1. Clinical Overview
A fixed-dose combination product primarily used as an antacid, electrolyte replenisher, and local analgesic for gastrointestinal discomfort. Magnesium carbonate neutralizes gastric acid, potassium chloride corrects hypokalemia, and procaine provides local anesthetic action on the gastric mucosa to relieve pain associated with hyperacidity and gastritis.
| Onset | Duration | Bioavailability |
|---|---|---|
| Magnesium carbonate: 5-10 minutes (antacid effect). Procaine: Local effect within minutes of ingestion. | Magnesium carbonate: 1-2 hours. Procaine: Local anesthetic effect is transient, lasting approximately 30-60 minutes. | Magnesium: Variable (15-30%) depending on gastric pH and need. Potassium: ~90% from chloride salt. Procaine: Orally administered procaine is rapidly hydrolyzed; systemic bioavailability of intact drug is negligible. |
2. Mechanism of Action
Magnesium carbonate reacts with hydrochloric acid in the stomach to form magnesium chloride, water, and carbon dioxide, thereby neutralizing excess acid and raising gastric pH. Potassium chloride directly supplies potassium ions to correct or prevent hypokalemia. Procaine, a local anesthetic, is intended to block sodium channels in the nerve endings of the gastric mucosa, providing temporary relief from pain associated with acid irritation, gastritis, or ulcers.
3. Indications & Uses
- Symptomatic relief in hyperacidity
- Gastritis
- Peptic ulcer disease (as adjunctive therapy for pain relief)
4. Dosage & Administration
Adult Dosage: 1-2 tablets, to be chewed or sucked, 3-4 times daily, preferably 1 hour after meals and at bedtime, or as directed by the physician. Maximum: 8 tablets in 24 hours.
Administration: Tablets should be chewed thoroughly or allowed to dissolve slowly in the mouth. Follow with a glass of water. Do not swallow whole. To be taken 1-2 hours apart from other oral medications (especially tetracyclines, fluoroquinolones, iron supplements, bisphosphonates) to avoid impaired absorption.
5. Side Effects
Common side effects may include:
- Diarrhoea (due to magnesium)
- Nausea
- Abdominal discomfort
- Chalky taste
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Tetracycline antibiotics (Doxycycline, Tetracycline) | Markedly decreased absorption of tetracyclines due to chelation by magnesium. | Major |
| Fluoroquinolone antibiotics (Ciprofloxacin, Levofloxacin) | Decreased absorption due to chelation. | Major |
| Bisphosphonates (Alendronate) | Severely reduced absorption. | Major |
| Iron supplements | Reduced absorption of oral iron. | Moderate |
| Digoxin | Hyperkalemia can increase risk of digoxin toxicity. Hypomagnesemia (if stopped abruptly) can also potentiate digoxin toxicity. | Major |
| Potassium-sparing diuretics (Spironolactone, Amiloride) | Increased risk of severe hyperkalemia. | Major |
| ACE inhibitors/ARBs (Ramipril, Losartan) | Increased risk of hyperkalemia. | Moderate |
| Neuromuscular blockers (Succinylcholine) | Procaine may potentiate neuromuscular blockade. | Moderate |
| Sulfonamides | PABA (procaine metabolite) may antagonize antibacterial action of sulfonamides. | Moderate |
7. Patient Counselling
- Do chew the tablet thoroughly before swallowing.
- Do take it 1-2 hours apart from other medicines.
- Do inform your doctor if you have kidney problems or heart disease.
- Don't take this medication for more than 2 weeks continuously unless advised by your doctor.
- Don't use it if you are on potassium-sparing diuretics or ACE inhibitors without medical supervision.
- Don't give this medicine to children.
8. Toxicology & Storage
Overdose: Primarily symptoms of hypermagnesemia (nausea, vomiting, hypotension, bradycardia, respiratory depression, coma, cardiac arrest) and hyperkalemia (muscle weakness, paralysis, paresthesia, arrhythmias, cardiac arrest). Procaine overdose symptoms (if absorbed) include CNS excitation followed by depression, convulsions, and methemoglobinemia (cyanosis).
Storage: Store in a cool, dry place, below 30°C. Protect from moisture and direct sunlight. Keep out of reach of children.