Alginic Acid
Brand names: Gaviscon Advance, Gaviscon Infant
Alginic acid is a raft-forming agent, usually combined with an antacid, used for the symptomatic relief of heartburn, acid reflux and dyspepsia.
Adult dose
Paediatric dose
Dose adjustments
§4.2, verbatim: 'Renal Insufficiency: Caution if highly restricted salt diet is necessary (see section 4.4).' No dose reduction is stated. §4.4 adds that the potassium content (1.0 mmol per 5 ml) must be taken into consideration in patients with reduced kidney function or on a controlled potassium diet.
§4.2, verbatim: 'Hepatic Impairment: No dose modification necessary.' §4.4 adds benzyl-alcohol advice for patients with liver disease.
Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.
Contraindications
- Known or suspected hypersensitivity to any of the ingredients, or to any of the excipients listed in section 6.1, including methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216)
Side effects
- Uncommon (≥1/1000 to <1/100): diarrhoea, nausea, vomiting
- Very rare (<1/10,000): anaphylactic and anaphylactoid reactions
- Very rare: hypersensitivity reactions such as urticaria
- Very rare: respiratory effects such as bronchospasm
Interactions
- §4.5: 'A time-interval of 2 hours should be considered between Gaviscon intake and the administration of other medicinal products, especially tetracyclines, fluoroquinolones, iron salts, thyroid hormones, chloroquine, bisphosphonates, and estramustine.'
Monitoring
- §4.4: 'If symptoms do not improve after 7 days, the clinical situation should be reviewed.'
- Sodium load — §4.4: 'This medicinal product contains 57.85 mg sodium per 5 ml, equivalent to 2.9 % of the WHO recommended maximum daily intake for sodium. The maximum daily dose of this product is equivalent to 23.14 % of the WHO recommended maximum daily intake for sodium. This product is considered high in sodium.' Take particular account of this in patients on a low salt diet, and per §4.2 use caution where a highly restricted salt diet is necessary
- Potassium — §4.4: 'This medicine contains 1.0 mmol (39.06 mg) potassium per 5 ml. To be taken into consideration by patients with reduced kidney function or patients on a controlled potassium diet.'
- Calcium — §4.4: 'Each 10 ml contains 200 mg (2.0 mmol) of calcium carbonate. Care needs to be taken in treating patients with hypercalcaemia, nephrocalcinosis and recurrent calcium containing renal calculi.'
- Excipients — contains methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216), which 'may cause allergic reactions (possibly delayed)'; contains 0.525 mg benzyl alcohol per 5 ml, with specific advice to seek pharmacist/doctor advice in pregnancy, breast-feeding, and liver or kidney disease because of the risk of metabolic acidosis with large amounts
- Separate administration from other oral medicines by 2 hours (§4.5)
Clinical monograph
How it works
In the acidic stomach it forms a viscous gel raft that floats on the gastric contents and acts as a mechanical barrier, reducing reflux of acid into the oesophagus.
Prescribing in practice
- Combination products containing sodium or calcium salts carry an electrolyte load, so check suitability in patients with sodium-restricted diets, renal impairment or heart failure.
- Administer after meals and at bedtime, and separate from other oral medicines to avoid impairing their absorption.
- Alarm features such as dysphagia, unintended weight loss or evidence of gastrointestinal bleeding require investigation rather than ongoing symptomatic treatment.
Monitoring
No specific monitoring is needed; review whether symptoms are controlled and reconsider the diagnosis if they persist.
Counselling the patient
- Take after meals and at bedtime for the best effect.
- Separate from your other tablets by a suitable interval.
- Seek review if heartburn persists or you develop swallowing difficulty.
Evidence & guidelines
Alginate-based raft therapy is an established option for reflux symptoms and is recognised in NICE dyspepsia guidance.
Reference: NICE CKS Dyspepsia — proven GORD (2023); NICE NG1 (Dyspepsia and gastro-oesophageal reflux disease, 2014 updated); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.
- DOAC Score for Selecting Direct Oral Anticoagulant in Non-Valvular AF · Anticoagulation
- Weight-Based Levothyroxine Dose Calculator · Thyroid
- DNACPR / ReSPECT Decision Support Tool · End-of-Life Care
- Los Angeles (LA) Grading of Reflux Esophagitis · Esophageal Disease
- Ho Index — Acute Severe Ulcerative Colitis · Inflammatory Bowel Disease
- Tumor Lysis Syndrome (Cairo-Bishop Criteria) · Oncological Emergency
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Acute Liver Failure · EASL 2017 / BSG
- Decompensated Cirrhosis · BSG 2015 / EASL 2018