St. John's wort is large. Medicinal herb St. John's wort: photo, application, composition
Registration number: P N014448/01
Trade name: Gastal®
INN or group name: -
Dosage form: lozenges
Compound
1 tablet contains: active substances: aluminum hydroxide - magnesium carbonate gel 450.0 mg, magnesium hydroxide 300.0 mg; excipients: mannitol (E421) 120.00 mg, sorbitol (E420) 50.00 mg, lactose monohydrate 30.00 mg, corn starch 75.80 mg, sodium cyclpamate 7.00 mg, sodium saccharinate 0.20 mg, talc 28.00 mg, magnesium stearate 6.00 mg, peppermint flavor 3.00 mg.
Description:
Round tablets from white to cream color with a smooth surface and bevel.
Pharmacological group: antacid
ATX code: A02AX
Pharmacological properties
Pharmacodynamics
The drug Gastal® is a combined antacid that reduces increased acidity gastric juice and does not have a stimulating effect on the secretion of gastric juice.
Aluminum hydroxide-magnesium carbonate gel and magnesium hydroxide provide immediate (immediately after administration) and long-term (about 2 hours) neutralization of hydrochloric acid in gastric juice, maintaining acidity in the stomach at a physiological level (pH 3-5). One tablet of Gastal® neutralizes 21.5 mmol of hydrochloric acid.
The drug Gastal® suppresses the effect of pepsin, lysolecithin and bile acids, eliminates dyspeptic symptoms. Strengthens protective and regenerative processes in the gastric mucosa. Aluminum ions have a cytoprotective effect by increasing the secretion of mucin and sodium bicarbonate, activating prostaglandin E2 and NO, accumulating epidermal growth factor at the site of mucosal damage, and increasing the concentration of phospholipids in the walls of the stomach.
Pharmacokinetics
The drug Gastal® does not have a systemic effect in patients with normal function kidney After interacting with hydrochloric acid of gastric juice, aluminum hydroxide reacts with phosphates and carbonates in the alkaline environment of the intestine and is excreted in the feces in the form of insoluble salts. Magnesium hydroxide reacts with hydrochloric acid in gastric juice to form magnesium chloride, which has osmotic properties and a mild laxative effect that neutralizes the fixing effect of aluminum hydroxide in small intestine. Magnesium ions are excreted in the feces in the form of insoluble carbonate.
Indications for use
Heartburn, dyspepsia (after taking medicines, alcohol, coffee, dietary errors, smoking); conditions accompanied by increased acid formation: peptic ulcer stomach and duodenum, gastritis; reflux esophagitis; hiatal hernia.
Contraindications
Hypersensitivity to aluminum, magnesium salts or other components of the drug; severe renal failure; Alzheimer's disease; hypophosphatemia; lactose intolerance, lactase deficiency or glucose-galactose malabsorption; childhood up to 6 years old.
With caution
In case of chronic renal failure (CRF), pregnancy and during breastfeeding, adults and children over 12 years old weighing less than 50 kg, children from 6 to 12 years old, elderly people.
Use during pregnancy and breastfeeding
The drug Gastal® is not released from breast milk. When used during pregnancy and breastfeeding, it is necessary to evaluate the balance of benefit to the mother and risk to the fetus and infant.
Directions for use and doses
Inside, gradually dissolving in the mouth.
1-2 tablets 4-6 times a day, approximately 1 hour after meals and before bedtime, but not more than 8 tablets per day. Duration of treatment is no more than 2 weeks.
Similar doses are recommended for the treatment of heartburn regardless of food intake.
Adults and children over 12 years of age weighing less than 50 kg, children aged 6 to 12 years
The dose is half the recommended dose for adults and children over 12 years of age weighing at least 50 kg. Duration of treatment is no more than 2 weeks.
No dose adjustment is required. Duration of treatment is no more than 2 weeks.
Overdose
Symptoms of acute overdose are not described.
At long-term use high doses of drugs containing aluminum and magnesium may develop hypophosphatemia, hypocalcemia, hypercalciuria, osteomalacia, osteoporosis, hypermagnesemia, hyperaluminemia, encephalopathy, nephrocalcinosis and renal dysfunction. It is possible to develop more pronounced adverse reactions from gastrointestinal tract(gastrointestinal tract) (constipation, diarrhea), in patients with renal failure - thirst, decreased blood pressure, hyporeflexia.
Treatment: symptomatic therapy.
Side effect
Interaction with other drugs
The drug Gastal®, when used simultaneously, enhances the activity of levodopa and nalidixic acid, reduces and slows down the absorption of quinolones, isoniazid, naproxen, iron preparations, indomethacin, aminazine, beta-blockers, diflunisal, H2-histamine receptor blockers, fat-soluble vitamins, indirect anticoagulants, barbiturates.
