Sodium alginate with potassium bicarbonate

How it works

On contact with gastric acid the alginate forms a viscous gel raft that floats on the stomach contents, while bicarbonate reacts with acid to generate carbon dioxide that buoys the raft, physically reducing reflux of acid into the oesophagus.

Prescribing in practice

• The potassium content means caution is needed in renal impairment and with other sources of potassium or potassium-sparing drugs; the sodium content is relevant where salt intake must be restricted.
• It should be separated in time from other medicines, as the raft can impair absorption of co-administered drugs.
• It is intended for short-term symptomatic relief and is taken after meals and at bedtime; persistent symptoms warrant review.

Monitoring

No routine monitoring is needed for short-term use, but consider potassium and sodium load in renal impairment or where electrolyte intake is restricted.

Counselling the patient

• Take after meals and at bedtime for best effect.
• Leave a gap before or after other medicines.
• Seek review if heartburn persists, worsens or is accompanied by difficulty swallowing or weight loss.

Evidence & guidelines

Alginate raft-forming preparations provide established symptomatic relief of reflux and are recommended within NICE dyspepsia and GORD guidance.