Phosphalugel for gastritis

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

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

Indications Phosphalugel

To quickly eliminate recurrent heartburn, Phosphalugel is used:

• with gastritis with increased acidity of gastric juice;
• with exacerbation of chronic gastritis;
• with erosive gastritis;
• with atrophic gastritis;
• with esophagitis and gastroesophageal reflux disease;
• with gastroduodenitis;
• with peptic ulcer of the stomach and duodenum; [1]
• with functional (non-ulcer) dyspepsia or food errors.

Pharmacodynamics

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

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

It is noted that the physiology of the release of hydrochloric acid when food enters the stomach is not disturbed.

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 allowed to mix a single dose of the gel with a small amount of water.

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

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

• Application for children

According to the doctor's prescription, Phosphalugel can be used in pediatric practice from 6 months of age.

Use Phosphalugel 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 Fosfalugel for gastritis, are contraindicated for use with hypersensitivity to aluminum phosphate, as well as in cases of severe abdominal pain of unexplained etiology. [4]

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

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

Side effects Phosphalugel

The most common side effects of Phosphalugel include:

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

It should be borne in mind that all antacids containing aluminum - when aluminum interacts with phosphate and fluoride anions in the intestine - affect the absorption of these elements. Also, long-term use of anti-heartburn agents 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 neurodegenerative disorders. [6], [7]

Overdose

As noted in the official instructions, an overdose of this drug leads to the appearance of chronic constipation, fraught with intestinal obstruction. To treat the consequences of exceeding the dose of Fosfalugel, laxatives are used.

Interactions with other drugs

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

Storage conditions

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

Shelf life

Expiration date - 36 months

Analogs

All antacids based on aluminum compounds - Alfogel, Compensan, Algikon, Alyugastal, Gasterin, Almapur, Almagel - are analogs of Phosphalugel.

If we compare Almagel or Fosfalugel, as well as Fosfalugel or  Maalox  (which is one of the trade names of antacids containing aluminum hydroxide (algedrate) and magnesium hydroxide, like Almagel, Altacid, Alumag, Gastracid, Palmagel), then their features should also be taken into account pharmacological effects, and reviews of their effectiveness.

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

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