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Antacid / Alginate (GORD Treatment) Pregnancy: Can be used during pregnancy and breast-feeding if clinically needed. §4.6 verbatim: 'Clinical studies in more than 500 pregnant women as well as a large amount of data from post-marketing experience indicate no malformative nor foeto/neonatal toxicity of the active substances. Gaviscon can be used during pregnancy, if clinically needed.' Breast feeding: 'No known effect on breast fed infants. Gaviscon can be used during breast feeding.' Fertility: 'No known effect on human fertility.' Note the separate §4.4 benzyl alcohol advice: patients who are pregnant or breast-feeding should ask a doctor or pharmacist for advice.

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

Dose: Symptoms of acid reflux — heartburn, acid regurgitation, reflux-related indigestion (GORD) — Gaviscon Advance Aniseed flavour Oral Suspension: 5-10 ml, adults and children 12 years and over. SCOPE: this volume belongs to this named suspension and must not be transferred to any other alginate preparation; Gaviscon Infant, this page's other listed brand, is a different product and is NOT covered by this SPC.
Route: Oral suspension.
Frequency: After meals and at bedtime (§4.2).
§4.1 of the fetched product, verbatim: 'Treatment of symptoms resulting from the reflux of acid, bile and pepsin into the oesophagus such as acid regurgitation, heartburn, indigestion (occurring due to the reflux of stomach contents) … accompanying reflux oesophagitis, including symptoms of laryngopharyngeal reflux…'. §4.2, verbatim: 'Adults and children 12 years and over: 5-10ml after meals and at bedtime. Children under 12 years: Should be given only on medical advice. Elderly: No dose modification is required for this age group. Hepatic Impairment: No dose modification necessary. Renal Insufficiency: Caution if highly restricted salt diet is necessary (see section 4.4).' Both numbers in the dose line are printed there. || NO MAXIMUM DOSE IS PUBLISHED, AND THAT IS DELIBERATE. §4.2 prints no ceiling. §4.4 refers to 'The maximum daily dose of this product' but expresses it only as a percentage of the WHO recommended maximum sodium intake ('equivalent to 23.14 % …'), never as millilitres or doses — converting that percentage into a volume would be arithmetic on the label, not a figure the label prints, so maxDose is left unset. The top of the 5-10 ml band is a per-dose range, not a stated maximum, and is not promoted into maxDose either. || SUBSTANCE-NAME CAVEAT, FOR A CONTENT DECISION RATHER THAN A RE-FETCH: this page is titled 'Alginic Acid' but categorised as an alginate/antacid class page, and the fetched product is a raft-forming alginate supplied under that class and named in the page's own brandNames. The bundle contains no §1/§2 composition section, so nothing in it evidences the precise alginate salt; the site's own clinical pearls describe Gaviscon Advance as 'alginate + potassium bicarbonate'. The dose is therefore published PRODUCT-SCOPED — the product is named inside the dose text — and must not be read as a figure for alginic acid as a bare substance or for any other alginate. If the page is meant to carry alginic acid as a distinct named substance, the page should be renamed/split rather than this source replaced. || ELDERLY: §4.2, verbatim: 'No dose modification is required for this age group.' HEPATIC: 'No dose modification necessary.' RENAL: 'Caution if highly restricted salt diet is necessary' — see the sodium and potassium entries under monitoring.

Paediatric dose

Dose: Children under 12 years: 'Should be given only on medical advice' (§4.2). This SPC states no numeric dose for under-12s.
Route: Oral suspension.
NO PAEDIATRIC NUMBER IS PUBLISHED because the label prints none: §4.2 covers 'Adults and children 12 years and over' with 5-10 ml and refers everyone under 12 to medical advice. Gaviscon Infant — this page's other listed brand, and the whole of its infant/regurgitation use — is a SEPARATE product with different constituents and its own sachet-based dosing, and no part of it appears in this bundle; the adult 5-10 ml volume must never be applied to it. Confirm any dose for a child under 12 against a children's formulary.

Dose adjustments

Renal

§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.

Hepatic

§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.