Viscid Gel (Alumina, Magnesia and Simethicone Oral Suspension)
Antacid and Antiflatulent. Viscid Gel is indicated as an antacid in peptic ulcer, hyperacidity, reflux oesophagitis and flatulent dyspepsia.
Prolonged use of aluminum containing antacids is contraindicated in patients with renal failure and in patients with gastric outlet obstruction.
These products are contraindicated in very young children because of the risk of hypermagnesaemia and aluminum toxicity, especially in infants and children with renal failure or dehydration.
Side effects and adverse reactions
Antacids alter the absorption, bioavailability and/or renal elimination of many drugs. Aluminium compounds delay the gastric emptying which can slow the rate of absorption of many drugs and the inclusion of magnesium compounds probably accelerates the absorption of many drugs.
Alkalinization of gastric contents decreases the bioavailability of iron, tetracyclines, digoxin, isoniazid, benzodiazepines, ranitidine, indomethacin, fat soluble vitamins and corticosteroid from the gastrointestinal tract if administered concomitantly.
Precautions and warnings
Aluminium hydroxide in common with other aluminium compounds is astringent and may cause constipation; large doses can cause intestinal obstruction. Care is necessary in patients with chronic renal impairment since osteomalacia or adynamic bone disease, encephalopathy, dementia and microcytic anemia have been associated with aluminium accumulation in patients with chronic renal impairment who received large doses of aluminium hydroxide.
Aluminium hydroxide must be taken with care in patients who have recently suffered massive upper gastrointestinal haemorrhage.
Prolonged use of aluminium containing antacids in patients with renal failure may result in or worsen dialysis osteomalacia.
Aluminium cause insoluble complexes with phosphate in the gastro-intestinal tract thus decreasing the phosphate absorption, hence, prolonged use of aluminium containing antacids by normophosphatemic patients may result into hypophosphataemia if phosphate intake is not adequate.
Hypermagnesia may occur in patients with impaired renal function. Ingestion of magnesium salts may cause gastrointestinal irritation and watery diarrhea.
Dose dependent rebound hyperacidity may be observed since antiacids may increase gastric secretion or serum gastric levels.
Pregnant women must consult a physician before using an antacid.
Dosage regimen and directions for use
Adults: 2-4 teaspoonfuls (10-20ml) two times a day or as directed by the physician.
Children (below 12 years): as directed by the physician.
Shake the bottle well before use.
Replace cap tightly after use.
Symptoms and treatment of overdosage
Excessive doses in a person with normal renal function are not associated with any major adverse effects except diarrhea or constipation. Prolonged excessive doses or even normal doses of aluminium hydroxide in patients with low phosphate diets may lead to phosphate depletion accompanied by increased bone resorption and hypercalciuria with the risk of osteomalacia. Hypermagnesia is uncommon except in the presence of renal impairment. Ingestion of magnesium salts may cause gastrointestinal irritation and watery diarrhea.
Massive overdosage should be treated by gastric lavage and by catharsis with castor oil or other laxatives not containing magnesium. Should symptoms of magnesium intoxication be present, calcium gluconate should be administered intravenously.