Sodium alginate with calcium carbonate and sodium bicarbonate

How it works

On contact with gastric acid the alginate precipitates into a viscous gel raft that floats on the stomach contents and physically impedes reflux, while the carbonate components neutralise acid and generate the gas that buoys the raft.

Prescribing in practice

• Each dose carries a notable sodium load from the bicarbonate and alginate, so use with caution in patients on a restricted-sodium diet or with heart failure, hypertension or significant renal impairment.
• Take after meals and at bedtime, and separate dosing from other oral medicines as the raft and the antacid component can reduce absorption of concurrently administered drugs.
• Persistent, worsening or alarm symptoms (dysphagia, weight loss, gastrointestinal bleeding) warrant investigation rather than continued self-treatment.

Monitoring

Routine laboratory monitoring is not required, but review symptom control and reconsider the diagnosis if reflux symptoms persist despite regular use.

Counselling the patient

• Take after meals and at bedtime for best effect on reflux.
• Leave a gap before or after other tablets to avoid reducing their absorption.
• See your prescriber if symptoms persist, worsen, or you have difficulty swallowing.

Evidence & guidelines

Raft-forming alginate preparations are recommended in NICE guidance as an option for the symptomatic management of dyspepsia and gastro-oesophageal reflux.