UNIGEL COMBINATION PRODUCT SUSPENSION

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

• Flatulence
• Bloating
• Gastroesophageal reflux disease
• Functional dyspepsia

Dosage

Children: For children, refer to the BNF for Children for specific dosing recommendations.

Adults: The usual adult dose is 40 to 125 mg taken after meals and at bedtime, as needed.

Mechanism of action

Simethicone is a surfactant that decreases the surface tension of gas bubbles in the gastrointestinal tract, facilitating their expulsion. It acts by forming a film of low surface tension that promotes the coalescence of mucus-surrounded gas bubbles, allowing for easier passage of gas.

Pharmacodynamics

Simethicone decreases the surface tension of gas bubbles in the gastrointestinal tract, facilitating their expulsion. Its effects are generally short-lived, as it is typically administered as needed. The therapeutic index is wide since it is not absorbed systemically, making it safe for use in various patient populations.

Pharmacokinetics

Simethicone is not systemically absorbed following oral administration, which contributes to its safety profile. Due to its lack of systemic absorption, specific pharmacokinetic parameters such as half-life, clearance, and volume of distribution are not applicable.

Pregnancy

Simethicone can be used during pregnancy as there are no known risks associated with its use.

Breast-feeding

Simethicone is considered safe to use during breastfeeding, as it is not absorbed systemically.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Oral suspension
• Chewable tablets
• Soft gels

Mechanism of action

Simethicone is a surfactant that decreases the surface tension of gas bubbles in the gastrointestinal tract, more easily allowing gas to exit the body. The clinical use of simethicone is based on its antifoam properties. Silicone antifoams spread on the surface of aqueous liquids, forming a film of low surface tension and thus causing collapse of foam bubbles. Simethicone reportedly allows mucus-surrounded gas bubbles in the GI tract to coalesce and be expelled.

Pharmacodynamics

Simethicone decreases the surface tension of gas bubbles in the gastrointestinal tract, facilitating their expulsion. It has a short duration of action as it is generally given as needed, and a wide therapeutic index as it is not systemically absorbed.