Composition
1 tablet for resorption contains: Â
Active ingredients:
aluminum hydroxide-magnesium carbonate gel 450 mg;
magnesium hydroxide 300 mg;
Auxiliary substances:
mannitol (E 421);
sorbitol (E 420);
lactose monohydrate;
corn starch;
sodium cyclamate;
sodium saccharinate;
talc;
magnesium stearate;
peppermint flavor.
Pharmacological action
Pharmaceutical group:
Antacid drug.
Pharmaceutical action: Â
Gastal® is a combined antacid preparation, a buffer antacid that reduces the increased acidity of gastric juice and does not have a stimulating effect on gastric juice secretion.
Aluminum hydroxide-magnesium carbonate gel and magnesium hydroxide provide immediate (immediately after ingestion) and prolonged (about 2 hours) neutralization of hydrochloric acid of gastric juice, while maintaining the acidity in the stomach at a physiological level (pH 3-5). One tablet of Gastal® neutralizes 21.5 mmol of hydrochloric acid.
Gastal® suppresses the action of pepsin, lysolecithin, and bile acids, eliminates dyspeptic symptoms.
Enhances protective and regenerative processes in the gastric mucosa. Aluminum ions have a cytoprotective effect by increasing the secretion of mucin and sodium bicarbonate, activating PG E2 and NO, accumulating epidermal growth factor at the site of mucosal damage, and increasing the concentration of phospholipids in the stomach wall. The mechanism of this action is not fully understood.
Pharmacokinetics:
 Gastal® has no systemic effect in patients with normal renal function. After reacting with the hydrochloric acid of gastric juice, aluminum hydroxide reacts with phosphates and carbonates in the alkaline environment of the intestine and is excreted by the intestine as insoluble salts. Magnesium hydroxide reacts with hydrochloric acid in gastric juice to form magnesium chloride, which has an osmotic mild laxative effect that neutralizes the fixing effect of aluminum hydroxide in the small intestine. Magnesium ions are excreted by the intestines as insoluble carbonate.
Indications
- dyspeptic symptoms, such as discomfort or pain in the epigastrium, heartburn, sour belching (and their prevention) arising out of the use of certain medications (NSAIDs, corticosteroids);
- dyspeptic symptoms, such as discomfort or pain in the epigastrium, heartburn, sour belching after errors in diet, excessive consumption of ethanol, coffee, nicotine;
- state, accompanied by increased acid production: peptic ulcer, gastritis, reflux esophagitis; hernia hiatal.
Use during pregnancy and lactation
During pregnancy and lactation (breastfeeding), the use of the drug is contraindicated.
Contraindications
- Hypersensitivity to aluminum, magnesium or other components of the drug;
- hypophosphatemia;
- lactose intolerance, lactase deficiency or glucose-galactose malabsorption;
- severe renal failure;
- Alzheimer’s disease;
- children under 6 years of age.
With caution: Â in patients with chronic renal failure (CRF), pregnancy and breast-feeding, adults and children over 12 years of age with a body weight of less than 50 kg, children aged 6 to 12 years, the elderly.
Side effects
When using the drug in the recommended doses, adverse reactions are rare (not less than 0.01%, but less than 0.1%): nausea, constipation, diarrhea, changes in taste sensations. In exceptional cases, allergic reactions are possible.
- constipation or diarrhea;
- weakness, nausea, abdominal pain.
Interaction
When interacting with metal ions that make up antacids, tetracyclines form insoluble chelate complexes; as a result of this interaction, the absorption of tetracyclines decreases by more than 90%. Simultaneous use of these drugs is not possible. If combined use is necessary, tetracycline should be taken at least 2 hours before taking the antacid. In the presence of aluminum and magnesium hydroxides contained in the antacid, the absorption of ciprofloxacin and ofloxacin decreases by 50-90%.
The drug Gastal, when used simultaneously, increases the activity of levodopa and nalidixic acid, reduces and slows down the absorption of quinolones, isoniazid, naproxen, iron preparations, Indometacin, aminazine, beta-blockers, diflunisal, H2-histamine receptor blockers, fat-soluble vitamins, indirect anticoagulants, barbiturates.
In the presence of antacids, the bioavailability of captopril is significantly reduced, and the combined use of antacids and metoprolol leads to a decrease in the concentration of metoprolol in blood plasma.
Concomitant use of high doses of antacids may reduce the absorption of ranitidine by 10-33%.
The use of antacids does not affect the bioavailability of amoxicillin, cephalexin and the combination of amoxicillin and clavulanic acid, but it can significantly reduce the absorption of doxycycline from the gastrointestinal tract.
An increase in the pH of urine during antacid therapy can increase the tubular reabsorption of basic (alkaline) drugs and reduce the reabsorption of acidic compounds. Antacids can reduce and slow down the absorption of salicylates, including acetylsalicylic acid, and also, by increasing the pH of urine, promote faster excretion of salicylates in the urine from the body, with a concomitant decrease in their concentration in the blood serum by 30-70%. The absorption of cardiac glycosides, including digoxin and digitoxin, does not significantly decrease when used concomitantly with antacids. M-holinoblokatory, slowing down the motility of the stomach, increase the duration of action of the drug Gastal.
In order to prevent possible interaction of Gastal with other medications, it is recommended to take it 1 hour before or 1 hour after their use.
How to take, course of use and dosage
Inside, gradually dissolving in the mouth.
Adults and children over 12 years of age with a body weight of at least 50 kg: 1-2 tablets 4-6 times a day approximately 1 hour after meals and before bedtime, but no more than 8 tablets per day. The duration of admission is not more than 2 weeks. Similar doses are recommended for treating heartburn regardless of food intake.
Adults and children over 12 years of age with a body weight of less than 50 kg, children aged 6-12 years: The dose is half of the recommended adult dose. The duration of admission is not more than 2 weeks.
Patients with CRF do not need to adjust the dose.
Overdose
No symptoms of acute overdose have been reported. It is possible to develop more pronounced adverse reactions from the gastrointestinal tract (constipation, diarrhea).
Treatment: Â symptomatic therapy.
Special instructions
Reduced doses and a shorter treatment period are indicated for adults with reduced weight (less than 50 kg) and children.
Do not exceed the recommended dose and duration of treatment when used in patients with impaired renal function.
Continuous admission for more than 2 weeks is possible only after consulting a doctor.
Influence on the ability to drive a car or perform work that requires an increased rate of physical and mental reactions. Application of Gastal® it does not affect the ability to drive motor vehicles and manage other mechanisms.
Form of production
Gastal resorption tablets, round, white to cream in color, with a smooth surface and chamfer.
Storage conditions
Store at a temperature not exceeding 25°C. Keep out of reach of children. Do not use after the expiration date.
Shelf
life is 3 years.
Active ingredient
Hydrothalcite, Magnesium Hydroxide
Dosage form
resorption tablets
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