When interacting with metal ions included in antacids, tetracyclines form insoluble chelate complexes; as a result of this interaction, the absorption of tetracyclines is reduced by more than 90%. The 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 is reduced by 50-90%.
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 the blood plasma.
Concomitant use of high doses of antacids can 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 can significantly reduce the absorption of doxycycline from the gastrointestinal tract.
An increase in urine pH during antacid therapy may 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, is not significantly reduced when used simultaneously with antacids.
M-anticholinergic blockers, by slowing down gastric motility, increase the duration of action of the drug Gastal®.
In order to prevent possible interaction of the drug Gastal® with other medicines It is recommended to take it 1 hour before or 1 hour after their use.
Special instructions
Impact on the ability to drive vehicles and operate equipment
Gastal is a popular antacid used for diseases of the gastrointestinal tract due to its low cost and really good medical properties. The big advantage of the drug is that it is not absorbed through the intestinal walls, but, having brought order to it, is excreted in the feces.
Many medications are available in different pharmacological forms. Gastal is supplied to consumers only in the form of lozenges. Traditional, mint and cherry lozenges are available as round, beveled and smooth white or cream colored tablets.
Pharmacological action
The medicine reduces acidity in the stomach, neutralizing the excess activity of hydrochloric acid. One tablet can neutralize 21.5 moles of this active substance in just 2 hours.
Gastal is famous for its antacid properties. They lie in the fact that the effect of normalizing acidity is maintained after taking the medicine for a long time.
Functional disorders are eliminated due to a decrease in the activity of bile acids and lysolycetin. This is facilitated by the action of the enzyme pepsin, the production of which is stimulated by Gastal.
The drug not only relieves symptoms, but also restores the health of the gastrointestinal tract, activating the processes of restoring the integrity of the structures of the mucous membrane of the gastric pouch. This effect of the tablets, called cytoprotective, is explained by the beneficial effect on regenerating processes:
The laxative factor of the tablets is provided by the action of magnesium chloride, the salt of which is formed when magnesium hydroxide reacts with hydrochloric acid.
Compound
Active substances in one mint tablet contain:
- aluminum hydroxide-magnesium carbonate gel – 450 mg;
- magnesium hydroxide – 300 mg.
Excipients per tablet contains:
- peppermint flavoring 11890-71 – 3 mg;
- mannitol – 120 mg;
- sorbitol – 50 mg;
- corn starch – 75.8 mg;
- lactose monohydrate – 30 mg;
- talc – 28 mg;
- sodium saccharinate – 0.2 mg;
- sodium cyclamate – 7 mg.
One cherry-flavored tablet contains the same amount of active substances and auxiliary substances:
- cherry flavoring – 4 mg;
- mannitol – 111 mg;
- lactose monohydrate – 112 mg;
- gelatinized starch – 32 mg;
- colloidal silicon dioxide – 2 mg;
- croscarmellose sodium (type A) – 50 mg;
- aspartame – 2.5 mg;
- magnesium stearate – 6 mg.
The traditional form of the drug does not contain any aromatic additives.
Indications for use
Gastal quickly and effectively copes with many diseases associated with digestion. Poor nutrition, nervous breakdowns and bad habits lead to gastritis, which this medicine successfully fights.
It is used for digestive disorders: heaviness in the stomach, heartburn, epigastric pain. All these symptoms are caused increased level acidity, which Gastal successfully copes with.
Thanks to its regenerating properties, it is an excellent medicine for gastrointestinal ulcers, erosive formations on the walls of the stomach and duodenum. They treat acute pancreatitis, fermentative dyspepsia and even diaphragmatic hernia.
Sometimes after fried, fatty or low-quality food, discomfort occurs in the stomach. Lozenges are first aid in these cases as well.
How to take?
Gastal is used orally, but not swallowed. The lozenge must be placed behind the cheek or under the tongue and held until completely dissolved. Do not drink it with water or chew it. For more than one-time treatment, it is carried out an hour after meals and before bedtime.
Before taking any medicine, consultation with a specialist is necessary. It is he who can accurately determine the duration of treatment and dosage for the most effective result.
The usual average dosage per day for an adult is 2 tablets 3 times a day. For children 6-12 years old, the dose is reduced by 2 times.
For long-term symptoms, the course of treatment can last from one to two weeks. But for one-time painful manifestations, for example, in case of poisoning, heartburn or overeating, taking one tablet is enough.
Side effects
When used correctly, side effects are extremely rare. And yet, sometimes they can manifest themselves in the form of nausea, diarrhea, or, conversely, constipation. There are known cases of changes in patients' sense of taste or the appearance of allergic reactions.
Contraindications
You cannot take Gastal:
- a patient with hypersensitivity to magnesium salts and its other components;
- children under 6 years of age;
- those suffering from Alzheimer's disease or hypophosphatemia;
- patients with lactose intolerance, as well as with a deficiency of glucose-galactose malabsorption or lactose in the body;
- with severe or chronic renal failure.
