gaviscon syrup

Written by Dr. Zohaib Tahir [Pharm-D, Gomal University, Dera Ismail Khan, Pakistan]

Brand Name

· Gaviscon Liquid

· Gaviscon Advance Liquid

Generic Name

Gaviscon Liquid

· Calcium Carbonate

· Sodium alginate 

· Sodium bicarbonate

Gaviscon Advance

· Sodium alginate

· Potassium hydrogen carbonate

Available Dosage Forms & Their Doses

· Gaviscon Liquid

· Gaviscon Advance

Prices & Packing Size in Pakistan

· Liqd: 120 mL : Rs. 189.05

· Liqd Advance: 120 mL (016024): Rs. 284.05

Therapeutic Class

· Antacid

Pharmacological Class

· Alginic acid compound with antacid

Manufacturer

· Reckitt Benckiser Healthcare (UK) Ltd

Storage

· Store this medicine at room temperature

· Keep away from direct light and heat.

Prescription Drug

· No

Clinical Pharmacology (Mechanism of Action)

· This medicine contains a combination of two antacids (calcium carbonate and sodium bicarbonate) along with alginate.

· It provides relief through two mechanisms:

· Neutralizes excess stomach acid, helping to relieve pain and discomfort.

· Forms a protective layer over the stomach contents, which helps soothe the burning sensation in the chest (heartburn) — with effects lasting up to 4 hours.

Indications

· Gastro-oesophageal reflux such as acid regurgitation

· Heartburn

· Indigestion.

Contraindication

· Hypersensitivity to sodium alginate, calcium carbonate, sodium bicarbonate, or any excipients

· Severe renal impairment – risk of electrolyte imbalance or accumulation of aluminum/magnesium salts.

· Hypercalcemia – due to calcium content

· Nephrocalcinosis or history of calcium-containing kidney stones

· Patients on sodium-restricted diets (e.g., heart failure, hypertension)

· Phenylketonuria (PKU) – if the formulation contains aspartame

Warnings

· Talk to your doctor if you have severe kidney problems.

· Consult your doctor if you have low phosphate levels in the blood (hypophosphatemia).

· Inform your doctor if you have or had kidney or heart disease, as some salts may affect these conditions.

Dosages

· Liquid: Adults: 10-20 mL after meals and at night.

· Liquid Advance: Adults: 5-10 mL after meals and at night.

Special Population

Children

· Liquid: Half adult dose.

· Liquid Advance: 2-12 yr: Half adult dose.

Elders

· No special dose adjustment is usually needed in elderly patients unless there is renal impairment or a sodium-restricted diet.

Renal Impairment

· Mild to moderate kidney disease:

o Gaviscon: 10–20 mL after meals and at bedtime

o Gaviscon Advance: 5–10 mL after meals and at bedtime

o Use with caution due to sodium and calcium content

· Severe renal impairment (CrCl <30 mL/min):

o Use only under medical supervision

o Risk of hypernatremia, hypercalcemia, and fluid overload

· In dialysis patients:

o Avoid regular use unless prescribed by a nephrologist

o Monitor electrolytes and fluid status

Hepatic Impairment

· Mild to moderate liver disease:

o Both Gaviscon and Gaviscon Advance can be used at standard doses

o Generally well tolerated if no ascites or fluid retention

· Severe hepatic impairment / cirrhosis:

o Use with caution

o High sodium content may worsen ascites or edema

o Consider low-sodium alternatives if available

Side Effects

· Stomach cramps

· Flatulence

· Skin rash

· Hives

· Itching

· Problems with breathing

Drug Interactions

· Tetracyclines (e.g., doxycycline): Reduces absorption; take 2 hours before/after Gaviscon.

· Iron Supplements: Decreases absorption; space doses by 2 hours.

· Aspirin/Salicylates: Alters gastric pH, affecting absorption.

· Digoxin: Reduces absorption; monitor for toxicity.

· Phenytoin: Reduces absorption; monitor drug levels.

· Corticosteroids (e.g., prednisone): Decreases absorption; monitor effects.

