Gastal ® lozenges. Is Gastal suitable for pregnant women, nursing mothers and children: how harmless is the usual medicine for heartburn? Gastal lozenges instructions

According to the instructions for use of the drug, Gastal can be used during pregnancy, lactation and childhood. Despite the relative safety of the drug, it is necessary to follow the recommendations for its use, know the mechanism of action, contraindications and side effects that may occur during therapy.

During the period of bearing a child, a number of physiological changes occur in the female body. Many organs and systems are involved in the restructuring process. Changes in the functioning of the gastrointestinal tract lead to dyspeptic symptoms, including heartburn.

Such mechanisms predispose a pregnant woman to a subjective feeling of burning in the esophagus:

• relaxation of the cardinal (lower) sphincter of the esophagus under the influence of progesterone;
• emotional instability;
• compression of the stomach by the growing uterus;
• toxicosis;
• physical inactivity;
• exacerbation of diseases of the digestive system;
• unusual food preferences.

Under normal conditions, hydrochloric acid does not enter the esophagus. During the period of bearing a baby, especially in the later stages, the digestive organs are pushed upward. As a result, the contents of the stomach are released under pressure into the esophagus.

The esophageal mucosa has no protection from the aggressive effects of hydrochloric acid. Irritation occurs, and with constant reflux (reverse reflux) - tissue damage with the development of inflammation and erosion. This causes a burning sensation in the chest, in the throat, and sour belching.

The prescription of any drug during pregnancy is carried out with great caution, since the active substances of the drugs can penetrate the placental barrier and affect the developing fetus.

Gastal contains aluminum and magnesium hydroxides, which, interacting with gastric juice, neutralize it and form a gel that envelops and protects the mucous membrane. Insoluble magnesium and aluminum salts are excreted in feces without being absorbed into the systemic circulation. Gastal is used in pregnant women, 1 tablet symptomatically, no more than 5 times a day.

Lactation

The instructions for use indicate that lactation is not a contraindication to taking Gastal. The active substances of the drug are not absorbed into the bloodstream and act only in the digestive tract. This determines the fact that when an antacid is used, it does not penetrate into the milk.

When feeding a child, a woman usually follows a diet that eliminates the occurrence of dyspeptic symptoms that provoke discomfort in the baby. After childbirth, heartburn, provoked by changes in the body during pregnancy, goes away. But organic damage to the esophagus and stomach may remain, which continues to bother the woman after the birth of the child.

With long-term use of Gastal, especially in large doses, side effects may occur, which are expressed in:

• bowel disorders: constipation or diarrhea;
• softening and fragility of bones;
• increased calcium, aluminum, magnesium in the blood (dysmetabolic disorders);
• deposition of calcium salts in the kidneys;
• encephalopathy;
• renal dysfunction.

These changes during breastfeeding (BF) negatively affect the baby's health. The baby may experience developmental delay, spasmophilia, intestinal dysfunction, and allergies.

Adverse reactions when taking Gastal occur extremely rarely. The drug is considered safe for use in breastfeeding, since it does not enter the baby’s body and does not have a direct effect on it. It is important that the mother adheres to the regimen of taking the drug, which involves either periodically taking 1-2 tablets when heartburn occurs, or in a course for 14 days when stomach diseases worsen.

For children

Children are prescribed antacids in the form of suspensions for heartburn. Currently, Gastal is not available in liquid form, but in children over 6 years of age it is possible to use an acid-lowering medicine in tablets.

The most common reason for using antacids in pediatric practice is. The reflux of gastric juice damages the delicate mucous membrane of the child’s esophagus, causing the development of erosion. Complex therapy includes the use of antacids, drugs that normalize the motility of the digestive tract, and drugs that affect the acid-forming function of the stomach.

In childhood, it is recommended to drink Gastal, half a tablet 2-3 times a day, an hour after meals. The course of treatment should not exceed two weeks. In children over 12 years of age weighing more than 50 kg, the regimen for taking antacid tablets corresponds to that of adults.

Gastal is a modern antacid that helps get rid of the painful sensation of heartburn. Due to its composition and pharmacological action, it is one of the drugs that can be taken by pregnant women, lactating women and children over 6 years of age.

1 lozenge contains:
active substances: aluminum hydroxide-magnesium carbonate gel 450.00 mg, magnesium hydroxide 300.00 mg;
Excipients: mannitol (E421), sorbitol (E420), lactose monohydrate, corn starch, sodium cyclamate, sodium saccharinate, talc, magnesium stearate

pharmachologic effect

Gastal- 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 action 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.

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.

Carefully:
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.

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.
Duration of treatment is no more than 2 weeks.

For patients with chronic renal failure no dose adjustment is required.

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-anticholinergics, by slowing down gastric motility, increase the duration of action of the drug Gastal.

