Alginate containing products have low acid suppressant activity and should be reserved for patients with reflux symptoms.

Liquid antacid preparations are more effective than solid tablets.

Peptac

(Sodium alginate with calcium carbonate and sodium bicarbonate)

• Oral suspension^SF 250mg / 133.5mg / 80mg in 5ml (contains 6.2 mmol of sodium in 10ml) (£3.29 = 500ml)

Indications

• Dyspepsia

Dose

• 10–20ml after meals and at bedtime

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. Peptac contains sodium alginate 250mg, sodium bicarbonate 133.5mg and calcium carbonate 80mg in 5ml

Gastro-oesophageal reflux disease (GORD) in children

See also: Specialist infant formulas in primary care

Gaviscon Infant

(Sodium alginate and magnesium alginate)

• Oral powder sachets^SF (contains about 1.04 mmol of sodium per dose) (£7.64 = 30 sachets)

Indications

• GORD in children

Dose

• Neonate: body-weight under 4.5 kg, one 'dose' as required, max 6 doses per day; body-weight 4.5 kg and above, 2 'doses' as required, max 12 doses per day
• Child 1- 23 months: body-weight under 4.5kg, one 'dose' as required, max 6 doses per day; body-weight 4.5kg and above, 2 'doses' as required, max 12 doses per day

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. Dose mixed with feeds (water or fresh expressed breast milk in breast-fed infants).
3. Parents and carers need to be advised on the challenges that administering alginates to a breast fed infant may bring. Gaviscon Infant should be mixed with 5 mL of cooled, boiled water to form a smooth paste, then add in another 10 mL of water and mix. Local specialists also recommend mixing with fresh expressed breast milk as an alternative to water. The treatment should be administered part way through the feed, using a syringe, spoon or finger.
4. Each half of the dual-sachet is identified as 'one dose'. To avoid errors prescribe as with directions in terms of dose.
5. Do not use Gaviscon Infant in children at risk of dehydration (for example because of vomiting, diarrhoea, fever or high room temperature), in children at risk of intestinal obstruction, in children already consuming thickened feeds (because of the risk of intestinal obstruction), in pre-term infants, or in children with renal impairment or congestive cardiac failure (because of the sodium content).
6. If a trial is successful, continue for 3 months or until weaning (ingestion of solid foods) is established.
7. See Paediatric reflux disease guidance