Antacids are availableover the counter and are taken by mouth to quickly relieve occasionalheartburn, the major symptom ofgastroesophageal reflux disease andindigestion. Treatment with antacids alone issymptomatic and only justified for minor symptoms.[4] Alternative uses for antacids include constipation, diarrhea, hyperphosphatemia, and urinary alkalization.[2] Some antacids are also used as anadjunct to pancreatic enzyme replacement therapy in the treatment ofpancreatic insufficiency.[5]
Non-particulate antacids (sodium citrate) increase gastricpH with little or no effect on gastric volume, and therefore may see some limited use in pre-operative procedures. Sodium citrate should be given within one hour of surgery to be the most effective.[6]
Conventional effervescent tablets contain a significant amount ofsodium and are associated with increased risk of adverse cardiovascular events according to a 2013 study.[7] Alternative sodium-free formulations containingmagnesium salts may cause diarrhea, whereas those containingcalcium oraluminium may causeconstipation.[8]: Table 2 Long-term use of antacids containingaluminium may increase the risk of developingosteoporosis.[9]In vitro studies have found a potential for acid rebound to occur due to antacid overuse, however the significance of this finding has been called into question.[10][11]
A proposed method to mitigate the effects ofstomach acidity andchelation on drug absorption is to space out the administration of antacids with interactingmedications by at least two hours,[19] however this method has not been well studied for drugs affected byurine alkalization.[16]
There are concerns regarding interactions between delayed-release tablets and antacids, as antacids may increase the stomachpH to a point at which the coating of the delayed-release tablet will dissolve, leading to degradation of the drug if it ispH sensitive.[18]
Several liquid antacid preparations aremarketed. Common liquid preparations includemilk of magnesia and magnesium/aluminiumcombinations. A potential advantage of using a liquid preparation over a tablet is that liquids may provide quicker relief, however this may coincide with a shorter duration of action.[21]
Chewable tablets are one of the most common forms of antacids, most frequently made fromcarbonate orhydroxidesalts, and are readily available over the counter. Upon reaching thestomach, the powdered antacid salts bind tohydronium (H+) ions, producingchloride salts, carbon dioxide, and water. This process reduces the concentration of H+ ions in the stomach, raising the pH and neutralizing the acid.[8]: Figure 1 Common carbonate salts available in tablet form include those of calcium, magnesium, aluminium, and sodium.[16]
Some common American brands areTums, Gaviscon chewable tablets, andMaalox chewable tablets.[22]
^abInternal Clinical Guidelines Team. (UK) (2014).Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both. National Institute for Health and Care Excellence: Clinical Guidelines. London: National Institute for Health and Care Excellence (UK).PMID25340236.
^abcdSalisbury BH, Terrell JM (2020)."Antacids".StatPearls. Treasure Island (FL): StatPearls Publishing.PMID30252305.Archived from the original on 5 November 2021. Retrieved24 November 2020.
^Graham DY (June 1982). "Pancreatic enzyme replacement: the effect of antacids or cimetidine".Digestive Diseases and Sciences.27 (6):485–490.doi:10.1007/BF01296725.PMID6282548.S2CID10640940.
^Apfelbaum JL, Agarkar M, Connis RT, Coté CJ, Nickinovich DJ, Warner MA, et al. (American Society of Anesthesiologists Committee on Standards and Practice Parameters) (March 2017). "Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration".Anesthesiology.126 (3):376–393.doi:10.1097/ALN.0000000000001452.PMID28045707.
^"Taking Antacids".Medline Plus. U.S. Department of Health and Human Services, National Institutes of Health, U.S. National Library of Medicine. 7 November 2014.Archived from the original on 5 July 2016.
^Texter EC (February 1989). "A critical look at the clinical use of antacids in acid-peptic disease and gastric acid rebound".The American Journal of Gastroenterology.84 (2):97–108.PMID2644821.
^Thompson WG (12 September 2014)."Antacids".IFFGD Publication #520. International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). Archived fromthe original on 6 May 2016.
^Barnett CC, Richardson CT (November 1985). "In vivo and in vitro evaluation of magnesium-aluminium hydroxide antacid tablets and liquid".Digestive Diseases and Sciences.30 (11):1049–1052.doi:10.1007/BF01315602.PMID4053915.S2CID8133980.
The dictionary definition ofantacid at Wiktionary
