Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension
Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension Uses, Dosage, Side Effects, Food Interaction and all others data.
Each tablet contains-
Dried Aluminium Hydroxide Gel BP 425.53 mg or 200 mgMagnesium Hydroxide 400 mg or 200 mgSimethicone 30 mgEach 5 ml Suspension contains-
Aluminium Oxide 200 mgMagnesium Hydroxide 400 mgSimethicone 30 mgThis drug is the mixture of non-systemic acid neutralizing substances and antiflatulent. This preparation offers reliability as well as long action. Aluminium Hydroxide and Magnesium Hydroxide induce the relief of ulcer by neutralizing gastric acid secreted from parietal cells of the stomach. The clinical use of simethicone is based on its antifoam properties. Simethicone spreads on the surface of aqueous liquids, forming a film of low surface tension and causing collapse of foam bubbles. Simethicone repeatedly allows mucous surrounded gas bubbles in the GI tract to coalesce and be expelled.
| Trade Name | Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension |
| Generic | Aluminium Hydroxide + Magnesium Hydroxide + Simethicone |
| Weight | (400 mg+400 mg+30 mg)/5 ml |
| Type | Oral Suspension |
| Therapeutic Class | Antacids |
| Manufacturer | Edruc Ltd. |
| Available Country | Bangladesh |
| Last Updated: | September 24, 2024 at 5:38 am |
Uses
This is used for dyspepsia, hyperacidity, gastric and duodenal ulcer, gastritis; also used for the relief of flatulence, abdominal distention and windy colic.
Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension is also used to associated treatment for these conditions: Acid indigestion, Colic, Constipation, Dyspepsia, Flatulence, Gastric Ulcer, Heartburn, Upset stomach, Antacid therapy, Gastric Acid SuppressionAbdominal Cramping, Abdominal Pain, Abdominal distension, Acid Reflux, Bloating, Colic, Diarrhoea, Distention, Dyspepsia, Flatulence, Gastric Ulcer, Gastritis, Heartburn, Hiatus Hernia, Hyperacidity, Pain, Pancreatic Insufficiency, Peptic Esophagitis, Peptic Ulcer, Stomach ache, Gastrointestinal cramps, Gastrointestinal cramps caused by Gas, Gastrointestinal spasms, Stomach cramps, Antacid therapy, Bowel preparation therapy
How Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension works
The suspension of magnesium hydroxide is ingested and enters the stomach. According to the amount ingested, the magnesium hydroxide will either act as an antacid or a laxative.
Through the ingestion of 0.5-1.5 grams (in adults) the magnesium hydroxide will act by simple acid neutralization in the stomach. The hydroxide ions from the magnesium hydroxide suspension will combine with the acidic H+ ions of the hydrochloric acid made by the stomachs parietal cells. This neutralization reaction will result in the formation of magnesium chloride and water.
Through the ingestion of 2-5 grams (in adults) the magnesium hydroxide acts as a laxative in the colon. The majority of the suspension is not absorbed in the intestinal tract and will create an osmotic effect to draw water into the gut from surrounding tissues. With this increase of water in the intestines, the feces will soften and the intraluminal volume of the feces will increase. These effects still stimulate intestinal motility and induce the urge to defecate. Magnesium hydroxide will also release cholecystokinin (CKK) in the intestines which will accumulate water and electrolytes in the lumen and furthermore increase intestinal motility.
Simethicone is a surfactant that decreases the surface tension of gas bubbles in the gastrointestinal tract, more easily allowing gas to exit the body.
Dosage
Epazel Plus (400 mg+400 mg+30 mg)/5 ml Oral Suspension dosage
Tablet: 1-2 tablets 1-3 hours after meal and at bed time or as directed by the physician.
Suspension: 1-2 teaspoonful 1-3 hours after meal and at bedtime or as directed by the physician.
Side Effects
Gastrointestinal side effects are uncommon. Occasionally, if excessive amount is consumed, diarrhea, constipation or regurgitation may occur.
Toxicity
LD50=8500 mg/kg (rat, oral)
Common side effects include drowsiness or flushing (warmth, redness or tingly feeling).
Daily use of magnesium hydroxide can result in fluid and electrolyte disturbances.
