ACICAL PLUS CHEW TAB 30/TAB

Indications

Approved Uses

Symptomatic relief of heartburn/acid indigestion (dyspepsia due to gastric hyperacidity) and relief of bloating/pressure/flatulence associated with excess gas.

Dosage & Administration

Dose Adjustment Notes

Renal impairment: use with caution and avoid prolonged/frequent use due to risk of aluminium accumulation; use the lowest effective dose for the shortest duration and seek medical advice if ongoing need.

How to Take

Chew tablets thoroughly before swallowing; take after meals and at bedtime as needed (may be taken with or without water). Do not swallow whole.

Side Effects

Common Side Effects

Constipation (most common), nausea, chalky taste; less commonly diarrhea or abdominal discomfort/cramps.

Side Effect Frequency

Common (≥1%): constipation (aluminium salts) and diarrhea (can occur with antacids depending on salt balance); Uncommon (<1%): nausea; with prolonged/high-dose use: hypophosphatemia and aluminium accumulation/toxicity risk especially in renal impairment.

Safety & Warnings

Contraindications

Hypersensitivity to any component; severe renal impairment; hypophosphataemia

Warnings & Precautions

Do not use for >14 days without medical advice; seek medical review if symptoms persist/worsen; use caution in renal impairment and in patients with low phosphate; separate from other oral medicines by 2-4 hours; consider sodium content in sodium-restricted patients

Driving Warning

Safe

Special Populations

Elderly

Use with caution; elderly patients may have reduced renal function increasing risk of aluminium accumulation. Use lowest effective dose for shortest duration.

Kidney Impairment

No specific dose adjustment provided; use with caution and avoid prolonged/frequent use in moderate-to-severe renal impairment (contraindicated in severe renal impairment)

Liver Impairment

No adjustment needed.

Storage & Patient Advice

Stopping the Medicine

Safe to stop anytime when symptoms resolve.

Overdose

Overdose may cause GI effects (constipation, nausea/vomiting, abdominal discomfort) and can cause hypophosphataemia; in renal impairment or very large/prolonged doses, aluminium toxicity may occur-manage supportively and seek medical attention/poison center advice for significant ingestion

Monitoring Requirements

No routine monitoring for short-term use. Monitor serum phosphate and aluminium levels with prolonged use, especially in renal impairment.

Pharmacology

Mechanism of Action

Dihydroxyaluminium sodium carbonate neutralizes gastric acid and increases intragastric pH; simethicone is an antifoaming agent that lowers surface tension of gas bubbles, promoting coalescence and easier expulsion.

Half-Life

Not applicable / not clinically meaningful due to local GI action with minimal (aluminium) or no (simethicone) systemic absorption.

Bioavailability

Minimal systemic absorption for dihydroxyaluminium sodium carbonate; simethicone is not systemically absorbed (acts locally in the GI tract).

Metabolism

No systemic metabolism; dihydroxyaluminium sodium carbonate undergoes local chemical neutralization reactions in the stomach, and simethicone is not metabolized (physiologically inert).

Excretion

Primarily excreted in feces; any small absorbed aluminium fraction is eliminated renally (urine), while simethicone is excreted unchanged in feces.

Protein Binding

Not applicable (negligible systemic absorption); if absorbed, aluminium may bind to plasma proteins (e.g., transferrin/albumin), so '0%' is not appropriate.

Product Information

Available Dosage Forms

Chewable tablet

Generic Availability

Yes

OTC Alternatives

Other OTC antacids (calcium carbonate; aluminium/magnesium combinations; alginate-based antacids) and antiflatulents (simethicone-only products).

Gi Condition

Acid Reflux/GERD

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