MOGEL SUSPENSION (Each 5ml contains Magaldrate/Oxethazaine/Polydimethylsiloxane 250mg/10mg/60mg)

Indications

• Dyspepsia
• Gastroesophageal reflux disease (GERD)
• Peptic ulcer disease
• Heartburn

Dosage

Children: Refer to the BNF for Children for specific pediatric dosing guidance.

Adults: Refer to the BNF for specific dosing recommendations.

Mechanism of action

Magaldrate works by neutralizing gastric acid through a chemical reaction that produces water and salts. It promotes a more alkaline environment in the stomach, which helps to alleviate symptoms of acid-related disorders. The presence of both aluminum and magnesium ions allows for a balanced effect, as magnesium can counteract the constipating effects of aluminum.

Pharmacodynamics

The pharmacodynamic effects of magaldrate involve the reduction of gastric acidity, leading to increased gastric pH. This action helps to relieve heartburn, indigestion, and discomfort associated with excess stomach acid. The combination of aluminum and magnesium also contributes to a more prolonged effect, as they act synergistically to enhance the antacid properties.

Pharmacokinetics

Magaldrate is generally not absorbed systemically; rather, it acts locally in the gastrointestinal tract. The onset of action is typically rapid, providing quick relief of symptoms. The duration of action can vary based on the formulation and dosage but generally lasts for several hours. Renal impairment may affect the elimination of aluminum and magnesium, necessitating caution in patients with compromised kidney function.

Adverse effects

• Constipation
• Diarrhea
• Nausea
• Abdominal pain

Precautions

• Use with caution in patients with renal impairment
• Monitor patients with electrolyte disturbances

Pregnancy

Magaldrate can be used during pregnancy if necessary, but it is advisable to consult a healthcare professional.

Breast-feeding

Magaldrate is considered safe during breastfeeding but should be used under medical supervision.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Oral suspension
• Tablets

Indications

• Symptomatic relief of gastritis
• Management of peptic ulcers
• Treatment of hyperacidity-related symptoms

Dosage

Children: Refer to the BNF for Children for appropriate dosing information in paediatric patients.

Adults: The dosage for adults should be determined based on the specific clinical scenario; refer to the BNF for detailed dosing recommendations.

Mechanism of action

Oxethazaine inhibits gastric acid secretion by suppressing gastrin secretion. It exerts a local anesthetic effect on the gastric mucosa by diminishing the conduction of sensory nerve impulses near the application site, which reduces the permeability of the cell membrane to sodium ions. This is facilitated by its weak base nature, allowing it to be relatively non-ionized in acidic solutions, thus penetrating cell membranes effectively.

Pharmacodynamics

Oxethazaine improves common gastrointestinal symptoms associated with hyperacidity and provides prolonged relief from pain at lower dosages. As part of the anesthetic antacids, it increases gastric pH while producing a reversible loss of sensation. Its local efficacy is significantly greater than that of traditional local anesthetics like lignocaine and cocaine. In vitro studies have shown its antispasmodic action on smooth muscle and its ability to block serotonin action, further contributing to its therapeutic effects.

Pharmacokinetics

Oxethazaine is absorbed locally at the site of application, with its effects lasting longer than typical local anesthetics due to its unique chemical properties. The metabolism and excretion pathways are not extensively documented. As a weak base, its solubility in organic solvents enhances its ability to penetrate tissues, improving its anesthetic effectiveness.

Adverse effects

• Nausea
• Vomiting
• Dizziness
• Headache
• Allergic reactions

Precautions

• Use with caution in patients with a history of hypersensitivity to local anesthetics
• Monitor for potential allergic reactions
• Avoid in patients with severe hepatic impairment

Pregnancy

Oxethazaine should only be used in pregnancy if the potential benefit justifies the potential risk to the fetus. Consult relevant guidelines.

Breast-feeding

It is not known whether oxethazaine is excreted in human milk. Caution should be exercised when administering to breastfeeding women.

Storage

Store at room temperature, protected from light and moisture. Keep out of reach of children.

Formulations

• Oral suspension
• Topical gel

Indications

• Dyspepsia
• Bloating
• Aerophagia
• Excessive gas

Dosage

Children: Refer to specific product guidelines for dosing.

Adults: Refer to specific product guidelines for dosing.

Mechanism of action

Polydimethylsiloxane works primarily by reducing surface tension at gas-liquid interfaces, which helps to prevent the formation of foam. This is achieved through its hydrophobic nature, which allows it to disrupt the stability of bubbles formed in liquids, thus facilitating the release of trapped gases.

Pharmacodynamics

Polydimethylsiloxane is not absorbed systemically when administered orally, and its pharmacological effects are localized to the gastrointestinal tract, where it acts to alleviate symptoms related to excess gas and bloating. Its anti-foaming properties help to reduce discomfort associated with conditions such as dyspepsia and aerophagia.

Pharmacokinetics

Polydimethylsiloxane is not significantly absorbed into the bloodstream following oral administration. It passes through the gastrointestinal tract intact and is excreted unchanged in the feces. Its pharmacokinetic profile indicates a rapid onset of action, with effects observed shortly after ingestion, and a relatively short duration of effect depending on the amount of gas present in the gastrointestinal tract.

Adverse effects

• Nausea
• Diarrhea
• Bloating
• Abdominal cramping

Precautions

• Use with caution in patients with known hypersensitivity to polydimethylsiloxane or any components of the formulation.
• Consult with a healthcare professional before use in patients with gastrointestinal obstruction.

Pregnancy

Polydimethylsiloxane is generally considered safe for use during pregnancy, but it is advisable to consult a healthcare provider before use.

Breast-feeding

Polydimethylsiloxane is not known to be absorbed systemically and is considered safe for use during breastfeeding.

Storage

Store at room temperature, away from moisture and direct sunlight.

Formulations

• Oral suspension
• Emulsion
• Chewable tablet

Mechanism of action

Oxetacaine inhibits gastric acid secretion by suppressing gastrin secretion. Moreover, oxetacaine exerts a local anesthetic effect on the gastric mucosa. This potent local anesthetic effect of oxetacaine may be explained by its unique chemical characteristics in which, as a weak base, it is relatively non-ionized in acidic solutions whereas its hydrochloride salt is soluble in organic solvents and it can penetrate cell membranes. Oxetacaine diminishes the conduction of sensory nerve impulses near the application site which in order reduces the permeability of the cell membrane to sodium ions. This activity is performed by the incorporation of the unionized form into the cell membrane.

Pharmacodynamics

Oxetacaine improves common gastrointestinal symptoms. Oxetacaine is part of the anesthetic antacids which increase the gastric pH while providing relief from pain for a longer period of duration at a lower dosage. This property has been reported to relieve the symptoms of hyperacidity. Oxetacaine is reported to produce a reversible loss of sensation and to provide a prompt and prolonged relief of pain. In vitro, oxetacaine was showed to produce an antispasmodic action on the smooth muscle and block the action of serotonin. The local efficacy of oxetacaine has been proven to be 2000 times more potent than lignocaine and 500 times more potent than cocaine. Its anesthetic action produces the loss of sensation which can be explained by its inhibitory activity against the nerve impulses and de decrease in permeability of the cell membrane.