Special instructions, overdose
Although the components of Gastal are not excreted into breast milk because they are not absorbed into the blood through the intestinal walls, it should be used for the treatment of pregnant and lactating women with caution and always under the supervision of a doctor. It is recommended to use this drug with the same caution in adults weighing less than 50 kg and the elderly.
An overdose of aluminum and magnesium contained in the drug threatens the development of nephrocalcinosis, hypercalceuria, hypermagnesemia, osteoporosis and renal dysfunction.
Analogues
Even if you are completely sure that the indications and contraindications are similar, it is necessary to consult with your doctor before changing the medicine.
Analogues of Gastal:
- Rennie;
- Domrid;
- Pepsan;
- Gaviscon;
- Domstal;
- Kvamatel;
- Remmax-kv;
- "Pechaevskie" for heartburn;
- gastric jelly leovit;
- Neosmectin;
- Talcid;
- Maalox;
- Phosphalugel;
- Secrepat forte and others.
Price
The cost of the medicine depends on the flavoring agents and the number of pieces in the blister. Today, 12 pieces of tasteless tablets cost approximately 150 rubles, and 30 - only 270 rubles. Medicine with mint or cherry flavor is much more expensive.
Experts' opinions
With normal kidney function, Gastal has a systemic effect on the human body. Aluminum hydroxide, interacting with stomach acid, reacts with carbonates and phosphates. After it, insoluble salts are excreted in the feces.
Magnesium hydroxide is also excreted from the body in the form of insoluble carbonates, after a lot of work has been done. It reacts with stomach acid. The result is magnesium chloride, which acts in the small intestine as an osmotic laxative.
Gastal tablets
The tableted product belongs to the group of antacids, because they neutralize the increase in acidity of stomach juice. In addition to the fact that the tablets normalize acidity, they relieve symptoms of gastrointestinal disorders such as heartburn, a feeling of heaviness in the stomach, severe pain and relieve the accumulation of gases. The medicine is intended to relieve individual symptoms, so it does not eliminate the cause of the detected disorder.
Gastal composition and form
The medicine Gastal is produced as rolling tablets with different flavors (mint, cherry) and without them. However, all tablets are whitish and very smooth. Those that contain additives are produced in blisters of 24 pcs. and 48 pcs. And without flavorings - in cellular plates of 12, 30 and 60 pieces. The active ingredients of Gastal are the following components: 450 milligrams of aluminum hydroxide-magnesium carbonate gel and 300 milligrams of magnesium hydroxide. Some ingredients in cherry- and mint-flavored tablets, as well as those that do not contain flavors, may cause allergies or are simply not tolerated by patients. Substances that cause allergies in flavored tablets are milk sugar (lactose), the diuretic mannitol, as well as starch, the sweetener aspartame and flavoring; in unflavored tablets - mannitol, milk sugar, corn starch, sodium cyclamate, sorbitol, and also saccharin.
Action of gastal
The medicine Gastal relieves high acidity of juice in the stomach and eliminates all disorders digestive tract. It is recommended for relieving heartburn, heaviness in the stomach and pain in it, with ulcers, erosion, acute and chronic gastritis, and even when a lot of fatty foods, smoked foods, fried foods are consumed, and there is also excessive consumption alcoholic drinks and smoking. This drug is intended to suppress the signs of gastrointestinal diseases; it relieves the discomfort caused by coffee, junk food and alcohol. The medicine belongs to the group of antacids, which are responsible for reducing the acidity of stomach juice. The tablets contain magnesium and aluminum, so the product is considered a combination product. These components enter into a chemical reaction with hydrochloric acid, as a result of which the increased acidity is normalized. Thus they function normally digestive organs, signs of dyspepsia disappear. The product is fast-acting and highly effective; moreover, it maintains normal acidity for some time after ingestion. The effects of gastal begin immediately after entering the body and remain effective for about two hours. 1 t. neutralizes the hydrochloric acid contained (21.5 mol). In addition to all this, the drug accelerates the action of pepsin, and also makes the effect of lysolecithin and acids contained in bile less intense. The advantage is that the tablets activate the mechanisms responsible for the restoration processes in the structure of the gastric mucosa and have protective properties. This process is called cytoprotective, because the effect of the tablets is to stimulate the production of mucin and sodium bicarbonate. The produced mucin (mucus) protects the gastric walls from the effects of hydrochloric acid, and Na bicarbonate neutralizes excess gastric acid. The regenerative effect of the tablets is due to the production of such a specific substance as epidermal growth factor. It collects at the site of damage to the mucosa and activates the restoration process of its integrity. The tableted medicine is not absorbed into the blood and does not affect the human body as a whole. IN chemical reaction Al hydroxide enters with HCl, forming a salt, which, being in the intestinal cavity, interacts with carbonates, as well as with phosphates, during which aluminum compounds are formed, which do not dissolve, but come out with the feces. And the resulting magnesium chloride (the reaction of Mg hydroxide with HCl) has laxative properties, which is a good prevention of constipation.