· Other Antacids: May cause excessive alkalinity, risking electrolyte imbalances.

Use in Pregnancy and Lactation

· Pregnancy: Category C– Risk cannot be ruled out.

· Lactation: Present in breast milk – Caution advised.

Precautions

· Do not give this medicine to children under 12 years unless advised by a doctor.

· There is a risk of hypernatremia (high sodium levels in the blood) in children with:

o Kidney problems

o Inflamed stomach or bowel (e.g., gastroenteritis)

How To Take

· Before Use:

o Check that the cap seal is unbroken.

o Shake well before use.

· For Adults and Children 12+:

o Take 10-20ml (2-4 x 5ml spoonfuls) after meals and at bedtime.

o Can be taken up to 4 times a day.

· For Children Under 12:

o Only use with medical advice.

· If You Take Too Much:

o You may feel bloated and experience abdominal discomfort.

o Unlikely to cause harm, but consult a doctor or pharmacist.

· If You Forget a Dose:

o Do not double the dose; continue as usual.

· If Symptoms Persist:

o Consult your doctor if symptoms continue after 7 days.

Counseling Points

· Take as Directed: 10-20ml after meals and at bedtime (up to 4 times a day). Don't exceed recommended dose.

· Missed Dose: Don't double the dose. Continue as usual.

· Monitor for Side Effects: Mild bloating or discomfort is common. Seek medical help if severe reactions occur.

· Consult if Symptoms Persist: If symptoms don’t improve after 7 days, see your doctor.

· Spacing from Other Medications: Space Gaviscon by 2 hours from other meds (e.g., antibiotics, iron supplements).

· Pregnancy and Lactation: Consult your doctor before use if pregnant or breastfeeding.

· Store Properly: Keep in a cool, dry place and check the cap seal before first use.

· Seek Medical Help: If severe stomach pain, vomiting, or other unusual symptoms occur.

pediasure

 Written by Dr Naima Zafar, [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan)

Brand name

Pediasure

Available dosage forms

Powder , liquid

Range with its specialized features 

■ Pediasure® Complete

• Supports the growth and development of children aged 1- 10 years, especially those who are picky eaters or have dietary gaps

• It is mainly available in vanilla, chocolate, and strawberry flavours

• It is available in powder form in packaging of

● 200 gm

Price: 1600 Rs

● 400 gm

Price: 3145 Rs

● 850 gm

Price: 6355 Rs

• It has triple sure system. It contains 37 essential nutrients, including Arginine and natural Vitamin K2 which fill nutritional gap amd support growth and development.

• It also contains FHA, Omega 3 and Omega 6 which support cognition and brain development.

■ PediaSure® 10+

• It is balanced nutrition for teens aged 10 - 15 years that aids in having optimal growth.

It has increased amount of key nutrients i.e. added arginine and 2× natural vitamin K2, 1.6× vitamin D and 2× calcium

• It is available in chocolate and vanilla flavors.

■ PediaSure® Gold

• Region-specific (Singapore)

25% less sugar and 25% higher in calcium.

For children aged 1 - 10 years. Contains high quality triple protein and added CPPs

It gives energy of 226Kcal/serve

■ PediaSure® Peptigro (Specialized Nutrition)

• Improved pediasure gold.

For children with digestive problems or malabsorption. Contains hydrolyzed protein in the form of CPPs

Contains Probiotic (L. acidophilus) and Prebiotic (FOS) Prebiotics help maintain a healthy digestive system.

■ PediaSure® Ready-to-Drink (RTD)

Ideal for snack purpose and on the go nutrition

• Pediasure gold RTD available in 220 ml (Packs of 6)

Available in classic vanilla and premium chocolate flavors

• PediaSure Plus® RTD available in 110 ml in vanilla and chocolate flavors

■ PediaSure® Advance Plus

For children aged above 2 years old

Improves immunity abd support recovery from infections.

