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magaldrate
simethicone
sorbitol
saccharin
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Riopan Plus Tablets
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Plus Tablets
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Plus Double Strength Tablets
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This product is available in an over-the-counter
form without a prescription.
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What are antacids?
An antacid is a compound that absorbs and neutralizes
stomach acid. The use of antacids has declined because of
the availability of many very potent drugs that are more
effective and much less troublesome to take than antacids.
Still, these drugs can be helpful in relieving intermittent,
infrequent heartburn and indigestion. If these symptoms
occur frequently such as multiple times a day or at night,
then the cause should be sought, as a more serious disorder
may be present.
Magaldrate is the chemical bonding of aluminum and
magnesium hydroxide. Simethicone is a defoaming agent that
breaks down small bubbles in the stomach, allowing the
swallowed air to be belched up more readily. Sorbitol and
saccharin are sweetening agents.
Some facts about antacids are as follows:
- Taken on an empty stomach, they only neutralize acid
for 30 to 60 minutes because the antacid quickly leaves
the stomach.
- If taken with food, the protective effect may be 2 or
3 hours.
- To get as much acid reduction as prescription
medicines produce is expensive as the antacid must be
taken frequently during the day and night. It is probably
cheaper to take an acid-reducing pill once or twice a
day.
- All antacids, but especially calcium carbonate, can
result in an acid rebound effect where the stomach acid
surges back after the antacid has left the stomach,
another reason for long-acting medications.
- Antacids interfere with many drugs. (See below.)
Staggering the antacid away from medications is always
preferable but again is a nuisance and hard to comply
with long-term.
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What are antacids used for?
Antacids are useful for the temporary relief of
occasional indigestion and heartburn. Frequent, daily or
nightly symptoms usually mean a more serious problem.
Antacids by themselves do not correct these problems. The
medications that are now available to treat acid problems
are generally superior to antacids.
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How do I take antacids?
It is best to take them with food as the buffering effect
in the stomach lasts for 2 to 3 hours. If you have symptoms
at night, take the antacids before retiring. However, it is
more important not to eat within 2 hours of sleep as eating
often promotes reflux of acid into the esophagus. Keep all
medications away from children.
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What do I do for a missed dose?
This is usually not a problem since most people only use
the antacid when they have symptoms. If you miss a physician
recommended dose, take it as soon as you remember. However,
it is not necessary to double up on the next dose.
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Are there interactions with food or beverages?
There are no known interactions between food or alcohol
and any of the antacids. However, caffeine and alcohol do
stimulate the production of stomach acid and nicotine delays
the healing of ulcers.
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Are there interactions with other drugs?
An interaction generally means that one drug may increase
or decrease the effect of another drug. Also, the more
medications a person takes, the more likely there will be a
drug interaction. Antacids do interact with or prevent the
absorption of many medications. As a general rule it is best
to separate antacid use and any other medications by at
least 1 hour. When antacids are only taken occasionally,
this seldom presents a serious problem. Since there are so
many good medications to reduce stomach acid, some of them
over-the-counter, it is unusual to require frequent antacid
use during the day and night.
Interactions with this antacid may occur with the
following:
- benzodiazepine (Valium, Xanax)
- captopril (Capoten)
- steroids (prednisone, Deltasone, Medrol)
- flecainide (Tambocor)
- ulcer medications (Tagamet, Zantac, Pepcid,
Axid)
- phenytoin type drugs (Dilantin, Mesantoin, Peganone,
Cerebyx)
- iron (Feosol, ferrous sulfate, Nu-Iron)
- ketoconazole (Nizoral)
- levodopa (Dopar)
- penicillamine (Depen, Cuprimine)
- phenothiazines (Thorazine, Stelazine, Compazine)
- quinidine (Quinidex, Quinaglute)
- aspirin, salicylates
- diabetic medicines (Diabinese, Micronase,
Glucotrol)
- tetracycline (Sumycin, Tetracyn)
- ticlopidine (Ticlid)
- valproic acid (Depakote, Depakene)
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Is there a problem if I have another disorder or
disease?
At times, a drug may have a different or enhanced effect
when other diseases are present. At other times, the drug
may worsen or effect another disease. Most antacids do not
interfere with any underlying disease or disorder. An
exception is the use of sodium bicarbonate when high blood
pressure or heart disease is present.
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What if I'm pregnant, considering pregnancy or
breast-feeding?
Most females now know that, if possible, no drug,
including alcohol, should be taken during pregnancy or
lactation. The potential danger, of course, is an injury to
the baby. However, some drugs are much safer than others in
this regard. So, the FDA has a grading system for each drug
which reflects what is known medically. It ranks drugs from
A, where medical studies show no evidence for danger to the
fetus or mother, to B, C, D and X, where the medical
evidence indicates that the risk to the fetus outweighs any
benefit to the mother. Acetaminophen is ranked B. Always
consult your physician before taking any drug during or when
planning pregnancy.
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How long is it safe to take this antacid?
Antacids can be used indefinitely if they are only taken
occasionally. However, when they are necessary several times
a day, medical attention is required. Excessive antacid use
in the short-term may indicate an underlying disorder that
needs different care. The long-term, heavy use of any
antacid can produce medical problems and should not be done
without a physician's input.
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How about side effects?
Adverse reactions can occur with any drug, even
over-the-counter medications. Most antacids produce only
minor side effects, especially if they are used
infrequently. Minor side effects are usually relieved by
reducing the dose or frequency. For major side effects,
contact the physician immediately.
Magaldrate is the chemical bonding of aluminum and
magnesium hydroxide. As such, there is probably less
diarrhea with this product than when these chemicals are
physically mixed, as found in Gelusil, Maalox and Mylanta.
Patients on dialysis or who have chronic kidney failure
should discuss its use with their physician. Sorbitol is a
sugar that is broken down by bacteria in the large bowel and
which, in turn, can cause diarrhea. Saccharin is an
artificial sweetener which has no known serious adverse
reactions in the body.
For this antacid, the following are the observed side
effects:
Minor:
- chalky taste
- increased thirst
- stomach cramps
- speckling or white discoloration of stools
- constipation
- diarrhea
Major:
- difficult or painful urination
- loss of appetite
- muscle weakness
- bone pain
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A physician's comment...
Antacids are one of mankind's oldest friends. If you
develop occasional heartburn or indigestion, you take an
antacid and get instant relief. No house should be without
an antacid. Yet, if these symptoms occur daily or several
times a day and especially at night, then there could be a
more serious problem. There may be an ulcer or serious acid
injury to the esophagus (food pipe). These conditions are
rarely healed by antacids alone. A specific diagnosis must
be made by the physician. If an ulcer is being caused by the
stomach bacteria, Helicobacter pylori, or if
gastroesophageal injury is occurring, specific potent
medications are available to heal or control these
conditions. Antacids, at best, just temporarily cover up the
symptoms. They do not solve the problem.
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Posted: July 1998
Peptic Ulcer
Disease | Helicobacter
Pylori | Gastroesophageal
Reflux Disease
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