Clinical and pharmacological group: & nbsp
Antacids
Included in the formulation
АТХ:A.02.A.D.02 Magaldrat
Pharmacodynamics:Neutralizes hydrochloric acid in the stomach, reduces the activity of pepsin. Provides relief from symptoms due to high acidity. It adsorbs (binding bile acids and lysolecithin) and enveloping action. Reduces the corrosive effect of gastric juice on the gastric mucosa, strengthens its own defense mechanisms (cytoprotective action, aluminum stimulates the secretion of prostaglandins). Does not affect the motility of the stomach and the physiology of the digestive process. Maintaining a pH value in the therapeutically optimal range (pH 3-5) for 20-40 min, does not cause acid ricocheting.
It contains aluminum and magnesium hydroxides in one molecule. The antacid effect is due to the neutralization of protons by sulfate and hydroxide ions.
Pharmacokinetics:It is not absorbed in the digestive tract. In the process of neutralizing the acid, a small amount of magnesium and aluminum ions are released, which when passed through the intestine turn into poorly soluble phosphates and then are excreted with feces. As a result, the phosphate content in the blood and urine decreases, which prevents the formation of phosphate stones in the urinary tract.Magnesium hydroxide interferes with the precipitation of calcium oxalate and calcium phosphate, preventing the formation of calcareous calculi. Some of the ions are suctioned. Elevated levels of aluminum ions in the blood plasma even in patients with normal renal function were noted. Long-term use of preparations containing aluminum can cause a decrease in phosphate absorption.
Indications:Heartburn, discomfort and pain in the epigastric region; acid-dependent gastrointestinal diseases (erosive gastroduodenitis, gastroduodenitis and duodenopathy caused by NSAIDs, stress ulcers, Zollinger-Ellison syndrome, gastroesophageal reflux disease); symptomatic therapy of peptic ulcer of the stomach and duodenum.
XI.K20-K31.K21 Gastroesophageal reflux
XI.K20-K31.K25 Stomach ulcer
XI.K20-K31.K26 Duodenal ulcer
XI.K20-K31.K27 Peptic ulcer of unspecified site
XI.K20-K31.K29 Gastritis and duodenitis
XI.K20-K31.K30 Dyspepsia
XI.K20-K31.K31 Other diseases of the stomach and duodenum
XI.K40-K46.K44 Diaphragmatic hernia
XVIII.R10-R19.R12 Heartburn
XVIII.R10-R19.R10.1 Pain localized in the upper abdomen
Contraindications:Hypersensitivity; children under 12 years.
Carefully:Chronic renal failure, Alzheimer's disease, hypophosphatemia, intestinal obstruction, appendicitis or its symptoms, gastrointestinal bleeding, the presence of ileostomy, pregnancy.
Pregnancy and lactation:Action category for the fetus by FDA - FROM.
Use during pregnancy is only possible for a short time (to avoid the penetration of aluminum ions into the fetal tissues). During breastfeeding magal use with caution because of the possible release of aluminum ions with milk.
Dosing and Administration:Inside to 0,8-1,6 g 1 hour after each meal and just before bed. The maximum daily dose for adults and children from 12 years is 6400 mg. Duration of treatment is set individually. If the symptoms do not disappear for more than 2 weeks during therapy with the magdalat, a clinical examination of the patient should be performed to exclude the presence of a malignant disease. In elderly patients, dose adjustments are not required.
Side effects:From the digestive system: often - unformed stool, rarely - diarrhea, nausea, stomach cramps, fecal color change.
Long-term use in high doses, as well as administration to patients with renal insufficiency, can cause an increase in the concentration of aluminum and magnesium ions in the blood and the deposition of aluminum, mainly in the nervous and bone tissue.
Possible:
from the nervous system - encephalopathy, weakening of reflexes, mood changes or mental disorders;
from the musculoskeletal system - decrease in phosphate content in bone tissue (there are reports of osteomalacia and osteoporosis development);
from the genitourinary system - nephrocalcinosis, impaired renal function.
Other: hypercalcemia, hypercalciuria.
In patients with concomitant renal failure - Thirst, reduction of blood pressure;
Overdose:There were no cases of overdose. Due to the fact that the active ingredient does not dissolve at pH> 5, intoxication by the drug due to an overdose is unlikely.
Interaction:Due to the fact that antacids can reduce the absorption of other drugs, the interval between taking the magdrate and other drugs should be at least 2 hours.
Reception of antacids can significantly reduce the absorption of antibiotics, including tetracyclines and quinolone derivatives (eg, ciprofloxacin, ofloxacin, norfloxacin).As a result, when using these antibiotics, the use of antacids is not recommended.
When used simultaneously with digoxin, isoniazid, iron compounds and chlorpromazine can cause a decrease in the absorption of these drugs.
Can potentiate the anticoagulant effect of coumarin derivatives.
Magaldrate should not be taken with beverages that have acidic properties (fruit juices, wine), and together with effervescent tablets containing citric or tartaric acid, due to increased intestinal absorption of aluminum ions.
Special instructions:Due to the possible relationship between elevated plasma concentrations of aluminum and the development of encephalopathy, special attention should be given to patients on dialysis, patients with impaired renal function (creatinine clearance less than 30 ml / min), Alzheimer's syndrome and other forms of dementia, to patients on a low-phosphate diet or having a disturbance of bone metabolism. In the case of long-term use of the magdalite, it is necessary to monitor the level of aluminum in the blood (the concentration of aluminum ions in the blood plasma should not exceed 40 ng / ml), ensure sufficient intake of phosphorus from food.
Patients with peptic ulcer of the stomach or duodenum should be tested for H. pylori. With a positive test result, standard therapy for H. pylori eradication should be performed.
Treatment should be continued for at least 4-6 weeks after all symptoms have disappeared, since the symptoms disappear. the correlation between the cessation of symptoms and the true healing of the ulcer is absent.
The maximum recommended dose should not be taken more than 2 weeks, except when this is done on the advice or under the supervision of a doctor.
Simultaneous reception of the magallrate and preparations with an enteric-soluble membrane due to its premature dissolution can lead to irritation of the mucous membrane of the stomach and duodenum.
Does not affect the ability to drive and work with machinery.