Contains prebiotics, dual protein i.e. high qualitywhey and casein and micronutrients that support immunity

Available in 200 gm and 400 gm in vanilla delight flavor

To prepare it in milk: Pour 130 ml milk and add three levelled scoops. Stir it and consume

■ PediaSure® SideKicks

Available in chocolate and vanilla flavors. Available in reclosable bottles.

Each shake is a source of 10g protein, 3g fiber and 27 essential vitamins and minerals for kids who are missing key nutrients.

Contains 6 grams of total fat per serving.

PediaSure SideKicks shakes have 180 calories per 8 fl oz.

■ PediaSure® Grow and Gain

PediaSure Grow & Gain with fiber shakes have 240 calories per 8 fl oz.

Preparation

To prepare one 225ml serving pour 190 ml of room temperature water in glass and mix five levelled scoops of or 48.6 gm powder. Stir it and consume it immediately or it can be stored in refrigerator and used within 24 hrs.

Recommended amount

For children 1 - 3 years : 1 serving per day

For children 3 - 8 years : 2 servings per day

For children 9 - 10 years : 2 - 3 servings per day

Pharmacological class

Nutritional supplement

Manufacturer

Abbott Nutrition

Storage

Opened Pediasure container should be kept at cool and dry place and should be used within 3 weeks

Store in air tight container

Prescription drug ?

 NO

Indications

Total or supplemental feeding for children.

 For children requiring short or long term tube feeding 

● with increased nutrient needs

● with or at risk for malnutrition

● with failure to thrive

Can be used as a supplement or as a sole source of nutrition

Side effects

NO

Contraindications

Not for children with galactosemia

Precautions 

Not suitable for children with cow's milk allergy

Contains high sugar content so multiple servings can exceed daily sugar intake limit

Warning

Not for parenteral (intravenous) use

Counselling points:

Use feed within 1 hour of reconstitution. Discard if unused.

Don't refrigerate

Shouldn't be warmed in microwave oven as the prebiotics and lactobacillus bacteria may be destroyed at higher temperature

oncosten vial

onosten انجکشن

Written by Dr. Maryam [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan.

Brand Name

Oncosten Injection

Dosage form:

Injection

Generic Composition (per vial)

· Carnitine (USP): 70 mg

· Ginseng Extract (MS): 270 mg

· Bilberry Extract (MS): 200 mg

· Royal Jelly (MS): 30 mg

· Potassium Chloride (USP): 100 mg

· Magnesium Sulphate (USP): 9.25 mg

Dosage:

Typical Doseage is 1 vial daily or on alternate days or as recommended by physician or pharmacist.

 Price Range

Approximately PKR 4000–5000 

Therapeutic Class

Nutritional Supplement

Pharmacological Class

•  Antioxidant and adaptogen

•  Electrolyte rebalancer

Manufacturer:  

Paradigm

Storage Instructions

• Store in cool and dry place

• Do not freeze

• Protect from heat

Prescription Status

Prescription Only

Mechanism of Action

· Carnitine supports cellular energy by transporting fatty acids into mitochondria.

· Ginseng acts as an adaptogen, reducing fatigue

· Bilberry Extract improves circulation

· Royal Jelly provides anti-inflammatory and antioxidant.

· Potassium and Magnesium restore vital electrolytes and support nerve and muscle function.

Indications

Oncosten Injection may be used as a supportive therapy in:

· Post-chemotherapy recovery

· Chronic fatigue or general weakness

· Nutritional deficiencies

· Immunity support

Side Effects

Some possible side effects include:

· Mild pain or swelling at injection site

· Dizziness or nausea

· Headache

 Drug Interactions

· May interact with potassium-sparing diuretics

· Ginseng may lower blood sugar

· Possible interaction with Anticoagulants

 Pregnancy

· Safety in pregnancy not established

 Lactation

· Not recommended

Precautions

· Use with caution in patients with kidney issues

· Monitor serum potassium levels with long-term use

· Administer slowly to avoid vein irritation

 Patient Counselling Tips

· Inform patients that the injection helps with energy, recovery and immunity

· Advise to report any allergic symptoms immediately

· Encourage patient to have a balanced diet and hydration along with therapy

· Reassure any mild soreness at the injection site