Heartburn, chest pain - sensations familiar to many firsthand. The causes of this are different: from malnutrition to diseases of the gastrointestinal tract. Regardless of the cause, effective treatment is required to alleviate the condition. Antacid drugs - a group of medicines designed to help with such conditions.
The effect of antacids
Antacids are medicines that are designed to help with acid-dependent gastrointestinal diseases by neutralizing hydrochloric acid and bile of gastric juice. The name is formed from the ancient Greek words “against” and “acid”. The peculiarity of the use of antacid medicines is that they do not treat the disease itself, the cause of the pain, but only affect the symptoms. They are used to:
- reduce pain from the irritating effect of acid on the mucous membrane of the digestive system,
- reduce pressure on the stomach,
- prevent the contents of the duodenum from being thrown into the stomach cavity.
Taking these drugs speeds up the movement of food through the digestive tract. They envelop, protect the esophagus from aggressive factors, and inhibit the activity of bacteria that cause ulcers and gastritis - Helicobacter pylori. The antacid effect begins to be felt after 5-10 minutes after administration, lasts 2-4 hours. Most drugs in this group are well tolerated, do not cause side effects.
Indications for the use of antacids
It is recommended that antacids be taken - both as stand-alone drugs and in complex treatment - with:
- malfunctions of the stomach from taking non-steroidal anti-inflammatory drugs,
- diseases, inflammation of the pancreas, gall bladder, gallstone disease,
- ulcer, GERD (gastroesophageal reflux disease),
- acid-dependent diseases, including in pregnant women,
- single heartburn
- exacerbation of chronic diseases (pancreatitis, cholecystitis).
Types of Antacids
Antacids are classified according to several criteria:
- By the type of assimilation, the drugs are absorbable and non-absorbable.
- Composition - modern antacid preparations contain: aluminum hydroxide and phosphate, magnesium hydroxide or carbonate, calcium carbonate, sodium bicarbonate. Combined antacids with several active ingredients are produced.
- By the speed of action, short and long-acting drugs are isolated. The first often include absorbable preparations based on magnesium, calcium. They reduce pain for a short time, about 30 minutes. The effect of drugs with aluminum hydroxide, magnesium trisilicate longer - up to 4 hours.
- According to their neutralizing ability, they emit effective ones: with magnesium oxide, aluminum hydroxide, calcium carbonate and weaker ones: magnesium trisilicate, sodium bicarbonate.
Antacids are available in the form of lozenges or suspensions. There are ready-to-use mixtures or powder for the preparation of medicine, packaged in bags. The release form directly affects usability and neutralizing ability:
- It is more convenient to take tablets - they do not need to be washed down with water, you just need to chew.
- Suspensions are more effective because their particles are smaller and the distribution area is larger. Their gel dense structure better envelops the mucous membrane, anesthetizing and protecting.
This group of drugs (or products of their chemical interaction) are absorbed by the intestines and enter the bloodstream. They differ in quick but short action from 30 minutes to 2 hours. The chemical reaction caused by them takes place with the release of carbon dioxide. This causes belching, flatulence, which after a while repeatedly leads to heartburn. They are characterized by a “rebound syndrome" - 1-2 hours after administration, the production of hydrochloric acid increases, which exacerbates the disease.
Absorbable antacids contain calcium carbonate, magnesium, sodium bicarbonate. These include: baking soda, Rennie, Vicalin, Vicair and others. With the ekrovascular system, they are distributed throughout the body - this increases the risk of side effects. Basic: changes in the composition of the blood, interruptions in the cardiac system, effect on the functioning of the kidneys, edema, increased blood pressure, the formation of kidney stones. Such signs appear more often while taking dairy products with medicines. It is recommended to apply them one-time, rather than long courses.
One of the common medications of this type is Rennie. These are chewable tablets with a mint, cooling or orange flavor that neutralize excess hydrochloric acid and protect the mucous membrane of the digestive tract and stomach. The action is felt after 5 minutes, due to the excellent solubility and high concentration of calcium:
- Active ingredients of Rennie: calcium carbonate and magnesium carbonate.
- The form of release of the drug is tablets. Packed in 6 or 12 pieces in blisters or packages of heat-seal aluminum. In a pack from 1 to 8 blisters.
- The cost of 24 tablets in the range of 290-320 rubles.
- They are taken at intervals of 2 hours or more, the maximum daily dose of 11 tablets.
