RENNIE TAB 48/TAB

Indications

Approved Uses

Symptomatic relief of heartburn, acid indigestion/dyspepsia, and other acid-related stomach complaints (including reflux-related symptoms).

Dosage & Administration

Dosing by Condition

Heartburn/acid indigestion: 1-2 tablets chewed or sucked as needed, preferably after meals and at bedtime; do not exceed 8 tablets in 24 hours; seek medical advice if symptoms persist beyond ~14 days.

Initial Dose

1-2 tablets as symptoms occur.

Maintenance Dose

1-2 tablets as needed. For heartburn, an additional 1-2 tablets may be taken between regular doses.

Maximum Dose

Maximum 10 tablets in 24 hours.

Dose Adjustment Notes

No routine dose adjustment for short-term OTC use in normal renal function; use with caution in mild-moderate renal impairment and avoid/contraindicate in severe renal impairment due to risk of hypermagnesemia/hypercalcemia-consider monitoring calcium/magnesium/phosphate if prolonged or high-dose use is necessary.

How to Take

Oral: chew or suck the tablet until fully dissolved, then swallow; water is not required. Take when symptoms occur, typically after meals and at bedtime.

Side Effects

Common Side Effects

Constipation; diarrhea/loose stools; nausea/abdominal discomfort; belching/flatulence. With excessive/prolonged use: hypercalcemia, hypermagnesemia (especially in renal impairment), and milk-alkali syndrome.

Side Effect Frequency

At recommended doses, adverse effects are generally uncommon; GI effects can occur (constipation more with calcium salts; diarrhea more with magnesium salts), and excessive/prolonged use can cause hypercalcemia and milk-alkali syndrome (and hypermagnesemia particularly in renal impairment); hypersensitivity reactions are very rare.

Safety & Warnings

Contraindications

Hypersensitivity to ingredients; severe renal impairment; hypercalcemia and conditions predisposing to hypercalcemia/hypercalciuria; nephrolithiasis (calcium stones); hypophosphataemia.

Warnings & Precautions

Do not use continuously for >14 days without medical advice; avoid excessive doses and large amounts of milk/dairy (milk-alkali risk); use caution in renal impairment; separate from other oral medicines by ≥2 hours; seek medical review if symptoms persist/alarms occur.

Drug Interactions

Interaction Severity

MODERATE (reduced absorption): tetracyclines, fluoroquinolones, bisphosphonates, levothyroxine, iron salts-separate administration (typically ≥2 hours; levothyroxine ≥4 hours).

Food Interaction

Can be taken after meals for better symptom control; avoid excessive milk/dairy or other high-calcium intake when using frequently/high doses (risk of hypercalcemia/milk-alkali syndrome).

Special Populations

Pregnancy

Consult Doctor

Elderly

Use with caution; start with lowest effective dose; monitor renal function and serum electrolytes with regular use due to increased risk of accumulation

Kidney Impairment

Mild-moderate renal impairment: use with caution and avoid prolonged/high-dose use; severe renal impairment: contraindicated/avoid.

Storage & Patient Advice

Missed Dose

Not applicable (PRN): take only when symptoms occur; do not double doses.

Stopping the Medicine

Safe to stop anytime.

Overdose

Symptoms: GI upset (nausea, vomiting, constipation), thirst/polyuria, weakness; severe/prolonged overdose may cause hypercalcemia, hypermagnesemia (especially in renal impairment), metabolic alkalosis/milk-alkali syndrome and renal dysfunction; management: stop product, ensure hydration, check electrolytes/renal function and seek urgent care if significant symptoms.

Patient Counseling

Chew (or suck) 1-2 tablets as needed for symptom relief, preferably after meals and at bedtime; separate from other oral medicines by at least 2 hours; avoid prolonged continuous use (>14 days) without medical review; do not exceed the product-labeled maximum daily dose; seek advice before use in renal impairment and avoid excessive calcium intake (e.g., large amounts of milk/dairy or calcium supplements).

Monitoring Requirements

No routine monitoring for short-term use in healthy patients; if prolonged/high-dose use or renal impairment: monitor serum calcium, magnesium (and phosphate) and renal function.

Pharmacology

Mechanism of Action

Locally neutralizes gastric hydrochloric acid (buffering) to raise intragastric pH and reduce pepsin activity, providing rapid relief of acid-related symptoms.

Onset of Action

Within minutes (typically ~5-10 minutes; median ~5-6 minutes to raise gastric pH >3 in studies)

Duration of Effect

Approximately 1-3 hours (shorter if taken on an empty stomach; longer after meals).

Bioavailability

Low and variable: calcium absorption typically ~10-30% (can be higher with food/acidic conditions); magnesium absorption is limited, generally ~15-30% (higher risk of accumulation in renal impairment).

Metabolism

No metabolism (not applicable); acts locally by neutralizing gastric acid.

Excretion

Absorbed calcium and magnesium are excreted primarily by the kidneys; unabsorbed salts are eliminated in feces.

Product Information

Available Dosage Forms

Tablet (chewable/suckable) for oral use.

Composition per Dose

Each chewable tablet: 680mg Calcium Carbonate, 80mg heavy Magnesium Carbonate.

OTC Alternatives

Other OTC antacids (e.g., alginate/antacid products like Gaviscon; aluminum/magnesium hydroxide combinations like Maalox; sodium bicarbonate products), OTC H2-receptor antagonists (e.g., famotidine), and OTC PPIs for frequent heartburn (e.g., omeprazole)

Gi Condition

Acid Reflux/GERD

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