Fosfalugel for gastritis

In gastroenterology, for inflammation of the stomach against the background of its increased acidity, Phosphalugel for gastritis can be prescribed - a symptomatic agent from the antacid group.

ATC code – A02AB03, other trade names: Alfogel, Gasterin.

Indications Fosfalugel

To quickly eliminate periodically occurring heartburn, Phosphalugel is used:

• for gastritis with increased acidity of gastric juice;
• in case of exacerbation of chronic gastritis;
• for erosive gastritis;
• for atrophic gastritis;
• for esophagitis and gastroesophageal reflux disease;
• with gastroduodenitis;
• for gastric ulcer and duodenal ulcer; [ 1 ]
• for functional (non-ulcer) dyspepsia or dietary errors.

Pharmacodynamics

The mechanism of action of Phosphalugel is due to its main active substance - a water-insoluble oxoanionic compound - aluminum phosphate (aluminum phosphate, AlO ₄ P), which partially neutralizes the hydrochloric acid of the gastric juice (since it is poorly soluble in it), but, forming a colloidal layer on the gastric mucosa, protects it from the aggressive effects of HCl and proteolytic enzymes of the gastric juice (in particular, pepsin). [ 2 ]

In addition, having a framework structure of molecules, aluminum phosphate can adsorb toxic lipophilic bile acids that enter the stomach during reflux, as well as the enzyme lysophosphatidylcholine (lysolecithin), which destroys the membranes of mucous cells.

It is noted that the physiology of hydrochloric acid secretion when food enters the stomach is not disrupted.

Pharmacokinetics

When hydrochloric acid reacts with aluminum phosphate, aluminum chloride (aluminum chloride) is formed, which is transformed into alkaline salts, which are excreted from the body through the intestines. [ 3 ]

Dosing and administration

Phosphalugel is taken orally; it is permissible to mix a single dose of the gel with a small amount of water.

The instructions indicate how to take Phosphalugel for gastritis with postprandial heartburn: before meals. A single dose for adults is the contents of one packet (16 g); for children over six months - half a packet.

The course of treatment with Phosphalugel for gastritis can last no more than 14 days.

• Application for children

As prescribed by a doctor, Fosfalugel can be used in pediatric practice from 6 months of age.

Use Fosfalugel during pregnancy

According to the official instructions, there is no information regarding the safety of using Phosphalugel during pregnancy and lactation.

Contraindications

All antacids containing aluminum compounds, including Phosphalugel for gastritis, are contraindicated for use in cases of hypersensitivity to aluminum phosphate, as well as in cases of severe abdominal pain of unknown etiology. [ 4 ]

Do not use this product if you have a history of:

• chronic constipation or diarrhea;
• chronic kidney disease (especially with elevated blood phosphate levels) and renal failure;
• Alzheimer's disease;
• hypercalcemia associated with primary hyperparathyroidism.

Side effects Fosfalugel

The most common side effects of Phosphalugel include:

• constipation;
• allergic reactions;
• accelerated demineralization of bones (associated with gastrointestinal absorption of aluminum and its deposition in tissues). [ 5 ]

It should be borne in mind that all aluminum-containing antacids – when aluminum interacts with phosphate and fluoride anions in the intestine – affect the absorption of these elements. Also, long-term use of heartburn remedies based on aluminum compounds can lead to its entry into the brain, accumulation throughout life (in the form of transferrin and aluminum citrate) and the risk of developing neurodegenerative disorders. [ 6 ], [ 7 ]

Overdose

As noted in the official instructions, an overdose of this drug leads to chronic constipation, fraught with intestinal obstruction. Laxatives are used to treat the consequences of an excess dose of Phosphalugel.

Interactions with other drugs

Phosphalugel, like other antacids, reduces the absorption of any oral medications. Therefore, it should not be taken simultaneously with other pharmacological drugs of systemic action.

Storage conditions

Phosphalugel should be stored at a temperature not exceeding +25°C.

Shelf life

Shelf life – 36 months

Analogues

All antacids based on aluminum compounds – Alfogel, Compensan, Algikon, Alugastal, Gasterin, Almapur, Almagel – are analogues of Phosphalugel.

When comparing Almagel or Phosphalugel, as well as Phosphalugel or Maalox (which is one of the trade names of antacids containing aluminum hydroxide (alhedrate) and magnesium hydroxide, like Almagel, Altacid, Alumag, Gastracid, Palmagel), one should take into account the features of their pharmacological effects and reviews of their effectiveness.

The pharmacodynamics of Almagel (Maalox) are almost identical to the mechanism of action of Phosphalugel. But the presence of magnesium hydroxide in Almagel increases the neutralizing effect on stomach acid. Magnesium hydroxide is transformed into magnesium chloride and increases intestinal peristalsis, i.e. it also acts as an osmotic laxative. This effect is mitigated by aluminum, which slows down the motility of the gastrointestinal tract (that is why they are combined in one composition). Almagel suspension is contraindicated for children under 14 years of age.

Aluminum phosphate in Phosphalugel is considered a weaker antacid than aluminum hydrate, which has a higher acid-neutralizing capacity (4.4 mmol/ml compared to 0.18 mmol/ml for aluminum phosphate).