GAVISCON DOUBLE ACTION SUSP 300ML

Indications

Approved Uses

Symptomatic treatment of gastro‑oesophageal reflux (e.g., acid regurgitation, heartburn and indigestion), including post‑prandial symptoms and reflux in pregnancy.

Dosage & Administration

Dosing by Condition

Adults and adolescents ≥12 years: 10-20 mL after meals and at bedtime (up to 4 times daily). Children <12 years: use only on medical advice (local labeling varies).

Initial Dose

10-20ml after meals and at bedtime

Maintenance Dose

10-20ml up to 4 times daily after meals and at bedtime

Maximum Dose

80 ml per day (20 ml, four times a day).

Children's Dosage

Children 6-12 years: 5-10ml after meals and at bedtime, up to 4 times daily. Children under 6 years: use only under medical supervision.

Dose Adjustment Notes

No hepatic dose adjustment is required; use caution in renal impairment and in patients on a restricted sodium diet/with heart failure due to sodium load, and avoid/prolonged high-dose use in severe renal impairment because of electrolyte (e.g., calcium) accumulation risk.

How to Take

For oral use: shake well before each use; measure the dose with a measuring spoon/cup; take after meals and at bedtime; do not exceed the maximum daily dose stated on the label.

How to Prepare

Ready-to-use oral suspension; no reconstitution required. Shake well before use and measure the dose using a suitable measuring device.

Side Effects

Common Side Effects

Constipation and flatulence (bloating) are the most commonly reported; other GI upset (e.g., nausea) can occur.

Side Effect Frequency

Very rare (<1/10,000): hypersensitivity reactions (e.g., rash/urticaria), anaphylactic/anaphylactoid reactions, bronchospasm; Frequency not known/rare: GI effects such as nausea, constipation, diarrhoea, vomiting, abdominal distension/flatulence; Metabolic effects (e.g., hypercalcaemia, metabolic alkalosis) are uncommon and typically associated with excessive/prolonged use or predisposition (e.g., renal impairment).

Safety & Warnings

Contraindications

Contraindicated in hypersensitivity to any ingredient; avoid/contraindicated in significant renal impairment and in patients with hypercalcaemia (or conditions predisposing to it).

Warnings & Precautions

Consider sodium load in patients on salt-restricted diets (e.g., heart failure, hypertension, renal impairment); use caution in hypercalcaemia, nephrocalcinosis, and recurrent calcium-containing renal stones; avoid prolonged/high-dose use; if symptoms persist >7 days or worsen, seek clinical review.

Age Restriction

Children <12 years: use only on medical advice; children <6 years: only under medical supervision.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Separate from other oral medicines by at least 2 hours; particularly tetracyclines, fluoroquinolones, iron salts, thyroid hormones (levothyroxine), bisphosphonates, chloroquine, estramustine.

Interaction Severity

MODERATE: reduces absorption of tetracyclines, fluoroquinolones, iron salts, bisphosphonates, levothyroxine/thyroid hormones, chloroquine, and estramustine-separate administration by at least 2 hours (up to 4 hours for some agents per their labeling).

Food Interaction

Take after meals and at bedtime; avoid taking simultaneously with large amounts of milk/dairy or other high-calcium products if using frequently.

Alcohol Interaction

Safe

Special Populations

Pregnancy

Safe

Breastfeeding

Safe

Children

Children 6-12 years: 5-10ml after meals and at bedtime, up to 4 times daily. Children under 6 years: use only under medical supervision.

Elderly

Standard adult dosing; use with caution in elderly patients with renal impairment, heart failure, or on sodium-restricted diets due to sodium content

Kidney Impairment

Use with caution in mild renal impairment and in patients requiring sodium restriction; avoid/contraindicated in moderate to severe renal impairment.

Liver Impairment

No dose adjustment required in hepatic impairment.

Storage & Patient Advice

Storage Conditions

Store below 30°C. Do not freeze. Keep bottle tightly closed. No reconstitution required; ready-to-use suspension.

Preparation Instructions

Ready-to-use oral suspension; no reconstitution required. Shake well before use and measure the dose using a suitable measuring device.

Missed Dose

If used regularly, take the missed dose when remembered unless it is close to the next dose; do not double. If used as needed, take when symptoms occur (typically after meals/at bedtime).

Stopping the Medicine

Safe to stop anytime if symptoms resolve. Consult a doctor if symptoms persist for more than 7 days.

Overdose

Usually minor (e.g., abdominal distension/belching); with large or prolonged excessive doses, risk of metabolic alkalosis and hypercalcaemia (milk‑alkali syndrome) - manage symptomatically, stop product, consider hydration and medical assessment if significant ingestion or symptoms.

Patient Counseling

Shake well; measure doses accurately; take after meals and at bedtime; do not exceed the labeled maximum daily dose; separate from other oral medicines by at least 2 hours; consult a clinician if symptoms persist/worsen (commonly >7 days) or if alarm features occur; use caution with renal impairment/heart failure or low-sodium diets; store below 30°C.

Monitoring Requirements

No routine monitoring for short-term OTC use; seek medical advice if symptoms persist or worsen (commonly if not improved within 7 days) and consider electrolyte/calcium monitoring only with prolonged high-dose use or in renal impairment.

Pharmacology

Mechanism of Action

Sodium alginate reacts with gastric acid to form a viscous, buoyant ‘raft’ barrier that sits on top of stomach contents and reduces reflux; calcium carbonate and sodium bicarbonate neutralize gastric acid to provide rapid symptom relief.

Onset of Action

Rapid-typically within a few minutes (about 3-4 minutes).

Duration of Effect

Up to about 4 hours.

Half-Life

Not applicable (no clinically meaningful systemic half-life); duration relates to gastric residence/raft persistence rather than plasma kinetics.

Bioavailability

Negligible systemic bioavailability; primary action is local in the stomach (raft formation/neutralization), with only limited absorption of some ions (e.g., sodium, calcium, bicarbonate-derived).

Metabolism

No clinically relevant systemic metabolism; alginate is not absorbed and is not metabolized systemically (carbonate/bicarbonate participate in normal acid-base chemistry).

Excretion

Alginate raft is eliminated in feces; any absorbed ions (e.g., calcium/sodium) are handled physiologically and excess is primarily renally excreted.

Protein Binding

Not applicable (no meaningful systemic absorption, therefore no clinically relevant plasma protein binding).

Product Information

Available Dosage Forms

Oral suspension

Composition per Dose

Each 10ml of oral suspension: 500mg sodium alginate, 213mg sodium bicarbonate, 325mg calcium carbonate.

Generic Availability

No

OTC Alternatives

Other antacids/alginate products; H2-receptor antagonists (e.g., famotidine); proton pump inhibitors (e.g., omeprazole) where OTC; non-systemic antacid combinations (e.g., aluminum/magnesium hydroxide).

Gi Condition

Acid Reflux/GERD

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