Gastal testimony
The product is used for heartburn, which can be caused by taking medications, drinking alcohol, caffeine, unhealthy food, or smoking. Gastal is also used for gastrointestinal diseases, in particular in the treatment of gastritis, mucosal ulcers of different origins and erosions of the gastric and esophageal membranes. The medicine is recommended for both reflux and a hernia that has formed in the opening of the esophageal diaphragm. For acute and chronic pancreatitis, for digestive disorders that are putrefactive in nature, gastal is prescribed as a means to eliminate individual symptoms in complex treatment.
The drug tablet should be placed in the oral cavity (under the tongue, behind the cheek) and kept there until completely dissolved. In no case should the tablet be swallowed or chewed, but dissolved like a caramel candy. You need to take Gastal 1-2 pcs. in 1 hour after meals for both adults and children over 12 years old. One additional dose (1 tablet) is taken a few minutes before bedtime. The total daily dose is 4-6 times. The limit dose is 8 tons per day. The duration of treatment depends on the time of elimination of signs of the disease. Then, when your health has returned to normal, you need to stop taking Gastal. The limit course of treatment is 14 days. In cases where an extension of treatment is required (more than 2 weeks), a doctor’s consultation is necessary. Sometimes you can take tablets from time to time to relieve irritation of the gastric mucosa, for example, before eating junk food or alcoholic drinks. The drug can be included in the treatment complex for children starting from 6 years of age. The child dose (6 to 12 years) is half the adult dose. Thus, the child is prescribed 0.5 tablets, taken after meals. Those who are light weight, as well as children, are advised to take the drug in reduced doses, but after short time. The dosage and duration of the course are also reduced for patients whose kidney function is impaired.
Gastal overdose
There have been no cases of overdose with tablets. But you need to remember that continuous long-term use of them can increase the concentration of magnesium and aluminum, this often causes osteomyelitis (bone tissue is destroyed), and calcium is also washed out of the bones, osteoporosis or nephrocalcinosis begins (calcium is deposited in the kidney canals). When a patient has kidney dysfunction, dry mouth may appear and blood pressure may drop. Calcium and magnesium drugs, if taken for a long time, lead to frequent bowel movements or constipation. When at least one of them appears listed signs the medicine should be discontinued.
Drug interactions
The interval between taking various types of medications and Gastal should be at least 1-2 hours. Drugs whose effects are enhanced by the influence of Gastal are levodopa and nalidixic acid. But the effect of tetracycline, ofloxacin and ciprofloxacin, as well as salicylate, isoniazid and ferrum-lek decreases. There is a decrease in the effect when taking cardiac glycosides, in particular strophanthin, and histamine blockers, such as suprastin, Zyrtec, Erius, etc., as well as the effect of fat-soluble vitamins, beta-blockers and anticoagulants such as warfarin and thrombostop ( indirect), barbiturates, indomethacin and similar drugs.
Gastal during pregnancy
Gastal is prescribed to children and pregnant women with great caution. During pregnancy, the drug is used only as indicated, because women carrying a child are often bothered by heartburn or feel heaviness in the gastrointestinal tract, which is caused by junk food. By eliminating such symptoms, the medicine can be used without fear, but use it in episodes (when required), that is, when heartburn or painful sensations in the stomach appear, you need to drink 1 t. If there are no undesirable signs, then you do not need to take the pill. There are cases when gastritis, peptic ulcers or duodenitis worsen in pregnant women, then the symptoms of such diseases can be eliminated with gastal immediately according to the instructions, the maximum course of taking the drug is 3 - 5 days. Pregnant women should take 1 tablet one hour after meals for 3 to 5 days. The maximum daily dose is 8 t.
Gastal for children
It is prohibited to prescribe the medicine to children under six years of age. Pediatric dosing is prescribed from 6 to 12 years. Those over twelve, with a body weight of more than 50 kilograms, take an adult dose. When a teenager’s body weight is less than 50 kg, the timing and dose of medication are reduced. Since the tablet has to be kept in the mouth, it is better to give the child a cherry-flavored pill; it will not make you want to spit, as it tastes good. To a small child It should be explained how to dissolve the tablet, emphasizing that it cannot be swallowed or chewed. Age category 6 - 12 years old are prescribed 0.5 - 1 t., taking the dose 1 hour after meals about 4 - 6 times daily. Five tablets is the maximum daily dose of Gastal for children. Continuous use of tablets should not last more than 14 days. When general condition the body has returned to normal, then the medication should be stopped.
Treatment of heartburn with gastal
In case of heartburn, taking 1-2 tablets is recommended, depending on the degree of its severity, 1 hour after eating. The pill is dissolved by holding it on the oral mucosa, without chewing or swallowing. The daily limit dose of tablets is 8 pcs. It happens that heartburn is accompanied by an ulcer or gastritis, then Gastal should be taken in a course of two weeks. In cases where heartburn is caused by smoking, alcohol or harmful products, the medicine is taken once only when undesirable symptoms appear, and positive effect should occur within five minutes. When the symptoms have disappeared, Gastal does not need to be taken as a prophylactic.
Contraindications and side effects
This medicine has absolute (not to be taken) and relative (use with caution and monitoring) contraindications. The drug should not be prescribed for renal dysfunction, Alzheimer's disease, reduced content phosphorus in the blood, lactose intolerance, as well as insufficient amounts of lactase, malabsorption syndrome, hypersensitivity or allergy to the ingredients of the product, as well as children under six years of age. Restrictions on taking the drug during pregnancy and lactation, in old age and for children under 12 years of age, as well as for patients weighing up to 50 kilograms are relative.
In rare cases, the medicine gives side effects from the gastrointestinal tract, in particular, it causes a gag reflex, nausea, impaired bowel movements, and also changes the sense of taste. Allergy may occur in some patients.
Gastal analogues
Today there are a lot of substitutes for Gastal. In particular, these are chewable tablets Ajiflux and Inalan; suspended and tableted substance Almagel and its subtypes - Almagel A, as well as Almagel Neo; in the form of chewable tablets and suspensions, the drugs Altacid, Gaviscon and Maalox; and in the form of a suspension and absorbable tablets, gastracid and reltser. Good analogues of Gastal are Gaviscon Forte suspension and Maalox mini-suspension; and also the medicine Alumag and Rennie in tablet form; gel products palmagel and palmagel A.
If the question arises about whether it is better to take Rennie or Gastal, then you need to pay attention that the first of the drugs is absorbed into the blood, and Gastal does not penetrate into the blood plasma. The advantage of Rennie is that by entering into a chemical reaction with hydrochloric acid on the gastric mucosa, the medicine relieves heartburn with lightning speed. The only downside is that the medicine often causes a kind of acid rebound, which is manifested by the fact that when the medicine stops working, the stomach cells synthesize even more acidic substance. We can say that rennie is a quickly effective remedy, but its effect is short-lived. The disadvantage of rennie is the formation of carbonic acid, which greatly irritates the gastric mucosa. But gastal absorbs excess hydrochloric acid and neutralizes it. Of course, it relieves heartburn more slowly, but it has long lasting effect. In addition to the fact that heartburn goes away, the amount of mucus covering the walls of the gastrointestinal tract also increases, and thus gastal protects the stomach and intestines from the undesirable effects of hydrochloric acid. So, based on the above, we can conclude that Gastal has more advantages, however, when heartburn is very intolerable, it is better to take a Rennie tablet, which will relieve it with lightning speed. There is only one conclusion: Rennie is recommended for a single dose, and Gastal is recommended for use in courses.
Gastal price
The approximate cost of hastal is as follows: cherry-flavored pills (24 pcs.) cost from 125 to 152 rubles; with mint (same amount) – 119 – 157 rubles. Packs of 48 pcs. cost: 215 – 279 rub. – cherry, 219 – 277 rub. – mint. Price 12 pcs. tasteless tablets range from 75 to 95 rubles, 30 pieces - 125 - 155 rubles, 60 pieces. – 235 – 293 rub. When purchasing a medicine, you need to look at the date of manufacture; the medicine is suitable for use for 36 months. Store the medicine in a dry place protected from light; the storage temperature should not exceed 25 degrees. Do not buy medicine even if the packaging is damaged.
Gastal reviews
The good news is that about 80 percent of the responses about gastal are positive character. Those who take this drug like the fact that it acts quickly and maintains a positive effect for a long time. In fact, everyone who has taken pills at least once talks about the pleasant taste and convenience that such pills do not need to be washed down with liquid, because the tablet can be dissolved even in public places and eliminate heartburn. They respond negatively to this means people who did not show a positive effect. But such a subjective point of view does not at all indicate that the remedy is ineffective, just that each organism perceives it in its own way. Therefore, any medicine must be taken according to individual characteristics human body.
According to the accepted classification, Gastal is an antacid drug based on magnesium hydroxide, produced by the pharmaceutical company Teva. The product reduces excess acidity of gastric juice, eliminating discomfort and heartburn. Read its instructions for use.
