Antacid / Alginate (GORD Treatment)

Alginic Acid

Brand names: Gaviscon Advance, Gaviscon Infant

Adult dose

Dose: Gaviscon Advance: 10–20 mL (or 2–4 tablets)

Route: Oral

Frequency: After meals and at bedtime (up to 4 times daily)

Clinical pearls

Acts by forming a raft on gastric contents, providing physical barrier against reflux
Gaviscon Advance (alginate + potassium bicarbonate) — most commonly used formulation; no antacid component
Gaviscon Original contains sodium alginate + sodium bicarbonate + calcium carbonate
Safe in pregnancy for GORD symptoms
Preferred OTC/first-line option before PPIs for mild intermittent reflux
Infant formulations (Gaviscon Infant) contain no antacid and are suitable for feeding-related regurgitation

Contraindications

Gaviscon Advance contains potassium — caution in renal impairment and hyperkalaemia
Phenylketonuria (some preparations contain aspartame)

Side effects

Generally well tolerated
Flatulence
Constipation (less common than with antacids alone)
Sodium content — relevant in heart failure, hypertension, renal impairment (check formulation)

Interactions

May impair absorption of other drugs — take other medications 2 hours apart
Antacids — combination products (Gaviscon) contain sodium bicarbonate; limit with sodium-restricted diets

Monitoring

Symptom control at 4 weeks
Sodium intake in patients with hypertension, heart failure, or renal impairment
Potassium levels if using Gaviscon Advance in renal impairment

Reference: BNF; NICE CKS Dyspepsia — proven GORD (2023); NICE NG1 (Dyspepsia and gastro-oesophageal reflux disease, 2014 updated); https://bnf.nice.org.uk/drugs/alginic-acid/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways