Top 10 Antacids

Many diseases of the digestive tract are accompanied by such an unpleasant symptom as heartburn. First of all, these are the so-called acid-dependent diseases: stomach and duodenal ulcers, reflux esophagitis, functional dyspepsia and others.

To get rid of heartburn, it is necessary to neutralize hydrochloric acid, which is produced in the stomach, but at some point begins to partially go beyond the limits allotted to it. Acid is thrown upward, irritating the walls of the esophagus and causing heartburn, and antacids are prescribed to moderate its aggression. Modern antacids not only neutralize excess acid, but also reduce the production of gastric juice.¹.

Rating of the top 10 inexpensive and effective antacids according to the KP

Antacids are divided into several groups depending on the active substance – these are compounds of calcium, magnesium, aluminum. In addition, there are absorbable and non-absorbable antacids. The former contain calcium and sodium salts, quickly stop heartburn and pain, but the effect of their use does not last long. In addition, when using them, an “acid rebound” is possible, that is, an increased formation of acid after the drug ceases to act.

Non-absorbable preparations contain salts of magnesium and aluminum, “start” more slowly, but provide a positive result longer. Therefore, in our ranking of the most popular and effective antacids, there were more of them.².

1. Maalox

The drug is available as a suspension and chewable tablets and contains aluminum hydroxide and magnesium hydroxide. Maalox not only quickly and permanently neutralizes free hydrochloric acid, but reduces its production. The product has an absorbent and enveloping effect, protecting the mucous membrane of the esophagus and stomach³.

Maalox is most often prescribed for exacerbation of gastric and duodenal ulcers, gastroduodenitis, reflux esophagitis, heartburn and discomfort after the use of certain drugs, diet errors, alcohol abuse, nicotine, etc.

Противопоказания: severe renal failure, fructose intolerance, hypophosphatemia. Prolonged use may cause constipation or diarrhea.

Advantages and disadvantages

2. Phosphalugel

Phosphalugel is available as a suspension in sachets and contains aluminum phosphate. The drug quickly neutralizes hydrochloric acid in the stomach, forms a protective layer on the mucous membrane of the gastrointestinal tract, helps to remove gases, toxins and microbes from the digestive tract without disturbing the digestive process. One of the advantages of the drug is that the higher the acidity in the stomach, the more active its action.

Phosphalugel is usually prescribed for gastric and duodenal ulcers, gastritis, reflux esophagitis, functional diarrhea and indigestion caused by intoxication, medication, acids or alkalis, alcohol. The drug is prescribed for adults and children from 6 years of age.

Противопоказания: severe impairment of kidney function. With cirrhosis of the liver, it is prescribed with caution.

Advantages and disadvantages

3. Almagel

Antacid Almagel is produced in the form of a suspension and contains aluminum and magnesium hydroxides. The drug neutralizes free hydrochloric acid without causing excessive production of gastric juice, envelops the gastric mucosa, protecting it from irritating substances (ethanol, non-steroidal anti-inflammatory drugs).

Almagel is used not only to relieve heartburn, but also in the complex therapy of gastric ulcer, duodenal ulcer, acute and chronic gastritis, colitis, duodenitis, enteritis, etc. Sorbitol in the composition acts as a choleretic agent. There are several varieties of the drug with additional properties. So, Almagel A with anestezin has an analgesic effect. Almagel Neo, thanks to the substance simethicone, which acts as a defoamer, also helps to cope with flatulence and belching.

Almagel is also known for its ability to absorb certain drugs, so an interval of 1-2 hours should be maintained between taking this antacid and other drugs. In addition, the drug may affect the results of some laboratory tests – stomach acidity, the amount of phosphorus in the blood serum, the diagnosis of bone tissue by scintigraphy.

Противопоказания: children under 10 years of age, severe renal failure, Alzheimer’s disease, hypophosphatemia, congenital fructose intolerance.

Advantages and disadvantages

4. Gastal

Gastal is available in the form of tablets that must be slowly absorbed. The active ingredients are aluminum hydroxide-magnesium carbonate gel and magnesium hydroxide.

The drug reduces the increased acidity of gastric juice to normal levels, neutralizing excess hydrochloric acid in the stomach. The effect occurs immediately after taking the tablets. In addition, Gastal activates protective and regenerative mechanisms in the gastric mucosa.

Indications for use: heartburn caused by errors in nutrition, as well as drugs, abuse of coffee, nicotine and alcohol, gastritis, gastric and duodenal ulcers, reflux esophagitis, acute pancreatitis and exacerbation of chronic,

Противопоказания: children under 6 years of age, chronic renal failure, Alzheimer’s disease, hypophosphatemia.

Advantages and disadvantages

5. Rennie

Rennie’s drug belongs to the group of absorbable antacids and contains calcium and magnesium carbonate. Produced in the form of tablets for chewing, mostly pleasant to the taste. Like all antacids of this group, Rennie acts quickly – after 3-5 minutes. The drug neutralizes the irritating effect of excess hydrochloric acid, stimulates the production of protective mucus in the stomach.

Rennie is prescribed for peptic ulcer, gastritis with high acidity, heartburn and acid belching, gastroesophageal reflux,

Противопоказания: children under 12 years of age, severe renal dysfunction and kidney stones.

Advantages and disadvantages

6. Rutacid

Rutacid is based on hydrotalcite, low in aluminum and magnesium, and is available in the form of chewable tablets. Since the concentration of the active substance is low, Rutacid can be used in children from 6 years of age.

The drug neutralizes hydrochloric acid, reduces its production and reduces the acidity of gastric juice. In addition, Rutacid has a protective effect on the gastric mucosa and promotes healing in erosive and ulcerative lesions.

Antacid is prescribed for heartburn in pregnant women at any time and lactating, gastritis with high acidity, erosive and ulcerative lesions.

Противопоказания: kidney problems, severe lesions of the digestive tract. Frequent use may cause diarrhea.

Advantages and disadvantages

7. Simalgel

Simagel is a drug from the third generation of aluminum-magnesium antacids with additional components. In this case, with simethicone, which regulates the formation of gases in the intestines. The main properties of the drug are the neutralization of hydrochloric acid, the decrease in the acidity of gastric juice, the binding of bile acids. Produced in the form of a suspension.

Simagel is usually prescribed for acute gastritis and duodenitis, exacerbations of ulcers and duodenal ulcers, ulcers and erosions of the gastrointestinal mucosa, reflux esophagitis, heartburn after drinking alcohol, nicotine, coffee, after taking medications and diet errors.

Противопоказания: children under 10 years of age, impaired renal function, hypophosphatemia, Alzheimer’s disease, sucrase deficiency.

Advantages and disadvantages

8. Extinguishes

Antacid Gasit is available in the form of chewable tablets and contains calcium carbonate and magnesium carbonate. It acts quickly – within 3-5 minutes after ingestion, provides fast and long-term neutralization of excess hydrochloric acid, protects the gastric mucosa.

Also, the drug helps to reduce symptoms associated with increased acidity of gastric juice and reflux esophagitis. Therefore, it is often prescribed in the symptomatic treatment of heartburn, sour belching, pain in the stomach, feeling of fullness or heaviness in the abdomen.

Противопоказания: children under 12 years of age, renal failure, hypercalcemia, hypophosphatemia, nephrocalcinosis, sucrose deficiency.

Advantages and disadvantages

9. Gastricide

Gastracid is also available in the form of chewable tablets and contains two active ingredients at once – aluminum hydroxide and magnesium hydroxide. The drug neutralizes hydrochloric acid and suppresses its excessive production, and also has a choleretic and carminative effect (eliminates increased gas formation).

Gastracid is most often prescribed for gastritis, exacerbation of gastric and duodenal ulcers, acute duodenitis, reflux esophagitis, acute and chronic pancreatitis, as well as heartburn after alcohol abuse, coffee, nicotine, medication and diet errors. The drug begins to act 5 minutes after ingestion, and within an hour the maximum effect is achieved. The course of treatment is up to 20 days.

Противопоказания: urolithiasis disease. It is prescribed with caution to children under 12 years of age and women during lactation.

Advantages and disadvantages

10. Gaviscon

Gaviscon antacid is available in the form of a gel and chewable tablets, and the composition contains 3 active ingredients at once: sodium alginate, sodium bicarbonate, calcium carbonate. The drug begins to act 3-4 minutes after ingestion, therefore it enters the esophagus faster than the rest of the gastric contents, creates a protective membrane for several hours, and reduces irritation of the mucous membrane. Allowed for pregnant women.

Gaviscon helps with acid belching, heaviness in the stomach, heartburn that occurs after eating against the background of gastroesophageal reflux or during pregnancy.

Противопоказания: phenylketonuria, children under 12 years of age.