Excessive use of the laxative effects of magnesium hydroxide may result in abdominal cramping, nausea and/or diarrhea.
In overdose, symptoms of gastrointestinal irritation and/or watery diarrhea may occur.
Magnesium hydroxide poisoning can result in hypermagnesemia which includes symptoms of: nausea, vomiting, flushing, thirst, hypotension, drowsiness, confusion, loss of tendon reflexes, muscle weakness, respiratory depression, cardiac arrhythmias, coma and cardiac arrest.
Not to be used in individuals with any form of kidney disease or renal failure, a magnesium restricted diet or with any sudden changes in bowel movement lasting over two weeks. Also not to be used in those individuals with abdominal pain, nausea, vomiting, symptoms of appendicitis or myocardial damage, heart block, fecal impaction, rectal fissures, intestinal obstruction or perforation or renal disease. Not to be used in women who are about to deliver as magnesium crosses the placenta and is excreted in small amounts in breast milk.
Using magnesium hydroxide with aluminum hydroxide can decrease the absorption rate of these drugs.
Magnesium hydroxide can react with digoxin, dicoumerol and cimetidine.
Use of ibuprofen with magnesium hydroxide can increase the absorption of the ibuprofen.
Use of magnesium hydroxide with penicallamine, bisphosphates, ketoconazole, quinolones or tetracycline can decrease the absorption of these drugs.
Enteric-coated tablets can be prematurely released when taken with magnesium hydroxide.
It is important to routinely monitor levels of serum magnesium and potassium in patients using magnesium hydroxide. Serum magnesium levels are necessary to determine how much magnesium is being absorbed and how much is being excreted by the kidneys. Excessive diarrhea can occur from use of magnesium hydroxide and thus it is important to also monitor serum potassium levels to ensure hypokalemia does not occur.
Data regarding overdoses with simethicone are rare due to the fact that it is not systemically absorbed.. In the case of an overdose stop the drug and initiate symptomatic and supportive care.
Precaution
Drugs containing Aluminum Hydroxide should not be taken concomitantly with any form of tetracycline, as the absorption of the later may be affected. Aluminum Hydroxide may also reduce the absorption of Digoxin.
Interaction
Enhanced absorption with citrates or ascorbic acid. Decreases absorption of allopurinol, tetracyclines, quinolones, cephalosporins, biphosphonate derivatives, corticosteroids, cyclosporin, delavirdine, Fe salts, imidazole antifungals, isoniazid, mycophenolate, penicillamine, phosphate supplements, phenytoin, phenothiazines, trientine.
Decreases absorption of tetracyclines and biphosphonates. Separate administration of these and other drugs by around 2 hr.
There is no evidence that Simethicone modifies the effect of other drugs. The defoaming effect of Simethicone is reduced by antacids such as Aluminium Hydroxide and Magnesium Carbonate, which absorb the Silicone.
Volume of Distribution
The peak action and distribution of magnesium hydroxide are variable.
Simethicone is not systemically absorbed and so these data are not readily available.
Elimination Route
About 15%-50% of magnesium hydroxide is absorbed very slowly through the small intestine.
Simethicone is not systemically absorbed and so these data are not readily available.
Half Life
N/A
Simethicone is not systemically absorbed and so these data are not readily available.
Clearance
Magnesium hydroxide is mainly excreted in the urine by the kidneys. Since the kidneys play a major role in its clearance, individuals with renal failure are at risk of hypermagnesemia with long term consumption as the appropriate amounts of magnesium may not be excreted.
Simethicone is not systemically absorbed and so these data are not readily available.
Elimination Route
After oral administration, up to 50% of the magnesium hydroxide suspension may be absorbed as magnesium ions through the small intestines and then rapidly excreted in the urine through the kidneys. The unabsorbed drug is mainly excreted in the feces and saliva.
Simethicone is eliminated in the feces.
Pregnancy & Breastfeeding use
It is advised to avoid antacid preparations in the first trimester of pregnancy.
Contraindication
Hypersensitivity to aluminium salts.
Intestinal obstruction, faecal impaction; renal failure; appendicitis.
Storage Condition
Store in cool and dry place, out of reach of children.
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