Gastal belongs to antacid drugs - drugs that reduce stomach acidity. Additional tasks include relieving heartburn, eliminating increased gas formation, heaviness and pain in the gastrointestinal tract. At the same time, Gastal eliminates only the symptoms of diseases that will have to be treated in other ways. However, it is still quite an effective and popular remedy for the symptoms of gastritis, ulcers and other stomach problems.

The drug is available in the form of tablets, depending on the manufacturer, having a white or cream color. Each of them contains 0.45 g of aluminum hydroxide-magnesium carbonate gel and 0.3 g of magnesium hydroxide. To give the active ingredients the necessary properties (taste, smell, color and dosage accuracy), Gastal tablets contain sorbitol, mannitol, corn starch, magnesium stearate, talc and lactose monohydrate.

How the drug works

The action of the tablets is based on the fact that the active substances contained in the medicine neutralize acid in the stomach, maintaining the acidity pH at a natural level (3-5). The drug begins to act immediately after administration. And its effectiveness lasts for 2 hours. Neutralization of the action of acids, in turn, increases the protection of the gastrointestinal mucosa and accelerates the healing of erosions and ulcers.

Indications and contraindications

Sleep therapy based on Gastal is prescribed when the following is detected in a patient:

• heartburn, gastritis, duodenal and stomach ulcers;
• digestive disorders caused by poor diet, illness, abuse of alcohol, tobacco products and coffee;
• damage to the gastric mucosa;
• hiatus hernia;
• acute form of pancreatitis;
• gastroesophageal reflux disease.

Contraindications to taking the medicine are the presence of Alzheimer's disease and hypophosphatemia, severe renal failure. Gastal is prohibited from use by patients suffering from lactose intolerance and sensitivity to the components of the drug (magnesium and aluminum salts). It poses a certain danger to children under 6 years of age and to patients undergoing hemodialysis with porphyrin disease.

It is not prohibited, but it is not recommended to take Gastal for people with mild forms of renal failure, during pregnancy and during lactation. Heartburn should be treated with caution in children aged 6 to 12 years and elderly patients. And the dosage for people weighing up to 50 kg should be reduced.

Medicine dosage

Gastal is taken orally by dissolving tablets:

• adults weighing more than 50 kg and children over 12 years of age are prescribed 1-2 tablets an hour after meals and before bedtime. The course of treatment is up to 2 weeks;
• Therapy for children 6–12 years old, as well as adults weighing less than 50 kg, involves taking half the standard dose at the same time and for the same period.

If severe heartburn occurs, the drug is prescribed in the same amount, regardless of food intake. For patients with renal failure, the dosage is not reduced. However, before starting to use Gastal, such patients should consult a doctor for recommendations regarding treatment.

Side effects from use

Taking the drug rarely leads to side effects. And an allergy to the action of active substances can manifest itself in the form of:

• diarrhea;
• constipation;
• changes in taste sensations.

In rare cases, an allergic reaction to the components of Gastal is nausea or vomiting. And if you have kidney problems, sometimes there is a decrease in blood pressure and the appearance of causeless thirst. All side effects are mainly the consequences of using the medicine for too long and stop after you stop taking it.

Overdose

If the dose of Gastal is exceeded, symptoms such as facial redness, muscle weakness, numbness, exhaustion and inappropriate behavior may appear, including changes in mood and mental activity. Due to the fact that the drug is almost not absorbed, an overdose can lead to hypermagnesemia (increased magnesium content in the body). If an overdose is suspected, immediate discontinuation of the drug and the adoption of measures to remove it from the gastrointestinal tract, including gastric lavage and the use of activated charcoal, are required.

Drug interactions

It is recommended that at least 1 hour pass between doses of Gastal and other medications. With simultaneous use or non-compliance with this period, it is possible to enhance the effect of nalidixic acid and levodopa, as well as reduce the effect of drugs such as chlorpromazine, phenytoin, barbiturates, indirect anticoagulants, beta-blockers, indomethacin, cardiac glycosides, fat-soluble vitamins and iron preparations.

Administration during pregnancy and lactation

Pregnant women are not recommended to use antacids due to their high aluminum content. An excess of this metal in the body leads to a risk of bone tissue damage in newborns and infants. Therefore, when heartburn occurs in pregnant women, it is recommended to use other medications that do not contain aluminum salts.

Due to the likelihood of aluminum salts getting into breast milk, it is not advisable to take Gastal during feeding. In a number of countries, nursing women are prohibited from treating heartburn with this drug due to the possibility of side effects and allergic reactions from taking it not only in the mother, but also in the child.

Important! The use of Gastal during pregnancy and lactation is allowed only in a situation where the positive effect on the mother’s health is higher than the expected risk to the fetus.

During lactation, single doses are allowed in case of heartburn.

