased absorption due to increased gastric pH. | Major |
| Digoxin | Altered absorption; monitor digoxin levels. | Moderate |
| Phosphate supplements | Aluminium hydroxide binds phosphate, reducing its efficacy. | Moderate |
| Enteric-coated medications | Premature dissolution in less acidic stomach, causing gastric irritation. | Moderate |
| Sodium Polystyrene Sulfonate | Risk of intestinal necrosis (with aluminium hydroxide). | Major |
| Neuromuscular Blockers (e.g., Succinylcholine) | Magnesium may potentiate effects. | Moderate |
Same composition (Oxetacaine (10mg/5ml) + Aluminium Hydroxide (600mg/5ml) + Magnesium (300mg/5ml) + Simethicone (25mg/5ml)), different brands: