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.