Sodium Alginate (Alginic acid)

Indications

Sodium Alginate (Alginic acid) is used for: Gastroesophageal reflux (GERD), Indigestion

Adult Dose

Chewable Tablet: Adults: 2-4 tablets. The tablet must be chewed thoroughly before swallowing. Oral Liquid: Adults: Take 10-20 mL (two to four 5 mL spoonfuls). Children 6-12 years: Take 5-10 mL (one to two 5 mL spoonfuls). Administered after meals and at bedtime.

Child Dose

Chewable Tablet: Children >12 years: 2-4 tablets. The tablet must be chewed thoroughly before swallowing. Oral Liquid: Children >12 years: Take 10-20 mL (two to four 5 mL spoonfuls). Children 6-12 years: Take 5-10 mL (one to two 5 mL spoonfuls). Administered after meals and at bedtime.

Renal Dose

Administration

Contra Indications

Hypersensitivity

Precautions

Magnesium carbonate, aluminum hydroxide and alginic acid have not been formally assigned to a pregnancy category by the FDA. There are no controlled data in human pregnancy. Magnesium carbonate, aluminum hydroxide and alginic acid should only be given in pregnancy when benefit outweighs risk.

Pregnancy-Lactation

Interactions

Side Effects

Side effects of Sodium Alginate (Alginic acid) : Gastrointestinal Gastrointestinal side effects have been reported the most frequently. These have included constipation (secondary to aluminum hydroxide therapy) and diarrhea (secondary to magnesium carbonate therapy). Patients with renal failure may be at risk of aluminum toxicity because of ingestion of aluminum hydroxide and because of exposure to aluminum-containing water used for dialysate solutions. Adverse effects of aluminum accumulation in these patients has led to monitoring of water source aluminum content by dialysis units and periodic measurements of serum aluminum in patients undergoing chronic dialysis. Concurrent administration of aluminum hydroxide with citrate containing products has been associated with unusually high serum concentrations of aluminum and, especially in cases of renal failure, severe toxicity. Citrate may increase aluminum solubility and absorption. During long-term use, aluminum has been shown to deposit in bone, joint, and brain. Signs and symptoms of hypermagnesemia may include hypotension, nausea, vomiting, EKG changes, respiratory depression, loss of deep tendon reflex, dilated pupils, altered mental status, and coma. Metabolic Metabolic side effects have included hypophosphatemia with the use of aluminum hydroxide. In patients on long-term aluminum hydroxide therapy, especially in association with poor diets, hypophosphatemia may result in muscle weakness, rhabdomyolysis, hemolysis, and encephalopathy. Osteomalacia due to aluminum deposition in bone is generally only seen in patients with chronic renal failure. Bone formation slows in response to aluminum bone deposits. Aluminum may also deposit in joint tissue, resulting in arthropathy and hydrarthrosis. Musculoskeletal side effects have included osteomalacia, due to aluminum hydroxide, which may occur by two different mechanisms. Osteomalacia may occur due to hypophosphatemia or due to aluminum accumulation in bone. Osteomalacia due to hypophosphatemia is often accompanied by malaise, bone pain, muscular weakness, and bone fractures. Osteomalacia due to aluminum deposition may present in a similar fashion and occurs predominately in patients with chronic renal failure. Aluminum deposits typically can be observed on bone biopsy. Nervous system Encephalopathy associated with aluminum accumulation is characterized by speech disorders, dysarthria, dyspraxia, dysphasia, tremor, myoclonus, seizures, coma, and ultimately death. EEG of patients with aluminum encephalopathy may show paroxysmal slowing and diffuse rhythmical bursts of delta activity. Renal Renal side effects have rarely included formation of renal calculi, most probably due to hypercalciuria, with the use of aluminum hydroxide.

Mode of Action

Alginic acid is used in combination with an antacid or histamine H2-antagonist in the management of gastro-esophageal reflux disease. It reacts with gastric acid to form a viscous gel which acts as a mechanical barrier to reduce reflux.