Advantages and disadvantages

How to choose antacids

Before taking antacids, you should consult your doctor. But if heartburn caught you at the most inopportune moment, and you urgently need to get rid of it, you can consult a pharmacist at a pharmacy and study the instructions that come with any drug. It is important to remember that antacids most often only eliminate the unpleasant symptoms of a gastrointestinal disease, but do not cure it.

If heartburn is new, doctors usually recommend absorbable antacids (such as Rennie). And if heartburn is not the first time, then, most likely, non-absorbable antacids (Almagel, Maalox, etc.) will be recommended.

If heartburn often worries, then antacids are indispensable here – you need to see a doctor, undergo an examination. Especially if at least one of the following symptoms is present along with heartburn: pain and bloating in the abdomen, nausea, vomiting, fever, weakness, blood in the stool, constipation.

In the presence of diarrhea, it is advisable to prescribe antacids with aluminum (Almagel, Phosphalugel), and with a tendency to constipation – with magnesium (Gastal). It is important to remember that for pregnant and lactating women, preparations containing aluminum are contraindicated. It is undesirable to take such antacids and the elderly⁴.

Reviews of experts about antacids

“Antacids used in the treatment of gastrointestinal diseases are characterized by rapid action, but they have a short therapeutic effect compared to antisecretory drugs,” explains director of the educational medical project Pharmedu Tatyana Khodanovich. – There are various classifications of antacids: local and systemic action, monocomponent and combined, anionic and cationic. The most commonly used classification: absorbable and non-absorbable antacids. Absorbable drugs begin to act very quickly, almost immediately after administration. The effect after taking non-absorbable antacids occurs after 10-15 minutes.

Absorbed are sodium bicarbonate (soda), magnesium carbonate + calcium carbonate (Rennie). Their features:

• the effect comes quickly, but it is short-lived;
• being absorbed into the blood, violate the acid-base balance;
• can lead to the “acid rebound” syndrome (when, after the end of the drug, hydrochloric acid begins to be produced more intensively than before taking the drug).

Non-absorbable are aluminum hydroxide + magnesium hydroxide (Almagel, Maalox), aluminum phosphate (Phosphalugel), aluminum hydroxide + magnesium carbonate + magnesium hydroxide (Gastal). Their features:

• first absorb hydrochloric acid, and then neutralize it;
• longer action (up to 3-4 hours);
• do not violate the acid-base balance;
• do not cause acid rebound syndrome;
• the effect is slower.

A change in the acidity of gastric juice during the use of antacids can lead to a decrease in the rate and extent of absorption of other drugs while taking. Therefore, other medicines should be taken 1-2 hours before or after taking antacids.

It should also be borne in mind that when taken simultaneously with antacids, the absorption of tetracycline antibiotics, fluoroquinolones, cardiac glycosides, levothyroxine, iron preparations, fluorides, and phosphates decreases. While taking thiazide diuretics with antacids (they are used in the treatment of arterial hypertension), the concentration of calcium in the blood serum should be regularly monitored.

It should be remembered that the rating of antacids, like any medicines, is, first of all, fact-finding information. Before using them, you should consult your doctor.

Popular questions and answers

Tatyana Khodanovich, director of the educational medical project Pharmedu, answers popular questions regarding the use of antacids.

Sources of:

1. Okhlobystin A.V. Modern possibilities of using antacid preparations // Russian Medical Journal. Diseases of the digestive system. – 2000. – T. 4. – No. 2. https://www.gastroscan.ru/literature/authors/734
2. State register of medicines. https://grls.rosminzdrav.ru
3. Intragastric pH-metry in assessing the acid-neutralizing activity of antacids. A.A. Ilchenko, E.Ya. Seleznev. Central Research Institute of Gastroenterology, Moscow. https://medi.ru/info/3340/
4. Modern antacids in gastroenterological practice. Yu. V. Vasiliev. Russian Gastroenterological Journal No. 4’99. https://www.lvrach.ru/2004/04/4531229
5. Analysis of the prevalence of heartburn: a national epidemiological study of urban adults. Isakov V.A., Morozov S.V., Stavraki E.S., Komarov R.M. Experimental Clinical Gastroenterology, 2008. https://cyberleninka.ru/article/n/analiz-rasprostranennosti-izzhogi-natsionalnoe-epidemiologicheskoe-issledovanie-vzroslogo-gorodskogo-naseleniya-ariadna/viewer