Analogues and prices

Due to the fact that drugs from the antacid group are interchangeable, there are many analogues for Gastal. Although you should not replace it with other means yourself - for this you need to consult a doctor. The list of medications with a similar medicinal effect consists of Domrid, Pepsan, Gaviscon, Rennie, Kvamatel, Leovit, Talcid, Gastrikumel and a number of other drugs. The range of analogues is represented not only by tablets, but also by jelly and solutions. Like the main drug, they all only help relieve symptoms, but do not cure the disease.

The cost of the medicine at the end of 2016 is about 400 rubles. per pack of 30 tablets. A package of 12 tablets will cost 120–180 rubles. And 60 tablets can be bought for about 450–500 rubles.

Advice: due to the fact that a course of treatment on average requires about 40–60 tablets, it is most profitable to buy a large pack. This will save you up to 40% of the price. And, even if the medicine is not completely used, it can be used for 3 years.

Reviews about the drug

The medicine Gastal, popular on the domestic market, receives many reviews on medical websites. Both patients and doctors leave their impressions of the use of the medicine:

Alexander, gastroenterologist, 42 years old: The drug copes quite successfully with heartburn. Has a good price-performance ratio. Although its effect is temporary. And the symptoms appear again after a while. Often patients take it on their own because Gastal is available without a prescription.

Anna K., patient, 35 years old: I like the medicine. Before I started taking it, almost every meal resulted in heartburn. Over time, the body got used to it and the drug became less effective. I had to stop drinking it and resume taking it only after a while.

Dmitry S., patient, 41 years old: For many years in a row I did not watch my diet, drank alcohol and smoked. Recently I started experiencing an unpleasant cutting sensation in my stomach. I had to give up bad habits and consult a doctor. The hospital recommended using Gastal as a medicine that has a restorative effect. Now, when heartburn worsens, taking 2-3 tablets a day is enough for me to get rid of pain for several days.

Oksana V., patient, 51 years old: Stomach problems often appear, especially after lunch. She noted that the reason for this was most likely the food from the canteen. A friend who has a similar problem advised Gastal. I tried a pleasant-tasting and easily absorbable drug and decided to use it to get rid of heartburn. I take it only after meals, and I refused to eat canteen food - although with Gastal I can always be sure of normal health.

Other Features

The drug can be bought in pharmacies without a prescription. And it must be stored in dark places inaccessible to children. The shelf life of Gastal (temperature no more than +25 degrees) is up to 36 months from the date of release.

The medicine does not affect the reaction rate at all. Therefore, it can be taken before starting to operate complex machinery or drive.

Gastal- a combined antacid that reduces the increased acidity of gastric juice and does not have a stimulating effect on the secretion of gastric juice.

The drug Gastal suppresses the effect of pepsin, lysolecithin and bile acids, eliminates dyspeptic symptoms. Strengthens protective and regenerative processes in the gastric mucosa.

Pharmacological properties

Pharmacodynamics. 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. 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 of Gastal

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.

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.

Features of application

The recommended dose and duration of treatment should not be exceeded when used in patients with impaired renal function. The use of the drug Gastal does not affect the ability to drive vehicles or control other mechanisms.

Side effects

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.

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 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.

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.

Questions and answers on the topic "Gastal"

Question:When and in what dosage should Gastal be prescribed to patients?

Answer: Gastal should be prescribed internally for increased acidity of gastric juice, food poisoning and peptic ulcer of the duodenum and stomach, chronic and acute hyperacid gastritis (inflammatory process in the stomach as a result of a persistent increase in acidity). Due to the fact that this drug has the property of binding phosphates and delaying their absorption from the gastrointestinal tract, there is also its use for increased levels of phosphates in the blood (hyperphosphatemia), which accompanies renal failure. Dosage: This drug should be taken 4-6 times a day, 1-2 tablets (1 hour after meals). The tablets must be swallowed and not chewed under any circumstances.

With long-term use in 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. Increased side effects from the gastrointestinal tract (constipation, diarrhea) are possible. In patients with concomitant renal failure - thirst, decreased blood pressure, hyporeflexia. If these symptoms appear, symptomatic treatment should be carried out.

Interaction of Gastal with other drugs

The interval between taking Gastal and other medications should be 1-2 hours.

Gastal enhances the activity of levodopa and nalidixic acid; reduces and slows down the absorption of tetracycline antibiotics, ciproflocacin and ofloxacin, salicylates, isoniazid, naproxen, iron preparations, cardiac glycosides, indomethacin, aminazine, phenytoin, H2-blockers, beta-blockers, diflunisal, fat-soluble vitamins, indirect anticoagulants, barbiturates .

M-anticholinergic blockers, by slowing down gastric emptying, enhance and prolong the effect of gastal.

over-the-counter remedy.

Manufacturers: Pliva Krakow, Pharmaceutical Plant A.O., Poland, Pliva Hrvatska d.o.o., Croatia.

Instructions from the manufacturer (pdf):

• “Instructions for medical use of the drug Gastal (tablets)”
• "Instructions for medical use of the drug Gastal (lozenges, mint and cherry)"