Affordable drug - Vicair tablets. They are prescribed to relieve symptoms of peptic ulcer, gastritis with a tendency to constipation. Dosage - 1-2 pieces 3 times a day. The action of the drug: antacid, astringent, laxative, antispasmodic. Composition: magnesium carbonate, sodium bicarbonate, bismuth subnistrate, calamus root, buckthorn bark. The price of a package of 10 tablets is 15-25 rubles.
These are more modern drugs compared to absorbable drugs, with a gentle effect. Carry out a therapeutic effect on gastrointestinal tract diseases; Their active substances are not absorbed by the body, side effects are noted by patients much less often. Main components: aluminum phosphate, aluminum and magnesium hydroxides, combined composition. Some preparations contain additional components: simethicone, alginic acid and its salts. Thanks to them, the risk of side effects is reduced.
Non-absorbable drugs envelop the mucous membrane, promote healing. Valid 15-20 minutes after administration, the result is up to 4 hours. Cautiously prescribed to people with kidney failure, due to the excretion of active substances in the urine. The main representatives of this group of medicines are Maalox, Almagel, Gaviscon, Fosfalugel, Palmagel A, Gastal, Alumag and others.
- renal failure
- Alzheimer's disease
- allergic reaction, individual intolerance to the components of drugs.
Not recommended, but can be used under medical supervision with:
- pregnancy, lactation,
- heart failure
- injuries, diseases of the brain,
- over 65 years old
- children under 18 years old
- cirrhosis of the liver,
- malfunctioning kidney function.
Almagel is a popular agent with active ingredient aluminum phosphate. Eliminates the symptoms of duodenitis, gastritis, stomach ulcers, duodenal ulcers and other gastrointestinal diseases. Anesthetizes, reduces heartburn. Available in the form of Almagel T tablets and suspensions. The medicine is available in 170 ml vials or disposable 10 ml sachets. The cost of pharmacy chains is 195-300 rubles per bottle. The price of packaging Almagel T with 12 tablets is 60 rubles.
Suspension is made in several options:
- Almagel is a standard gel composition with aluminum and magnesium hydroxide. The box is green.
- Almagel A - gel antacids with anesthetics (benzocaine). The packaging is yellow.
- Almagel Neo - simethicone in the composition eliminates gas formation. Red box design.
Phosphalugel is a drug of the antacid group that protects the gastric mucosa, lowers the acidity of gastric juice. It is used for gastritis, gastrointestinal ulcers, reflux esophagitis, digestive upsets and food poisoning. Sold in pharmacies without a doctor’s prescription. Before taking, the contents of the sachet are kneaded with fingers to mix. It is used in its pure form or mixed with a small amount of water:
- The main component is aluminum phosphate, additional - sorbitol, agar-agar, pectin, calcium sulfate dihydrate, purified water, flavor.
- The release form of Phosphalugel is a white gel with a uniform structure. It is unpacked in bags of 16 or 20 grams for one reception.
- The package contains 20 sachets weighing 20 grams or 26 sachets weighing 16 grams.
- The price is 360-390 rubles.
Antacids for children
In children, there are diseases that require the use of antacids. These are gastroduodenitis, erosion or an ulcer of the gastrointestinal mucosa, heartburn due to an unbalanced diet. If necessary, choose a medicine for a young child (up to 10 years), it is worth considering that absorbed antacids are strictly prohibited. The reason is the rebound effect, penetration into the circulatory system, and possible side effects.
You can choose a medicine for a child from non-absorbable antacids: these are Maalox, Gaviscon, Alumag, Almagel, Fosfalugel and others. Phosphalugel does not upset the phosphate balance and leaches calcium from bones. Allowed for children with a dosage reduced by 2–4 times (compared with adults). Exact recommendations for the drug are given by the doctor. Long-term use of even authorized antacids is not recommended for children: it is necessary to treat the disease, and not to alleviate its symptoms.
Taking antacids worsens the absorption of nutrients and elements from food and medicine. Therefore, they should be consumed with an interval of 1-2 hours between them. The film that covers the gastrointestinal mucosa will reduce absorption and action:
- iron preparations, iron sulfates,
- non-steroidal anti-inflammatory drugs,
- antibiotics: tetracycline, metronidazole,
- anti-tuberculosis drugs
- Phenytoin, Digoxin, Quinidine, Warfirin.
The principle of action of drugs
For normal digestion, hydrochloric acid is produced in the stomach - it helps to activate a number of enzymes and destroy pathogenic bacteria that enter the digestive tract with food. The organ itself, to protect against the aggressive effects of hydrochloric acid, is internally covered with a thick mucous membrane. If its integrity is violated, erosion begins to appear on the inner surface of the stomach, which over time can lead to peptic ulcer. In some cases, weakening of the lower esophageal sphincter is possible, which leads to the ingress of enzymes into the esophagus, causing irritation and inflammation.
