1.1.1 Antacids and simeticone

Prescribing Notes

• Refer to NICE clinical guideline on dyspepsia and gastro‑oesophageal reflux disease (2014) here.
• Particular care is required in patients presenting with ‘alarm features’.
• Multi-ingredient GI preparations such as Peptac^® should not be prescribed generically.
• Antacids are best given when symptoms occur or are expected, usually between meals and at bedtime.
• Antacids should preferably not be taken at the same time as other drugs since they may impair absorption and can damage enteric coatings designed to prevent dissolution in the stomach.
• Use a low sodium content preparation for patients suffering from hypertension or heart failure, e.g. co-magaldrox.
• Compound alginic acid preparations are less powerful antacids than co-magaldrox but may be more effective for heartburn. They are significantly more expensive than simple antacids.
• Antacids may be useful to be taken as required when patients are stepping down or stopping treatment with long-term PPI/acid suppression therapy.