Composition of Gastal
The drug is presented in the form of lozenges, which differ in taste and aromas. Their composition and packaging:
Description | White-cream round tablets |
Concentration of aluminum hydroxide-magnesium carbonate gel, mg per piece. | |
Level of magnesium hydroxide, mg per piece. | |
Auxiliary components | Mannitol, magnesium stearate, sorbitol, talc, lactose monohydrate, sodium saccharinate, corn pregelatinized starch, peppermint or cherry flavors, sodium cyclamate, croscarmellose sodium, aspartame, colloidal silica |
Package | Blisters of 6 pcs., 2, 5 or 10 blisters in a pack with instructions for use |
Pharmacodynamics and pharmacokinetics
The combined antacid is designed to reduce the increased acidity of gastric juice. The drug does not stimulate the secretion of gastric secretions. The medicine begins to act immediately, its effect lasts about 2 hours. Magnesium and aluminum hydroxides neutralize hydrochloric acid (1 tablet can hold 21.5 mmol of acid), maintains stomach acidity at a physiological level.
Gastal suppresses the activity of lysolecithin, pepsin, bile acids, relieves dyspepsia without adsorption. The drug increases the regenerative and protective functions of the gastric mucosa. Aluminum has a cytoprotective effect, enhances the production of mucin and sodium bicarbonate, and activates prostaglandins. The mechanism of action of the drug is based on the accumulation of epidermal growth factor in the area of violation of the integrity of the membrane, increasing the content of phospholipids in the walls of the stomach.
If patients have normal kidney function, Gastal does not exhibit systemic effects. Aluminum hydroxide interacts with hydrochloric acid, reacts with carbonates and phosphates in an alkaline environment, and is excreted in the feces in the form of insoluble salts. Magnesium hydroxide reacts with hydrochloric acid to form magnesium chloride, which exhibits osmotic and mild laxative effects. The substance neutralizes the binding effect of aluminum in the small intestine. Residues of magnesium are excreted in feces in the form of an insoluble carbonate salt.
Indications for use
The instructions for use of the drug highlight a number of indications. These include:
- heartburn, other uncomfortable dyspeptic symptoms caused by taking medications, coffee, alcohol, dietary errors, smoking (nicotine), nervousness;
- hiatal hernia;
- reflux esophagitis;
- increased acid formation due to gastritis, stomach or duodenal ulcers.
How to take Gastal
The instructions for use of Gastal state that the tablets are intended for oral administration and are gradually dissolved in the mouth. Patients over 12 years of age with a body weight of 50 kg are prescribed 1-2 tablets 4-6 times a day, 60 minutes after meals and before bedtime, but not more than 8 tablets per day. The reception lasts two weeks. For heartburn, you can drink similar doses without reference to meals. If the patient weighs less than 50 kg, his age is 6-12 years, then half the indicated dose is prescribed, the course lasts no more than 14 days. For chronic renal failure, the dose is not adjusted.
Special instructions
If renal function is impaired, the indicated doses and duration of treatment should not be exceeded. Other special instructions for using Gastal from the instructions:
- During therapy, it is not prohibited to drive a car or operate dangerous machinery.
- Aluminum hydroxide can lead to constipation, and magnesium hydroxide can lead to intestinal hypokinesia. Large doses of the drug can lead to the appearance or intensification of intestinal obstruction, especially in renal failure or in old age.
- If during treatment your body weight decreases, the patient feels constant discomfort, difficulty swallowing, or has digestion problems, you should consult a doctor.
- Excessive or prolonged use of aluminum compounds can reduce the concentration of phosphates in the body, which is manifested by accelerated bone resorption, hypercalciuria with an increased risk of developing osteomalacia.
- Long-term use of Gastal increases the plasma concentration of magnesium, which can cause dementia, microcytic anemia, and encephalopathy.
- The drug contains lactose, so if you are intolerant, taking the drug is contraindicated.
Gastal during pregnancy
Gastal for pregnant women can be used, but only if it is prescribed by a doctor. The doctor must determine the benefit to the mother and the potential risk to the development of the fetus, and if the first indicator is higher, then use is relatively safe. During treatment with medication while carrying a child, the dose and duration of the course must not be exceeded.
Gastal during breastfeeding
During lactation, only a doctor can prescribe the use of Gastal to a patient. The active components of the drug are not excreted in breast milk, so theoretically they cannot enter the baby’s body, but in practice no one has conducted such studies of effectiveness and safety. If the doctor allows, a nursing mother can save herself from heartburn with the help of medicine.
In childhood
The use of Gastal is contraindicated in children under six years of age due to the fact that the effectiveness and safety of using the product have not been studied. The instructions contain information that the medicine is prescribed with caution in children over 12 years of age weighing less than 50 kg and in children aged 6-12 years. For everyone else, the dosage is 0.5-1 tablet three times a day.
