Riflux

Uses

Aluminium Hydroxide is used for Duodenal ulcer, Dyspepsia, Flatulence, Gastric Hyperacidity, Gastric ulcer, Gastritis, Gastroesophageal reflux disease (GERD), Gastrointestinal hyperacidity, Heartburn, Heartburn & gastritis, Hyperacidity, Indigestion, Oesophagitis, Peptic ulcer disease, Stomach distension, Upper Gl bloating.

Management of acidosis in cardiac arrest.

Management of metabolic acidosis in:

• Severe renal disease
• Uncontrolled diabetes
• Circulatory insufficiency from shock or dehydration
• Severe primary lactic acidosis

Alkalinization of urine.

Riflux is also used to associated treatment for these conditions: Acid indigestion, Barbiturate intoxication, Breast Cancer, Constipation, Dental Decay, Duodenal Ulcer, Dyspepsia, Gastro-esophageal Reflux Disease (GERD), Gingival Bleeding, Heartburn, Helicobacter Infections, Hyperkalemia, Ischaemia, Metabolic Acidosis, Myocardial Infarction, Plaque, Dental, Pruritis of the skin, Skin Irritation, Upset stomach, Zollinger-Ellison Syndrome, Abdominal bloating, Benign, active Gastric Ulcer, Methyl alcohol poisoning, Prophylaxis of Contrast-induced nephropathy, Salicylate poisoning, Severe Diarrhea, Swelling of the gums, Bowel preparation therapy

How Riflux works

Sodium bicarbonate is a systemic alkalizer, which increases plasma bicarbonate, buffers excess hydrogen ion concentration, and raises blood pH, thereby reversing the clinical manifestations of acidosis. It is also a urinary alkalizer, increasing the excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. By maintaining an alkaline urine, the actual dissolution of uric acid stones may be accomplished. Sodium bicarbonate acts as an antacid and reacts chemically to neutralize or buffer existing quantities of stomach acid but has no direct effect on its output. This action results in increased pH value of stomach contents, thus providing relief of hyperacidity symptoms. [PharmGKB]

Dosage

Riflux dosage

Usual Adult Dose: Up to 1 g daily.

Dyspepsia: 500 to 600 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Duodenal Ulcer: 500 to 1500 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Erosive Esophagitis: 500 to 1500 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Gastric Ulcer: 500 to 1500 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Gastroesophageal Reflux Disease: 500 to 1500 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Zollinger-Ellison Syndrome: 500 to 3600 mg orally 4 to 6 times a day as needed, between meals and at bedtime.

Hyperphosphatemia: 500 to 1000 mg orally 4 times a day, with meals and at bedtime. The dosage should be titrated to the serum phosphate level. Max Dosage: 10 g daily in divided doses may be taken with or without food.

Oral: The usual dose is 300 mg to 2 grams, 1 to 4 times daily.

Intravenous (Severe metabolic acidosis):

• Adult: By slow inj of a hypertonic solution of up to 8.4% (1000 mmol/L), or by continuous infusion of a weaker solution, usually 1.26% (150 mmol/L). For correction of acidosis during advanced cardiac life support procedures, 50 ml of an 8.4% solution may be given.
• Elderly: Dosage adjustments may be required.

Side Effects

Constipation; intestinal obstruction (with large doses); phosphate depletion may occur with prolonged admin or large doses.

This medication is generally well tolerated. However, high doses may cause headache, nausea or irritability. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop: muscle weakness, slow reflexes, confusion, swelling of the feet or ankles, black tar-like stools, coffee-ground vomit. If you notice other effects not listed above, contact your doctor or pharmacist.

Precaution

Chronic renal impairment; CHF; oedema; cirrhosis and low Na diets; patients with recent Gl haemorrhage. Administer 2-3 hrs before/after another medication to minimise drug interactions. Pregnancy and lactation

Pre-existing heart disease, kidney disease, liver disease, high blood pressure, any allergies.

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.

This medication has the potential to interact with many medications. Should not take any other medication within 1 to 2 hours of taking an antacid. Potentially hazardous interactions with Corticosteroids and Corticotropin, Alkalis, Calcium, Diuretics and Potassium.

Pregnancy & Breastfeeding use

Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Contraindication

Hypersensitivity to aluminium salts.

This drug is contraindicated in hypoventilatory states, chloride depletion owing to continuous gastric fluid loss, metabolic and/or respiratory alkalosis, hypocalcemia and diuretics known to produce hypochloremic alkalosis.

Acute Overdose

If alkalosis results, the bicarbonate should be stopped and the patient managed according to the degree of alkalosis present. 0.9% sodium chloride injection intravenous may be given; potassium chloride also may be indicated if there is hypokalemia. Severe alkalosis may be accompanied by hyperirritability or tetany and these symptoms may be controlled by calcium gluconate. An acidifying agent such as ammonium chloride may also be indication in severe alkalosis.

Storage Condition

Store in a cool & dry place protected from light. Keep out of reach of children.

Innovators Monograph

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