This preparation is indicated for:

• Gastric reflux
• Heartburn
• Indigestion
• Flatulence associated with gastric reflux
• Heartburn during pregnancy
• All cases of epigastric and retrosternal discomfort where the underlying cause is gastric reflux

This preparation is a combination of two antacids (Calcium Carbonate and Sodium Bicarbonate) and an alginate (Sodium Alginate). It works in two ways:

• Neutralizing excess stomach acid to relieve pain and discomfort
• Forming a protective barrier over stomach contents to reduce burning sensation in the chest

Its action is purely physical and does not depend on systemic absorption. After ingestion, it rapidly reacts with gastric acid to form a raft of alginic acid gel with near-neutral pH. This raft has been shown to interact with and cover the acid pocket in the stomach, reducing acid exposure to the esophagus. The raft floats on stomach contents and effectively prevents gastro-esophageal reflux for up to 4 hours, protecting the esophagus from acid, pepsin, and bile. In severe cases, the raft itself may reflux into the esophagus instead of stomach contents and provides a soothing protective (demulcent) effect. In addition, in vitro studies show that the raft can trap bile and pepsin within its structure, further protecting the esophagus. Calcium Carbonate neutralizes stomach acid and provides fast relief from indigestion and heartburn. This effect is enhanced by Sodium Bicarbonate, which also contributes to acid neutralization.

For oral suspension

• Adult and children over 12 years: 10-20 mL after meals and at bedtime, up to four times a day.
• Children 6 to 12 years: 5-10 mL after meals and at bedtime, up to four times a day.
• Children under 6 years: Not recommended.
• Elderly: No dose modifications necessary.

Chewable Tablet should be taken in oral route after being thoroughly chewed. Recommended dose:

• Adults and children 12 years and over: Take two to four tablets after meals and at bedtime, up to four times a day.
• Children under 12 years: Tablets should be given only on medical advice.

Hepatic Impairment: No dose modification necessary.
Renal Insufficiency: Caution if highly restricted salt diet is necessary.

A time interval of at least 2 hours should be maintained between this medicine and other medicinal products, especially tetracyclines, digoxin, fluoroquinolones, iron salts, ketoconazole, neuroleptics, thyroid hormones, penicillamine, beta-blockers (atenolol, metoprolol, propranolol), glucocorticoids, chloroquine, bisphosphonates (diphosphonates), and estramustine.

This product is contraindicated in patients with known or suspected hypersensitivity to the active ingredients or any excipients.

In addition to the desired effect, some side effects may occur such as constipation, flatulence, stomach cramps, or belching. In such cases, medical advice should be taken. In case of excessive dose, a feeling of abdominal swelling or bloating may occur. In this situation, consultation with a physician is recommended.

Pregnancy: Clinical studies in more than 500 pregnant women and extensive post-marketing data show no evidence of malformations or fetal/neonatal toxicity of the active ingredients. This medicine may be used during pregnancy if clinically needed.

Breastfeeding: No harmful effects have been observed in breastfed infants of treated mothers. This medicine can be used during breastfeeding.

Fertility: Pre-clinical studies show no negative effect on fertility or reproduction. Clinical data also do not suggest any effect on human fertility.

Each 20 ml dose contains 254.5 mg (11.06 mmol) sodium, which should be considered in patients on a strict salt-restricted diet, such as those with congestive heart failure or renal impairment.

Each 20 ml contains 260 mg (6.5 mmol) calcium. Caution is required in patients with hypercalcaemia, nephrocalcinosis, or recurrent calcium-containing kidney stones.

Use in children under 12 years is generally not recommended unless advised by a physician. This combination is high in sodium and should be used carefully in patients requiring salt restriction. Each tablet contains 75 mg calcium. Due to aspartame content, it should not be used in patients with phenylketonuria. If symptoms persist for more than 7 days, medical advice should be taken. This medicine may mask symptoms of serious underlying conditions. It should not be used in patients with renal impairment or hypophosphatemia. Allergic reactions may occur.

In case of overdose, symptomatic treatment should be given. The patient may experience abdominal distension.

Antacids

Store in a cool (below 30°C) and dry place, away from light. Keep out of reach of children. Do not refrigerate or freeze.