The active components of antacids in an aqueous solution have alkaline properties, and therefore neutralize the excess of hydrochloric acid. This reduces the aggressive effect of gastric juice, which is manifested by a decrease in heartburn. Modern drugs not only neutralize the environment of the stomach, but also envelop the walls of the organ, which contributes to a faster restoration of the mucous membrane.
The mechanisms of action of antacids
Varieties of Antacids
All drugs of the antacid group are divided into two large categories.
- Suction. This group of drugs contains substances that are able to be absorbed into the systemic circulation through the gastric wall. They are characterized by a quick manifestation of a therapeutic effect. At the same time, during the patient’s neutralization, a large amount of carbon dioxide is released in the stomach. This leads to the appearance of belching, flatulence, reflux. The total proportion of absorbed active substances can be up to ⅕ of the total amount of active substance. Therefore, the intake of absorbed antacids is best done once, to avoid severe disturbances in the electrolyte balance.
Attention! The intake of absorbed antacids can lead to the effect of an “acid rebound” - when the stomach begins to synthesize hydrochloric acid more intensively at the end of the drug’s action. This effect occurs as a result of too fast alkalization of the stomach environment, which causes a compensatory effect. For this reason, absorbed antacids are not recommended for intake at night, when food cannot mitigate the effect of hydrochloric acid on the stomach.
According to the active substances, the following groups of antacid preparations are distinguished:
- means based on magnesium salts,
- means based on aluminum salts,
- calcium carbonate,
- sodium bicarbonate,
The mechanism of action of carbonate antacids
Antacids are available in several dosage forms:
- oral tablets
Powder for suspension
Such dosage forms begin to act immediately - they are not protected by the shell, and therefore their dissolution begins after it enters the stomach. Suspensions are more convenient for home use, while tablets are more convenient to use outside the home. When chewing and resorption of tablets, the time of onset of exposure is reduced and relief of heartburn occurs faster.
Admission Rules and Duration
Antacids are taken once to eliminate heartburn and dyspeptic symptoms. To prevent such violations, drugs are taken in a course whose duration is set individually.
The effect of intake of absorbable agents is manifested immediately, and non-absorbable - after 10-15 minutes. The duration of non-absorbable preparations lasts up to 4-5 hours. The effect of the use of absorbable products lasts 1.5-2 hours.
Contraindications and side effects
There are practically no special contraindications to the use of antacids. You can not take the funds of this group with hypersensitivity to the active components and with renal failure. A number of drugs are prohibited for use in children under 3 years of age, during pregnancy and lactation.
The main side effects of the application include:
- diarrhea when using magnesium-based products,
- constipation in the treatment of calcium-based drugs,
- the appearance of an allergic rash,
- drowsiness when taking large doses of the drug.
Drowsiness is one of the possible side effects of taking large doses of antacids.
The above side effects occur quite rarely and, in most cases, in violation of the instructions for use.
In medicine, antacids are considered drugs of maintenance drug therapy for conditions such as peptic ulcer of the stomach and duodenum, chronic gastritis, and GERD. When taken in patients, the symptoms that occur due to an increase in the level of acidity or a violation of the evacuation function of the stomach disappear or decrease. They are independently used for the symptomatic treatment of heartburn, heaviness, bloating, acid belching, as well as in the initial stages of acid-dependent diseases.
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Antacids are a group of drugs whose main task is to reduce the high level of acidity in the stomach. By chemical nature, they are bases. The mechanism of action is to neutralize hydrochloric acid.
Peculiarity of drugs: rapid onset of effect, but also its short duration, therefore, in chronic conditions, they are prescribed for the complex with agents that reduce the formation of hydrochloric acid (omeprazole, pariet, nolpase, ranitidine).
Pharmacology has come up with many combinations of drugs with antacid effects. In addition to the main one - neutralization of the acidic environment, they successfully perform the following functions:
- Sorb harmful substances.
- Relieve severity, pain.
- Capable of binding bile acids.
- Prevent flatulence.
- They have a cytoprotective effect on the cells of the walls of the stomach.
- They envelop the stomach, reliably protecting it from ulcerogenic effects.
The classification is based on absorption capacity. Antacids are divided into two categories - absorbable and non-absorbable. The first group is considered obsolete and has a large number of side effects. The second group is more modern and in some cases can be prescribed even during pregnancy.
Please note that this separation is arbitrary. Since even non-absorbable antacids can partially enter the blood plasma. Although much smaller than the first group.
List of absorbable antacids
- Ordinary soda or sodium bicarbonate (NaHCO3).
