Simeticone with aluminium hydroxide and magnesium hydroxide

How it works

Aluminium and magnesium hydroxides neutralise gastric acid to raise intragastric pH, while simeticone lowers the surface tension of gas bubbles to aid their dispersal; the combined magnesium and aluminium salts balance their opposing effects on bowel habit.

Prescribing in practice

• Antacids reduce the absorption of many drugs and should be separated in time from agents such as tetracyclines, quinolones, iron and certain other medicines; aluminium- and magnesium-containing products require caution in renal impairment owing to accumulation.
• Magnesium salts tend to cause diarrhoea and aluminium salts constipation, so bowel habit may shift depending on the balance.
• It is for short-term symptomatic use; persistent or alarm symptoms warrant investigation.

Monitoring

No routine monitoring is required for short-term use, but review symptom control and exercise caution with repeated use in renal impairment.

Counselling the patient

• Take after meals and at bedtime when symptoms occur.
• Leave a gap before or after other tablets, as antacids can stop them working properly.
• See your prescriber if symptoms persist, worsen or are accompanied by weight loss or difficulty swallowing.

Evidence & guidelines

Compound antacids provide established short-term symptomatic relief of dyspepsia, consistent with NICE dyspepsia guidance.