Antacid

Source: Wikipedia, the free encyclopedia.
This article is about the medication used to relieve heartburn. For the acid produced by ants, known in many languages as "ant acid", see Formic acid.
Not to be confused with acid suppression therapy with PPIs or H2RAs, which reduces acid production.

Calcium carbonate antacid tablets

An antacid is a substance that

aluminum hydroxide (e.g., hydrotalcite).[3]

Medical uses

Antacids are available

over the counter and are taken by mouth to quickly relieve occasional heartburn, the major symptom of gastroesophageal reflux disease and indigestion. Treatment with antacids alone is symptomatic and only justified for minor symptoms.[4] Alternative uses for antacids include constipation, diarrhea, hyperphosphatemia, and urinary alkalization.[2] Some antacids are also used as an adjunct to pancreatic enzyme replacement therapy in the treatment of pancreatic insufficiency.[5]

Non-particulate antacids (sodium citrate) increase gastric pH with little or no effect on gastric volume, and therefore may see some limited use in pre-operative procedures. Sodium citrate should be given within 1 hour of surgery to be the most effective.[6]

Side effects

Conventional effervescent tablets contain a significant amount of sodium and are associated with increased odds of adverse cardiovascular events according to a 2013 study.[7] Alternative sodium-free formulations containing magnesium salts may cause diarrhea, whereas those containing calcium or aluminum may cause constipation.[8]: Table 2  Long-term use of antacids containing aluminum may increase the risk of developing osteoporosis.[9] In vitro studies have found a potential for acid rebound to occur due to antacid overuse, however the significance of this finding has been called into question.[10][11]

Properties of antacids

When an excess amount of acid is produced in the

acid reflux.[2][12]

Antacids do not directly inhibit acid

ulcers.[4]

Interactions

Structural depiction of tetracycline metal chelation, where 'M' is a metal such as those found in antacids

Antacids are known to

tetracyclines), leading to decreased absorption of the chelated drug. Some interactions may be due to the pH increase observed in the stomach following antacid ingestion, leading to increased absorption of weak acids, and decreased absorption of weak bases.[citation needed] Antacids also cause an increase in pH of the urine (alkalization), which may cause increased blood concentrations of weak bases, and increased excretion of weak acids.[14]

A proposed method to mitigate the effects of stomach acidity and chelation on drug absorption is to space out the administration of antacids with interacting medications by at least two hours,[15] however this method has not been well studied for drugs affected by urine alkalization.[13]

There are concerns regarding interactions between delayed-release tablets and antacids, as antacids may increase the stomach pH to a point at which the coating of the delayed-release tablet will dissolve, leading to degradation of the drug if it is pH sensitive.[14]

Formulations

Antacids may be

simethicone to control gas, or alginic acid to act as a physical barrier to acid.[16]

Liquids

Several liquid antacid preparations are

marketed. Common liquid preparations include milk of magnesia and magnesium/aluminum combinations. A potential advantage of using a liquid preparation over a tablet is that liquids may provide quicker relief, however this may coincide with a shorter duration of action.[17]

Tablets

Chewable tablets

Chewable tablets are one of the most common forms of antacids, most frequently made from carbonate or hydroxide salts, and are readily available over the counter. Upon reaching the stomach, the powdered antacid salts bind to hydronium (H+) ions, producing chloride salts, carbon dioxide, and water. This process reduces the concentration of H+ ions in the stomach, raising the pH and neutralizing the acid.[8]: Figure 1  Common carbonate salts available in tablet form include those of calcium, magnesium, aluminum, and sodium.[13]

Some common American brands are Tums, Gaviscon chewable tablets, and Maalox chewable tablets.[18]

Effervescent tablets

Effervescent tablets are tablets which are designed to dissolve in

ulceration due to aspirin's effects on the mucous membrane of the stomach.[24]

Brand names

Some brands include Alka-Seltzer, Gaviscon, Tums, Gelusil and Eno.[25][26][27]

References

  1. ^
    PMID 25340236
    .
  2. ^
    PMID 30252305. Archived
    from the original on 5 November 2021. Retrieved 24 November 2020.
  3. ^ "Aluminum hydroxide and magnesium carbonate Uses, Side Effects & Warnings". Drugs.com. Archived from the original on 20 May 2021. Retrieved 24 November 2020.
  4. ^ a b c "Consumer Summary – Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults". U.S. Department of Health & Human Services. Agency for Healthcare Research and Quality. 23 September 2011. Archived from the original on 11 October 2014.
  5. S2CID 10640940
    .
  6. PMID 28045707
    .
  7. PMID 24284017
    .
  8. ^
    PMID 35343261
    .
  9. ^ "Taking Antacids". Medline Plus. U.S. Department of Health and Human Services, National Institutes of Health, U.S. National Library of Medicine. 7 November 2014. Archived from the original on 5 July 2016.
  10. PMID 2644821
    .
  11. S2CID 10897187
    .
  12. PMID 22242022
    .
  13. ^
    S2CID 36875514
    .
  14. ^
    PMID 31788764
    .
  15. ISBN 978-0-6485158-6-9.{{cite book}}: CS1 maint: location missing publisher (link
    )
  16. ^ Thompson WG (12 September 2014). "Antacids". IFFGD Publication #520. International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). Archived from the original on 6 May 2016.
  17. S2CID 8133980
    .
  18. ^ "Maalox Antacid Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing". WebMD. Archived from the original on 24 June 2022. Retrieved 24 June 2022.
  19. ^ Dubogrey I (2013). "Putting the Fizz into Formulation". European Pharmaceutical Contractor. No. Autumn. Archived from the original on 28 August 2021. Retrieved 17 April 2017.
  20. ^ "Tablets". British Pharmacopeia. 2003. Archived from the original on 3 January 2013.
  21. ISBN 978-92-4-156301-7
    . Retrieved 1 July 2013.
  22. ^ "Alka Seltzer Directions of use, Sodium & Aspirin content – Alka Seltzer relief from Headaches, Migraine & Upset stomach". alkaseltzer.ie. Archived from the original on 29 April 2015. Retrieved 17 April 2017.
  23. ISBN 978-0471238966
    .
  24. PMID 3511824
    .
  25. ^ "Which OTC Meds Treat Heartburn?". WebMD. 30 March 2023. Retrieved 8 January 2024.
  26. ^ "Eno – Summary of Product Characteristics at eMC". Electronic Medicines Compendium. Retrieved 2 September 2016. Last updated 1 January 2016
  27. ^ "Gelusil - Uses, Side Effects, and More". Retrieved 27 February 2024.

External links

The dictionary definition of antacid at Wiktionary

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