- Basic calcium carbonate (CaCO3).
- Basic magnesium carbonate (MgCO3).
- Magnesium Oxide (MgO).
Pharmacy assortment products:
- Rennie (Calcium Carbonate + Magnesium Carbonate).
- Vicalin and Vicair (Magnesium carbonate + Sodium bicarbonate + other components).
Currently, this list of antacids is considered obsolete due to a significant number of side effects.
List of nonabsorbable antacids
The combination of magnesium hydroxide and algeldrate (hydrated aluminum oxide) was widely used. They are traditionally considered the most balanced, studied and safe, this allows you to use them almost every day. The main components provide a complementary effect that allows you to get a fairly long-lasting effect, as well as minimize risks.
Magnesium hydroxide acts quickly, and algildrate is long-lasting. Together, this is an effective combination that does not have an acid rebound.
Preparations with such a composition, in addition to antacid action, have:
- Cytoprotective effect, due to an increase in the production of prostaglandins, which provide protection factors for the gastric mucosa.
- Stimulate the healing of mucosal tissues.
- Do not contribute to gas and bloating.
- Helicobacter pylori is delayed.
- Unlike absorbable antacids, they are allowed for hypertension.
- Capable of binding, stomach irritating, bile acids.
Non-absorbable antacids, a list of drugs sold in the pharmacy:
- Maalox (Aluminum hydroxide + Magnesium hydroxide). One of the most popular drugs on the market. Available in the form of a suspension, tablets and maalox-mini preparation (small sachets with improved palatability).
- Almagel (Aluminum hydroxide + Magnesium hydroxide). The same composition as that of maalox. Release form - suspension.
- Almagel A (Aluminum hydroxide + Magnesium hydroxide + Benzocaine). The composition includes a local anesthetic. It has a local analgesic effect. Apply longer than a month is contraindicated.
- Almagel NEO (Aluminum hydroxide + Magnesium hydroxide + Simethicone). Here, an additional component is simethicone (carminative). Removes bloating, methiarism.
- Gastal (Hydrotalcite + Magnesium hydroxide). It is made in tablets with different tastes. Well-known medication.
- Phosphalugel (Colloidal aluminum phosphate + Pectin + Agar-agar). Sasha for a single dose. Monocomponent andacid. Pectin (acts as an auxiliary substance) enhances peristalsis and removes harmful substances from the intestines.
- Gastracid (Aluminum hydroxide + Magnesium hydroxide). All the same popular composition from the European manufacturer Natur Product.
- Relzer (Aluminum hydroxide + Magnesium hydroxide + Simetikov + Licorice root powder). The original composition, in addition to antacid components, includes: Simethicone - a carminative, reduces bloating. Licorice - enhances the protective factors of the gastric mucosa and has antispasmodic properties.
- Talcide (hydrotalcite or aluminum magnesium hydroxide carbonate hydrate). A complex chemical compound based on aluminum and magnesium. Provides long-term maintenance of acidity at an optimal level due to the gradual release of ions.
- Rutacid (hydrotalcite). Chewable tablets.
Antacids are drugs that have proven effective. Modern complex formulations can minimize side effects and prolong the therapeutic effect. It is worth abandoning outdated formulations.
In general, antacid drugs are well tolerated and have a quick result. However, their long reception, without the appointment of a doctor, is undesirable.
The short-term effect of absolutely all antacids (up to 4 hours) inevitably leads to the fact that their frequent intake is necessary to maintain the level of optimal acidity. This is inconvenient and inevitably entails the risk of side effects. Therefore, most often they are used in emergency cases or in the complex treatment of chronic gastritis and stomach ulcers.
Varieties and scope of antacids
Antacids are called medicines that are used in acid-dependent diseases. This group of drugs has been known for a very long time. The first antacids began to be used in medicine more than 100 years ago. Medicines from this group have the following features:
- able to neutralize hydrochloric acid, normalizing pH,
- possess a cytoprotective effect, protecting cells from the aggressive influence of acids,
- able to absorb bile acids,
- have an enveloping effect.
In most cases, antacids are in addition to the main treatment. These are medications for symptomatic therapy. Unlike other acid-correcting drugs, antacids have a faster and more pronounced effect. The therapeutic effect is achieved due to the presence of magnesium, aluminum or calcium compounds in their composition.
Indications and contraindications for use
Antacids are taken orally in the form of gels, suspensions or tablets. This group of drugs is used for the following pathological conditions:
- gastroesophageal reflux,
- peptic ulcer of the stomach during an exacerbation,
- peptic ulcer of the duodenum during exacerbation,
- hiatal hernia
- inflammation of the mucous membrane of the esophagus against a background of gastric reflux,
- functional disorders of the intestine,
- discomfort in the epigastric region after drinking.