Drug interactions
Instructions for use describe possible drug interactions between Gastal and other drugs. These are the combinations and effects:
- The drug increases the activity of nalidixic acid, Levodopa, reduces the absorption and effectiveness of beta-blockers, quinolones, barbiturates, Isoniazid, indirect anticoagulants, Indomethacin, iron-based drugs, fat-soluble vitamins, Aminazine, histamine receptor blockers, Diflunisal, diphosphonates, Ketoconazole, Lanzoprazole, Lin cosamide , antipsychotics, penicillamines, Pirenzepine, Propranolol.
- The simultaneous use of the drug with tetracyclines leads to the formation of insoluble chelate complexes, which reduce the absorption and metabolism of antibiotics. If such a combination is necessary, tetracyclines are taken two hours before taking antacids.
- Magnesium and aluminum hydroxides reduce the absorption of Ofloxacin, Ranitidine, Ciprofloxacin, Doxycycline, salicylates, acetylsalicylic acid, Fexofenadine, Phenothiazine, fluorides, fluoroquinolones, Quinidine, Quinoline, hydrochloric acid, Chloroquine, citrates, Ethambutol.
- Antacids reduce the biavailability of Captopril and the concentration of Metoprolol in the blood plasma.
- The drug does not affect the pharmacokinetic properties of Amoxicillin, clavulanic acid, Cephalexin, cardiac glycosides, Digitoxin, Digoxin, thyroxine.
- During antacid therapy, urine pH increases, which leads to tubular reabsorption of alkaline drugs and decreased reabsorption of acidic compounds.
- M-choline blockers increase the duration of Gastal activity by slowing gastric motility.
- It is recommended to maintain an hour interval between the use of the drug and other medications.
Side effects
While taking Gastal tablets, it is possible that side effects. The most common are:
- diarrhea, nausea, change in taste, constipation, loss of stool color, loss of appetite;
- arrhythmia, alkalosis, fatigue;
- allergic reactions, sensitization, anaphylaxis, urticaria, Quincke's edema, dermatitis, itching;
- decreased phosphorus concentration, increased processes of bone tissue decalcification;
- hyperaluminemia, osteomalacia, hypermagnesemia, hypercalciuria, osteoporosis;
- dementia, encephalopathy.
Overdose
The instructions do not describe the symptoms of acute drug overdose. With long-term use of tablets, metal ions accumulate in the body, which leads to osteoprosis, hypophosphatemia, hypocalcemia, nephrocalcinosis and impaired renal function. Possible increased side effects, in case of renal failure - thirst, hyporeflexia, decreased blood pressure. To eliminate symptoms it is shown symptomatic treatment, rehydration, forced diuresis.
Contraindications
The medication is prescribed with caution in chronic renal failure, pregnancy, lactation, with a weight less than 50 kg, in old age and childhood. Contraindications to the use of Gastal are:
- porphyria;
- undergoing hemodialysis;
- severe renal failure;
- Alzheimer's disease;
- hypophosphatemia;
- age up to six years;
- lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
- hypersensitivity to the components of the drug.
Trade name: Gastal ®
INN or group name: -
Dosage form:
lozengesCompound:
1 tablet containsactive substances: aluminum hydroxide-magnesium carbonate gel 450.0 mg, magnesium hydroxide 300.0 mg;
excipients: mannitol (E421) 120.00 mg, sorbitol (E420) 50.00 mg, lactose monohydrate 30.00 mg, corn starch 75.80 mg, sodium cyclpamate 7.00 mg, sodium saccharinate 0.20 mg, talc 28.00 mg, magnesium stearate 6.00 mg, peppermint flavor 3.00 mg.
Description:
Round tablets from white to cream color with a smooth surface and bevel.
Pharmacological group: Antacid
ATX code: A02AX
Pharmacological properties
Pharmacodynamics
The drug Gastal is a combined antacid that reduces the increased acidity of gastric juice and does not have a stimulating effect on the secretion of gastric juice.
Aluminum hydroxide-magnesium carbonate gel and magnesium hydroxide provide immediate (immediately after administration) and long-term (about 2 hours) neutralization of hydrochloric acid in gastric juice, maintaining acidity in the stomach at a physiological level (pH 3-5). One tablet of Gastal neutralizes 21.5 mmol of hydrochloric acid.
The drug Gastal ® suppresses the effect of pepsin, lysolecithin and bile acids, eliminates dyspeptic symptoms. Strengthens protective and regenerative processes in the gastric mucosa. Aluminum ions have a cytoprotective effect by increasing the secretion of mucin and sodium bicarbonate, activating prostaglandin E2 and NO, accumulating epidermal growth factor at the site of mucosal damage, and increasing the concentration of phospholipids in the walls of the stomach.
Pharmacokinetics
The drug Gastal does not have a systemic effect in patients with normal renal function. After interacting with hydrochloric acid of gastric juice, aluminum hydroxide reacts with phosphates and carbonates in the alkaline environment of the intestine and is excreted in the feces in the form of insoluble salts. Magnesium hydroxide reacts with hydrochloric acid in gastric juice to form magnesium chloride, which has osmotic properties and a mild laxative effect that neutralizes the fixing effect of aluminum hydroxide in the small intestine. Magnesium ions are excreted in the feces in the form of insoluble carbonate.
