Usage
This combination medication is prescribed to alleviate symptoms related to gastrointestinal discomfort, including:
- Acidity: Neutralizes excess stomach acid, offering relief from heartburn and acid indigestion.
- Heartburn: Reduces the burning sensation in the chest caused by stomach acid refluxing into the esophagus.
- Gas: Relieves bloating, pressure, and fullness caused by excess gas in the stomach and intestines.
- Stomach Ulcers: Benzocaine provides a local anesthetic effect to numb the pain associated with stomach ulcers or acid irritation.
Pharmacological Classification: This is a combination product encompassing three classifications: antacid (Magaldrate), antiflatulent (Simethicone), and local anesthetic (Benzocaine).
Mechanism of Action: Magaldrate, an inorganic salt, neutralizes excess stomach acid, thus raising the gastric pH. Simethicone, an antifoaming agent, works by decreasing the surface tension of gas bubbles in the stomach and intestines, allowing them to coalesce and be expelled more easily. Benzocaine inhibits voltage-gated sodium channels, blocking nerve impulse transmission and providing a local anesthetic effect.
Alternate Names
- Nugel MPS Syrup
- Polycain Oral Gel
How It Works
Pharmacodynamics: Magaldrate neutralizes gastric acid. Simethicone reduces the surface tension of gas bubbles. Benzocaine inhibits nerve impulse transmission, causing local anesthesia.
Pharmacokinetics: Magaldrate is not systemically absorbed and is excreted unchanged in the feces. Simethicone is also not absorbed and is eliminated unchanged in the feces. Benzocaine is minimally absorbed through the gastrointestinal mucosa, metabolized in the liver, and excreted in the urine.
Mode of Action: Magaldrate reacts with hydrochloric acid in the stomach to form aluminum and magnesium chlorides and water. Simethicone alters the surface tension of gas bubbles, facilitating their coalescence. Benzocaine binds to sodium channels on nerve cell membranes, preventing depolarization and thus blocking pain signals.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: Benzocaine acts by inhibiting voltage-gated sodium channels, blocking nerve impulse transmission. Magaldrate and Simethicone do not involve receptor binding, enzyme inhibition, or neurotransmitter modulation.
Elimination Pathways: Magaldrate and Simethicone are eliminated unchanged in the feces. Benzocaine is metabolized in the liver and excreted in the urine.
Dosage
Standard Dosage
Adults: 5-10 mL (1-2 teaspoonfuls) four times daily, after meals and at bedtime. Do not exceed 40 mL in a 24-hour period unless directed by a physician.
Children: Generally not recommended unless prescribed by a doctor. Dosage should be determined by the child’s weight and age.
Special Cases:
- Elderly Patients: Dose adjustments are usually not necessary but should be based on renal function.
- Patients with Renal Impairment: Caution should be exercised due to the magnesium content of magaldrate. Monitor for signs of hypermagnesemia.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically required.
- Patients with Comorbid Conditions: Use with caution in patients with diabetes, electrolyte imbalances, or heart failure.
Clinical Use Cases
This medication is generally not indicated for use in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Dosage adjustments may be necessary based on individual patient response and underlying conditions, particularly renal impairment.
Side Effects
Common Side Effects:
- Constipation
- Diarrhea
- Stomach upset
- Chalky taste
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling, severe dizziness, difficulty breathing)
- Hypermagnesemia (muscle weakness, fatigue, confusion, irregular heartbeat)
Long-Term Effects:
Long-term use of aluminum-containing antacids like magaldrate may lead to aluminum toxicity, especially in patients with renal impairment.
Adverse Drug Reactions (ADR):
Severe allergic reactions and symptoms of hypermagnesemia require immediate medical attention.
Contraindications
- Hypersensitivity to any components
- Severe renal impairment
- Bowel obstruction
- Appendicitis
Drug Interactions
Aluminum and magnesium-containing antacids can interact with various medications, including some antibiotics (tetracyclines, quinolones), levothyroxine, and phenytoin, potentially affecting their absorption. Antacids can also alter the absorption of other drugs by changing the gastric pH.
Pregnancy and Breastfeeding
- Pregnancy: Consult a physician before use during pregnancy.
- Breastfeeding: Consult a physician before use while breastfeeding.
Drug Profile Summary
- Mechanism of Action: Antacid (magaldrate), antiflatulent (simethicone), local anesthetic (benzocaine)
- Side Effects: Constipation, diarrhea, stomach upset, chalky taste
- Contraindications: Hypersensitivity, severe renal impairment, bowel obstruction
- Drug Interactions: Interacts with some antibiotics, levothyroxine, phenytoin, and other medications
- Pregnancy & Breastfeeding: Consult a physician before use
- Dosage: 5-10 mL four times daily after meals and at bedtime
- Monitoring Parameters: Renal function (in patients with renal impairment) and serum magnesium levels with prolonged use
Popular Combinations
This combination itself is commonly used and is not typically combined with other drugs for the same indications.
Precautions
- General Precautions: Pre-screening for allergies, renal impairment, or history of bowel surgery is advised.
- Specific Populations:
- Pregnant Women: Consult a physician.
- Breastfeeding Mothers: Consult a physician.
- Children & Elderly: Use with caution in children and adjust dosage in the elderly based on renal function.
- Lifestyle Considerations: Avoid alcohol as it can increase acidity.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Benzocaine + Magaldrate + Simethicone?
A: 5-10 mL (1-2 teaspoonfuls) four times daily, after meals and at bedtime, for adults. Not recommended for children unless prescribed by a physician.
Q2: How does this combination medication work to relieve gas?
A: Simethicone reduces the surface tension of gas bubbles, allowing them to combine and be expelled more easily.
Q3: Can this medication be used for long-term treatment of heartburn?
A: Long-term use should be monitored by a physician, especially in patients with renal impairment, due to the risk of aluminum toxicity.
Q4: What are the common side effects of this medication?
A: Constipation, diarrhea, stomach upset, and a chalky taste are common side effects.
Q5: Are there any drug interactions I should be aware of?
A: This medication can interact with certain antibiotics, levothyroxine, phenytoin, and other medications. Consult your physician about potential interactions.
Q6: Can I take this medication if I am pregnant or breastfeeding?
A: Consult your physician before using this medication if you are pregnant or breastfeeding.
Q7: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule.
Q8: Can this medication be used to treat other digestive issues besides gas and heartburn?
A: While primarily used for gas, heartburn, and acidity, it can offer symptomatic relief for stomach ulcers due to the local anesthetic effect of benzocaine. However, it does not treat the underlying cause of the ulcer. Consult a doctor for appropriate diagnosis and treatment.
Q9: How should this medication be stored?
A: Store in a cool, dry place away from direct sunlight.
