• Home
• GJF
  • Joint Wound Care Formulary
  • . . . Introduction
  • 1. Gastro-Intestinal System
    • 1.1 Dyspepsia and Gastro-oesophageal reflux disease
    • 1.2 Antispasmodics and other drugs altering gut motility
    • 1.3 Antisecretory drugs and mucosal protectants
    • 1.4 Antidiarrhoeal drugs
    • 1.5 Chronic bowel disorders
    • 1.6 Laxatives
    • 1.7 Local Preparations for anal and rectal disorders
    • 1.9 Drugs affecting intestinal secretions
  • 2. Cardiovascular System
  • 3. Respiratory System
  • 4. Central Nervous System
  • 5. Infections
  • 6. Endocrine System
  • 7. Obstetrics, Gynaecology and Urinary Tract Disorders
  • 8. Malignant Disease and Immunosuppresion
  • 9. Nutrition and Blood
  • 10. Musculoskeletal and Joint Disease
  • 11. Eye
  • 12. Ear, Nose and Oropharynx
  • 13. Skin
  • 14. Immunological products and vaccines
  • 15. Anaesthesia
  • Appendix 1. Drugs for emergency use in General Practice
  • Appendix 2. Palliative Care
  • Appendix 3. Oral Nutritional Supplements (ONS)
  • Appendix 4. Gluten-free and cow's milk protein-free products
  • Medicines No Longer included in the GJF
  • Medicines not recommended for use in NHS Grampian
• eGJF
• Medicines Management
• Policies
• News Letters
• Shared Care Protocols
• Patient Group Directions

1.1 Dyspepsia and Gastro-oesophageal reflux disease

See GP portal - dyspepsia/GORD guidelines [intranet], also see 1.3.

Co-magaldrox (magnesium hydroxide 195mg, dried aluminium hydroxide 220mg/mL) available as Mucogel® (sugar-free suspension) is an effective antacid with a low sodium content (less than 1mmol per 10mL dose).

Peptac® (sugar-free suspension containing sodium alginate 250mg, sodium bicarbonate 133.5mg and calcium carbonate 80mg/5mL) is the most cost-effective liquid compound alginic acid preperation and is only recommended for the treatment of gastric reflux as it has low acid suppressant activity. It has a high sodium content (6.2mmol per 10mL dose).

Gaviscon® Advance (sugar-free suspension containing sodium alginate 500mg, potassium bicarbonate 100mg/5mL is an alternative to Peptac® for the treatment of gastric reflux only in patients where the lower sodium content may be considered advantageous. It has a lower standard dose and contains 2.3mmol sodium and 1mmol potassium per 5mL dose. It is also available in a tablet formulation (containing sodium alginate 500mg and potassium bicarbonate 100mg/tablet).

SPECIAL INDICATIONS

Co-simalcite 125/500 available as Altacite Plus® (sugar-free suspension containing simeticone 125mg, hydrotalcite 500mg/5mL) is used for the treatment of biliary gastritis and is initiated in hospital.

Citrate antacid mixture is used pre-op in patients undergoing elective caesarean section.

PRESCRIBING POINTS FOR DYSPEPSIA AND GASTRO-OESOPHAGEAL REFLUX DISEASE

• Offer simple advice regarding lifestyle factors that may affect reflux.
• Liquid preparations are more effective than tablets.
• Antacids are best given when symptoms occur or are expected, usually between meals and at bedtime - four or more times daily.
• Antacids, taken at the same time as other drugs, may impair their absorption. They may also damage enteric coatings designed to prevent irritant drugs from dissolving in the stomach.