Indications for use
Heartburn, dyspeptic symptoms (after taking medications, alcohol, coffee, dietary errors, smoking); conditions accompanied by increased acid formation: peptic ulcer of the stomach and duodenum, gastritis; reflux esophagitis; hiatal hernia.
Contraindications
Hypersensitivity to aluminum, magnesium salts or other components of the drug; severe renal failure; Alzheimer's disease; hypophosphatemia; lactose intolerance, lactase deficiency or glucose-galactose malabsorption; children under 6 years of age.
With caution
In case of chronic renal failure (CRF), pregnancy and during breastfeeding, adults and children over 12 years old weighing less than 50 kg, children aged 6 to 12 years, old age.
Use during pregnancy and breastfeeding
The drug Gastal is not excreted in breast milk. When used during pregnancy and breastfeeding, it is necessary to evaluate the balance of benefit to the mother and risk to the fetus and infant.
Directions for use and doses
Inside, gradually dissolving in the mouth.
Adults and children over 12 years of age weighing at least 50 kg
1-2 tablets 4-6 times a day, approximately 1 hour after meals and before bedtime, but not more than 8 tablets per day. Duration of treatment is no more than 2 weeks.
Similar doses are recommended for the treatment of heartburn regardless of food intake.
Adults and children over 12 years of age weighing less than 50 kg, children aged 6 to 12 years
The dose is half the recommended dose for adults and children over 12 years of age weighing at least 50 kg. Duration of treatment is no more than 2 weeks.
Patients with chronic renal failure
No dose adjustment is required. Duration of treatment is no more than 2 weeks.
Overdose
Symptoms of acute overdose are not described.
With long-term use of high doses of drugs containing aluminum and magnesium, the development of hypophosphatemia, hypocalcemia, hypercalciuria, osteomalacia, osteoporosis, hypermagnesemia, hyperaluminemia, encephalopathy, nephrocalcinosis and impaired renal function is possible. It is possible to develop more pronounced adverse reactions from the gastrointestinal tract (gastrointestinal tract) (constipation, diarrhea), in patients with renal failure - thirst, decreased blood pressure, hyporeflexia. Treatment: symptomatic therapy.
Side effect
When using the drug in recommended doses, adverse reactions are rare (not less than 0.01%, but less than 0.1%): nausea, constipation, diarrhea, changes in taste. In exceptional cases, allergic reactions are possible.
Interaction with other drugs
The drug Gastal, when used simultaneously, enhances the activity of levodopa and nalidixic acid, reduces and slows down the absorption of quinolones, isoniazid, naproxen, iron preparations, indomethacin, aminazine, beta-blockers, diflunisal, H2-histamine receptor blockers, fat-soluble vitamins, indirect anticoagulants, barbiturates.
When interacting with metal ions included in antacids, tetracyclines form insoluble chelate complexes; as a result of this interaction, the absorption of tetracyclines is reduced by more than 90%. The 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 is reduced by 50-90%.
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 the blood plasma.
Concomitant use of high doses of antacids can 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 can significantly reduce the absorption of doxycycline from the gastrointestinal tract.
An increase in urine pH during antacid therapy may 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, is not significantly reduced when used simultaneously with antacids. M-anticholinergic blockers, by slowing down gastric motility, increase the duration of action of the drug Gastal ®.
In order to prevent possible interaction of the drug Gastal ® with other drugs, it is recommended to take it 1 hour before or 1 hour after their use.
Special instructions
The recommended dose and duration of treatment should not be exceeded when used in patients with impaired renal function.
Impact on the ability to drive vehicles and operate equipment
The use of the drug Gastal does not affect the ability to drive vehicles or control other mechanisms.
Release form
Lozenges.
6 tablets per blister made of PVC/aluminum foil.
2, 4, 5, 8 or 10 blisters along with instructions for use in a cardboard box.
Storage conditions
Store at a temperature not exceeding 25 °C. Keep out of the reach of children.
Best before date
3 years.
Do not use after the expiration date stated on the package.
Conditions for dispensing from pharmacies
Over the counter.
Owner of RU:
Pliwa Krakow, Pharmaceutical Plant A.O., Poland
Manufacturer:
Pliwa Krakow, Pharmaceutical Plant A.O., ul. Mogilska 80, 31-546 Krakow, Polandor
Pliva Hrvatska d.o. o., Prilaz Baruna Filipovic 25, 10000 Zagreb, Republic of Croatia.
Consumer complaints should be sent to the following address:
Teva LLC
119049, Moscow, st. Shabolovka, 10, bldg. 1.