Antacids can be used prophylactically to prevent inflammation of the stomach during the use of drugs from the NSAID group. Almagel A may be part of a comprehensive diabetes treatment regimen. Absorbable drugs are practically not used. Antacids are well tolerated, however, there are some limitations in their use.
An antacid such as Almagel is contraindicated in Alzheimer's disease, impaired renal excretory function and individual intolerance. The drug is not prescribed for children under 1 month of age. "Gaviscon" can not be taken by people who have hypersensitivity to the main components of the drug.
The antacid preparation "Maalox" cannot be used in the following conditions:
- severe renal failure
- sucrose deficiency
- fructose intolerance.
"Maalox" is only suitable for people over 15 years old. Contraindications to taking "Fosfalugel" are individual intolerance and renal failure.
Possible adverse reactions
If you follow the treatment regimen prescribed by your doctor, side effects when taking antacids are very rare. They are possible with the uncontrolled use of drugs. Magnesium-based antacids can cause diarrhea. In case of an overdose of them, impaired renal function and a decrease in heart rate are possible. Aluminum-based antacids can trigger hypophosphatemia. If medications are taken in the presence of renal failure, then encephalopathy and bone softening are possible. With prolonged use of magnesium-based drugs against the background of urolithiasis, patients may deteriorate and stone formation may intensify.
These are common unwanted effects. Taking "Phosphalugel" in rare cases can lead to constipation. Most often this is observed in older people. When using Gaviscon, allergic reactions may develop.
Reception of "Maaloksa" in rare cases can cause nausea, vomiting, impaired stool and taste sensitivity. Thus, nonabsorbable antacids are most effective. They are widely used to treat adults and children whose acidity is impaired.
What are antacids?
Drugs (a list is given below), the effect of which allows you to neutralize or eliminate the increased acidity of the stomach, are called antacid drugs.
However, this is not the only function of these tools. Modern drugs perfectly sorb lysolecithin and bile acids. They provide an enveloping effect on the digestive tract. In addition, they have cytoprotective properties.
Antacids are produced in a wide variety of dosage forms. Drugs are usually saturated with pleasant flavors. And, most importantly, such drugs have a minimal list of side effects.
Of course, all these features made antacid preparations quite popular. In modern clinical practice, these drugs occupy one of the most important positions in the treatment of acid-dependent ailments.
Indications for appointment
It is completely undesirable to use antacids on their own. The names and use of such medicines should be discussed with your doctor. In what cases can drugs of this group be prescribed?
Since antacids are means that ensure the normalization of hydrochloric acid, it is quite clear that such medications can cope with the negative consequences that such a liquid provokes in the gastrointestinal tract (heartburn, colic, pain, heaviness).
The main indications for the appointment:
- Gastritis (with any acidity), in a chronic, acute stage.
- Reflux esophagitis (GERD).
- Duodenitis is chronic, acute.
- Peptic ulcer in the phase of exacerbations.
- Gastrointestinal upset caused by poor diet, alcohol, certain medications, or smoking.
According to the mechanism of action and the therapeutic effect provided, antacids are classified into:
- absorbed are drugs of the old generation,
- nonabsorbable - modern means.
Let's consider them in more detail.
Effective Absorbable Antacids
Such drugs after penetration into the digestive tract provide a rapid decrease in acidity. Accordingly, discomfort passes almost instantly.
However, absorbed antacids have several disadvantages:
- they provoke weakness, headache, sometimes nausea,
- provide a short-term beneficial effect,
- may cause belching, heaviness in the abdomen, fullness, vomiting,
- sometimes contribute to increased pressure,
- can cause drowsiness, increase swelling.
Act as regular therapeutic agents (since their effect is short-term) can not such antacids drugs.
The list of the most common absorbable medicines:
The cost of the most popular drugs
Of course, for most people an important role is played not only by the effectiveness of the effect of the drug on the body. Many patients, before purchasing a product, think about its cost.
Therefore, we consider how much the most popular antacid medicines cost the population.
List of drugs and prices:
- "Gaviscon" - an average of 120 rubles.,
- "Rennie" - about 100 rubles.,
- "Almagel" - the cost is 50-130 rubles.,
- “Maalox” will cost from 80 to 120 rubles.
Antacids are an indispensable tool for patients experiencing excruciating problems with the gastrointestinal tract. Such drugs can quickly stop negative symptoms and restore good health to a person.