Gastolin Oral Suspension

Introduction

Aluminium Oxide and Magnesium Trisilicate are antacid agents used primarily to neutralize excess stomach acid. They are commonly used in combination in over-the-counter medications to relieve symptoms of indigestion, heartburn, and peptic ulcers. The combination works by reducing acidity in the stomach, providing relief from discomfort and preventing further irritation to the stomach lining.

Uses

The combination of Aluminium Oxide and Magnesium Trisilicate is used for:

Heartburn relief: Provides quick relief from acid reflux and heartburn symptoms.
Indigestion: Eases discomfort associated with indigestion by neutralizing stomach acid.
Peptic ulcers: Used to alleviate symptoms of peptic ulcers by reducing acidity and irritation in the stomach.
Gastroesophageal reflux disease (GERD): Helps to manage the symptoms associated with GERD by lowering stomach acid levels.

Brand Name	Gastolin
Type	Oral Suspension
Weight	(200 mg+250 mg)/5 ml
Generic	Aluminium Oxide + Magnesium Trisilicate
Manufacturer	Belsen Pharmaceuticals Ltd.
Available in	English বাংলা

Mechanism of Action

Aluminium Oxide acts as an antacid by neutralizing hydrochloric acid in the stomach. It reduces acidity, forming a protective layer over the stomach lining, which prevents irritation. Magnesium Trisilicate neutralizes acid as well, and also forms a gel-like barrier on the stomach lining. Together, they provide a longer-lasting neutralization effect and symptomatic relief from hyperacidity.

How Long Does It Take to Work?

The effects of Aluminium Oxide and Magnesium Trisilicate usually begin within 15 to 30 minutes after ingestion, providing quick relief from acidity and discomfort. The duration of action typically lasts for 1 to 3 hours, depending on the dose and individual response.

Absorption

These compounds are not significantly absorbed in the gastrointestinal tract. Instead, they exert their effects locally in the stomach by neutralizing gastric acid. Any small amounts absorbed are excreted by the kidneys.

Route of Elimination

The majority of Aluminium Oxide and Magnesium Trisilicate remain in the gastrointestinal tract and are excreted through the feces. Any absorbed aluminium or magnesium is excreted via the kidneys in the urine.

Dosage

Take 2-4 teaspoonful after meals and at bedtime as needed (up to 4 times a day)

The usual adult dose is 500 mg to 1 gram of Magnesium Trisilicate, combined with 300 mg to 600 mg of Aluminium Oxide, taken orally 1 to 2 hours after meals and at bedtime. The dosage may be adjusted based on the severity of symptoms and as recommended by a healthcare provider.

Administration

Aluminium Oxide and Magnesium Trisilicate are typically administered orally in the form of chewable tablets or liquid suspensions. It is recommended to take these medications after meals and at bedtime for optimal effect, following the dosage instructions on the label or as directed by a healthcare provider.

Side Effects

Common side effects include:

Constipation (due to Aluminium Oxide)
Diarrhea (due to Magnesium Trisilicate)
Nausea
Stomach cramps

Prolonged use may lead to electrolyte imbalances or kidney stones, especially in individuals with underlying kidney conditions.

Toxicity

Excessive use of Aluminium Oxide can lead to aluminum toxicity, especially in individuals with impaired kidney function. This may result in symptoms such as confusion, muscle weakness, and bone pain. Magnesium toxicity is rare but can occur in individuals with severe kidney dysfunction, leading to symptoms such as low blood pressure, drowsiness, and cardiac arrhythmias.

Precautions

Caution should be exercised in individuals with kidney disease, as the accumulation of aluminium or magnesium could lead to toxicity. Prolonged use of these antacids may interfere with the absorption of other medications and nutrients, such as phosphate and iron. It is important to avoid overuse, especially without consulting a healthcare provider.

Interaction

Aluminium Oxide and Magnesium Trisilicate may interact with several medications:

Antibiotics (e.g., tetracyclines, quinolones): Reduced absorption of these medications when taken simultaneously with antacids.
Iron supplements: Antacids may decrease iron absorption.
Levothyroxine: Antacids can interfere with thyroid medication absorption.
Digoxin: Decreased absorption of this cardiac medication when taken with antacids.

Disease Interaction

Individuals with kidney disease should use Aluminium Oxide and Magnesium Trisilicate with caution due to the potential for toxic accumulation of aluminium or magnesium. People with hypophosphatemia should also avoid these antacids, as aluminium may bind phosphate and worsen this condition.

Drug Interaction

These antacids may interact with a range of drugs, including digoxin, iron supplements, tetracycline antibiotics, and bisphosphonates, by decreasing their absorption. It is recommended to take these medications either 1 hour before or 2 hours after the administration of Aluminium Oxide and Magnesium Trisilicate.

Food Interactions

Taking Aluminium Oxide and Magnesium Trisilicate with food may delay their onset of action but can also prolong their effectiveness. High-fat meals may increase the amount of magnesium absorbed, which could lead to side effects in individuals with compromised kidney function.

Pregnancy Use

Aluminium Oxide and Magnesium Trisilicate are generally considered safe for short-term use during pregnancy. However, prolonged or excessive use should be avoided, as it may affect maternal electrolyte balance. It is important to consult a healthcare provider before using these antacids during pregnancy.

Lactation Use

These antacids are generally safe to use during breastfeeding, as they are not significantly absorbed into the bloodstream. However, it is still advisable to consult a healthcare provider before using them while breastfeeding.

Acute Overdose

An acute overdose of Aluminium Oxide and Magnesium Trisilicate may cause symptoms such as nausea, vomiting, stomach cramps, diarrhea (from magnesium), and constipation (from aluminium). In severe cases, toxicity may lead to hypermagnesemia or aluminum toxicity, particularly in patients with renal impairment. Medical intervention is required for overdose cases.

Contraindication

Contraindications include severe kidney impairment, known hypersensitivity to any components of the formulation, and conditions like hypophosphatemia. Individuals with severe gastrointestinal conditions, such as bowel obstruction, should also avoid these antacids.

Use Direction

Take Aluminium Oxide and Magnesium Trisilicate as directed by a healthcare provider or according to the product label. Chew tablets thoroughly or shake the liquid suspension well before use. It is recommended to take the antacids after meals and at bedtime for best results.

Storage Conditions

Store in a cool, dry place away from direct sunlight and moisture. Keep the medication out of reach of children. Ensure that the cap is tightly closed after use to maintain the efficacy of the product.

Volume of Distribution

Aluminium Oxide and Magnesium Trisilicate act locally in the stomach and are minimally absorbed into systemic circulation. Thus, they have a very low volume of distribution.

Half Life

These compounds do not have a defined half-life due to their limited systemic absorption. The duration of their local effect in the stomach depends on gastric emptying time and the formulation used (tablet vs. liquid).