Usage
This combination medication is prescribed for the relief of symptoms associated with gastrointestinal disorders, including:
- Acidity: Excessive production of stomach acid.
- Peptic Ulcers: Sores in the lining of the stomach and small intestine.
- Gastroesophageal Reflux Disease (GERD): A condition where stomach acid flows back into the esophagus.
- Gastritis: Inflammation of the stomach lining.
- Indigestion/Dyspepsia: Discomfort or pain in the upper abdomen, often after eating.
- Bloating and Flatulence: Excessive gas in the stomach and intestines.
Pharmacological Classification: This is a combination product containing:
- Antacids (Aluminium Hydroxide, Magnesium Hydroxide): Neutralize stomach acid.
- Local Anesthetic (Oxetacaine): Numbs the esophageal lining, providing relief from heartburn and acid reflux.
- Antiflatulent (Simethicone): Reduces gas bubbles in the stomach and intestines.
Alternate Names
While a standard international non-proprietary name doesn’t exist for this specific combination, the individual components are recognized globally. Several brand names exist depending on the region and manufacturer, including Disocain Suspension and Maalox Plus (though Maalox Plus doesn’t contain Oxetacaine).
How It Works
Pharmacodynamics:
- Aluminium Hydroxide and Magnesium Hydroxide: Neutralize gastric acid by reacting with hydrochloric acid (HCl) in the stomach to form water and salts, thereby increasing the pH.
- Oxetacaine: Acts as a local anesthetic by blocking nerve impulses, which reduces the sensation of pain and discomfort in the esophagus caused by acid reflux.
- Simethicone: Reduces the surface tension of gas bubbles in the gastrointestinal tract, allowing them to coalesce and be expelled more easily.
Pharmacokinetics:
- Aluminium Hydroxide and Magnesium Hydroxide: Poorly absorbed systemically, primarily acting locally in the gastrointestinal tract. Excreted mainly through feces.
- Oxetacaine: Minimally absorbed systemically following oral administration, with its action primarily local in the esophagus. Metabolized in the liver and excreted in the urine.
- Simethicone: Not absorbed and is eliminated unchanged in the feces.
Mode of Action: The combination provides symptomatic relief through the distinct actions of its components. There is no receptor binding, enzyme inhibition, or neurotransmitter modulation involved with the antacids or simethicone. Oxetacaine blocks voltage-gated sodium channels on sensory neurons, thus inhibiting nerve impulse transmission.
Dosage
Standard Dosage
Adults:
5-10 mL taken 20 minutes to 1 hour after meals and at bedtime, or as needed. Do not exceed 60 mL within a 24-hour period.
Children:
Not recommended for children under 12 years without direct medical supervision due to the lack of established safety data. For children over 12, the adult dose may be appropriate. Consult with a physician. Children under 5 years of age should not exceed 5ml three times daily.
Special Cases:
- Elderly Patients: The standard adult dose is usually appropriate, but dose adjustments may be necessary based on renal function.
- Patients with Renal Impairment: Caution should be exercised, and dose reduction may be necessary as aluminum and magnesium can accumulate in patients with reduced kidney function.
- Patients with Hepatic Dysfunction: No specific dose adjustment is typically required, but caution is advised.
- Patients with Comorbid Conditions: Consider underlying conditions that may affect drug metabolism or clearance.
Clinical Use Cases
This combination is not typically used in clinical settings like intubation, surgical procedures, mechanical ventilation, the ICU, or emergency situations. Its primary use is for symptomatic relief of common gastrointestinal discomfort.
Dosage Adjustments
Adjustments may be necessary in patients with renal impairment. Close monitoring is recommended, especially with prolonged use.
Side Effects
Common Side Effects:
Constipation, diarrhea, dizziness, drowsiness.
Rare but Serious Side Effects:
Allergic reactions (rash, itching, swelling), difficulty breathing.
Long-Term Effects:
Aluminum accumulation with prolonged use, especially in renal impairment.
Adverse Drug Reactions (ADR):
Severe allergic reactions, hypermagnesemia (in patients with renal failure).
Contraindications
Hypersensitivity to any component, severe renal impairment, bowel obstruction.
Drug Interactions
Antacids can interact with several medications, including certain antibiotics, antifungals, and heart medications. They can also interfere with the absorption of other drugs. Concurrent use of other medications should be evaluated by a physician.
Pregnancy and Breastfeeding
Consult a physician before use during pregnancy or breastfeeding. The safety profile is not fully established.
Drug Profile Summary
- Mechanism of Action: Antacid, local anesthetic, and antiflatulent combination providing symptomatic relief for gastrointestinal disorders.
- Side Effects: Constipation, diarrhea, dizziness, drowsiness.
- Contraindications: Hypersensitivity, severe renal impairment, bowel obstruction.
- Drug Interactions: Interacts with several medications; consult a physician.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Varies depending on age and condition; see dosage section.
- Monitoring Parameters: Renal function, electrolyte levels (with prolonged use).
Popular Combinations
Not generally combined with other drugs for synergistic effects, as this formulation already contains multiple active ingredients.
Precautions
Evaluate renal function, especially before long-term use. Avoid alcohol and trigger foods. Caution in patients with heart failure or edema due to the potential for sodium retention with some formulations.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Aluminium Hydroxide + Magnesium + Oxetacaine + Simethicone?
A: See the detailed dosage section above, as it varies by age and condition.
Q2: Can this medication be used during pregnancy?
A: Consult a doctor before use during pregnancy or breastfeeding.
Q3: How does this combination relieve heartburn?
A: The antacids neutralize stomach acid, while oxetacaine numbs the esophagus, reducing the burning sensation. Simethicone relieves pressure from trapped gas.
Q4: What are the common side effects?
A: Common side effects include constipation, diarrhea, dizziness, and drowsiness.
Q5: Are there any drug interactions I should be aware of?
A: Yes, antacids can interact with several medications. Inform your physician about all medications you are currently taking.
Q6: Can this medication be used long-term?
A: Long-term use should be monitored by a physician, especially in patients with kidney problems, due to the risk of aluminum accumulation.
Q7: How should this medicine be stored?
A: Store in a cool, dry place away from sunlight.
Q8: What should I do if I miss a dose?
A: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Q9: What if I accidentally take too much?
A: If you suspect an overdose, seek immediate medical attention.
