Page 38 - Retail Pharmacy March 2021

RAPID RELIEF, WHENEVER REFLUX STRIKES Did you know that symptomatic reflux can be caused not just by acid, but other stomach secretions? ACID • Acid is secreted by the stomach lining after eating and accumulates on top of the stomach contents, forming an ‘acid pocket’.1–3 • Extension of the acid pocket above the LOS into the oesophagus, contributes to the symptoms of reflux. PEPSIN • A stomach enzyme, a non-acid factor in BILE • Bile has been found in higher concentrations in reflux sufferers which can contribute to mucosal injury.4,6 gastric reflux. 4 • Activity of pepsin is pH-dependent.5 2 Only Gaviscon blocks reflux by keeping stomach contents where they should be When reflux cannot be controlled with lifestyle modifications alone, antacids and alginate-based therapies are first-line pharmacotherapies for mild reflux.7 But did you know they have different modes of action? Mode of action Protects against Drug interactions • Forms a physical barrier against reflux.4,8 • Targets and displaces the acid pocket away from the LOS.8,10–12 • Acid, pepsin and bile.4,8 • None known.13 • Neutralises acid in the stomach.9 • Acid only.9,11 • Various.14 Gaviscon provides fast relief for the symptoms of reflux Gaviscon Dual Action provides relief from 4 minutes15 while Gaviscon Original Liquid provides relief that lasts up to 4 hours.8 For patients with frequent heartburn who need something stronger, PPIs can provide long-lasting relief, but can take time before peak reduction in acid secretion.16 Give your frequent heartburn sufferers fast relief while their PPI is taking effect: Gaviscon is there to provide fast relief, whether on its own or in conjunction with a PPI: For the occasional sufferer who needs fast-acting on-demand relief.17 For the frequent sufferer who may need a PPI to help block acid production plus may need fast-acting on-demand relief18 or to help with breakthrough symptoms.19 For people when stepping up or down with a PPI who need fast- acting on-demand relief18 while initiating PPI therapy or help relief of symptoms19 when stepping down off a PPI. Start PPI therapy Up to 5 days before peak reduction in acid secretion16 Assess outcome LOS=lower oesophageal sphincter; PPIs=proton-pump inhibitors. Gaviscon® Double Strength is for the relief of heartburn and indigestion. Liquids: Contains (per 10ml dose): 1000 mg sodium alginate, 200 mg potassium bicarbonate, 200 mg calcium carbonate. Tablets: Each tablet contains 500 mg sodium alginate, 267 mg sodium bicarbonate and 160 mg calcium carbonate. Gaviscon® Dual Action is for the relief of heartburn and indigestion. Liquids: Contains (per 10 ml dose): 500 mg sodium alginate, 213 mg sodium bicarbonate, 325 mg calcium carbonate. Tablets: Each tablet contains 250 mg sodium alginate, 106.5 mg sodium bicarbonate, 187.5 mg calcium carbonate. References: 1. Boeckxstaens G, et al. Gut 2014;63:1185–93. 2. Kahrilas P, et al. Am J Gastroenterol 2013;108:1058–64. 3. Fletcher J, et al. Gastroenterology 2001;121:775–83. 4. Strugula V, et al. J Pharm Pharmacol 2009;61:1021–8. 5. Kahrilas P. Cleveland Clinic J Med 2003;70(Suppl. 5):S4–S19. 6. Kauer WK, et al. Surgery 1997;122:874–81. 7. Therapeutic Guidelines, Disorders of the oesophagus. December 2020 edition. Available from www.tg.org.au (accessed Jan 2021). 8. Sweis R, et al. Aliment Pharmacol Ther 2013;37:1093–102. 9. MacFarlane B. Integr Pharm Res Pract 2018;7:41–52. 10. Rohof WO, et al. Clin Gastroenterol Hepatol 2013;11:1585–91. 11. De Ruigh A, et al. Aliment Pharmacol Ther 2014;40:531–7. 12. Kwiatek MA, et al. Aliment Pharmacol Ther 2011;34:59–66. 13. Gaviscon Summary of Product Characteristics, October, 2014. 14. Australian medicines handbook. Antacids. Last modified July 2020. Available from: amhonline. amh.net.au (accessed December 2020). 15. Strugula V, et al. J Int Med Res 2010;38:449–57. 16. Guardium (esomeprazole) Product Information. 17. Gaviscon Dual Action Product Label. 18. Gaviscon Double Strength Product Label. 19. Reimer C, et al. Aliment Pharmacol Ther 2016;43:899–909. ®Gaviscon is a registered trademark of the Reckitt Benckiser (Australia) Pty Ltd. Level 47, 680 George St, Sydney 2000, NSW Australia. Prepared January 2021. RB0222. ANTACIDS ALGINATES