Explore all range of Gaviscon
All alginate Gaviscon products improve reflux symptoms such as heartburn and indigestion by:
A systematic review and meta-analysis investigating the utility of alginate-based therapy in the management of gastro-oesophageal reflux disease (GORD) in adults showed that alginates are superior to placebo and antacids for controlling GORD symptoms.(5)
Gaviscon Core products – Provide relief for heartburn through the formation of raft which physically stops refluxate entering the oesophagus(6)
Please see the full Prescribing Information before prescribing Gaviscon Original Aniseed Relief (view Prescribing Information), Gaviscon Peppermint Liquid Relief (view Prescribing Information), Gaviscon Liquid Sachets Mint (view Prescribing Information), Gaviscon Peppermint Flavour Tablets (view Prescribing Information) or Gaviscon Strawberry Flavour Tablets (view Prescribing Information).
Liquid relief: Each 10 mL dose contains 500 mg sodium alginate, 267 mg sodium carbonate and 160 mg calcium carbonate(6)
See full list of excipients here
Chewable tablets: Each tablet contains 250 mg sodium alginate, 133.5 mg sodium hydrogen carbonate and 80 mg calcium carbonate (7)
See full list of excipients here
Gaviscon Core products should be orally administered. The liquid formulation is indicated for adults, while the chewable tablets are suitable for adults and children 12 years and over(6,7) The following doses are recommended:
Both formulations can be used during pregnancy and breastfeeding.(6,7)
The chemical characterisation of alginate rafts for good raft performance was investigated in this study. Established products were scored and ranked using the following criteria:
- The level of alginate content within the raft
- The capacity of the raft to neutralise acid
- Raft neutralisation profile
Overall, both Gaviscon Double Action and Gaviscon Original Aniseed Relief were shown to be superior to the tested comparators.
- Clinical studies, including more than 500 pregnant women, as well as large amounts of data from post-marketing experiences indicate no malformities or foeto/neonatal toxicity of the active components(6,7)
- Very rare adverse events reported: anaphylaxis, hypersensitivity reactions, respiratory effects such as bronchospasm(6,7)
Gaviscon Advance – contains double the concentration of sodium alginate of Gaviscon Original Aniseed Relief and forms a raft to effectively impede reflux for up to 4 hours(9)
Please see the full Prescribing Information before prescribing Gaviscon Advance Aniseed Suspension 250 mL, 500 mL, 600 mL (view Prescribing Information), 150 mL or 300 mL (view Prescribing Information), Gaviscon Advance Peppermint Suspension (view Prescribing Information), Gaviscon Advance Tablets (view Prescribing Information).
Gaviscon Advance should be orally administered and is indicated for adults and children 12 years and over. Children under the age of 12 should only receive Gaviscon Advance under medical supervision.(9,10) The following doses are recommended:
Both formulations can be used during pregnancy and breastfeeding.(9,10)
In a multicentre, prospective, open-label, and baseline-controlled study, 90% of pregnant women (n=114) rated Gaviscon Liquid as ‘good’ or ‘very good’ at relieving reflux symptoms after 4 weeks(11)
Night-time symptoms in this study population also improved with Gaviscon treatment(11)
- Very rare adverse events reported: anaphylaxis, hypersensitivity reactions, respiratory effects such as bronchospasm(9,10)
Gaviscon Double Action neutralises excess stomach acid and forms a physical raft over the stomach contents to provide long-lasting relief from heartburn and indigestion.(12-14)
Please see the full Prescribing Information before prescribing Gaviscon Double Action Mint 150 mL, 300 mL, 600 mL (view Prescribing Information) or 500 mL (view Prescribing Information), Gaviscon Double Action Liquid Sachets (view Prescribing Information), Gaviscon Double Action Mint Chewable Tablets (view Prescribing Information), Gaviscon Double Action Aniseed (view Prescribing Information), Gaviscon Double Action Mixed Berries (view Prescribing Information).
Chewable Tablets: Each tablet contains 250 mg sodium alginate, 106.5 mg sodium bicarbonate and 187.5 mg calcium carbonate(12)
Excipients include 5.863mg Aspartame (E951) and 0.375mg Carmoisine Lake (E122) per tablet. See full list here.
Liquid Sachets: Each 10 mL dose contains 500 mg sodium alginate, 213 mg sodium bicarbonate and 325 mg calcium carbonate (13)
Excipients include methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216). See full list here.
Suspension: Each 10 mL dose contains 500 mg sodium alginate, 213 mg sodium bicarbonate and 325 mg calcium carbonate(14)
Excipients include methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216). See full list here.
|Gaviscon Double Action Tablets(12)||Gaviscon Double Action Liquid Sachets(13)||Gaviscon Double Action Suspension(14)|
|Two to four tablets after meals and at bedtime, up to four times per day.||One to two sachets (10-20 mL) after meals and at bedtime, up to four times per day.||Between 10-20 mL after meals and at bedtime, up to four times per day.|
In a randomised, double-blind, placebo-controlled trial in 110 patients with symptoms of GORD, the following mean changes from baseline in the overall Reflux Disease Questionnaire (RDQ) symptom score were evaluated after 7 days of treatment with Gaviscon Double Action (alginate treatment):(15)
Overall, the Double Action (alginate treatment) group had:(15)
a 72% greater decrease in RDQ score compared to the placebo group
a greater number of patients with a shift of ≥1 below baseline value compared with placebo (75% vs 46.3%)
significantly greater decreases in symptom scores for heartburn, regurgitation and GORD compared with the placebo group
- Open controlled studies in 281 pregnant women did not demonstrate any significant adverse effects of Gaviscon on the course of pregnancy or on the health of the foetus/newborn child.(12-14)
Very rare adverse events reported: anaphylaxis, hypersensitivity reactions, abdominal pain, acid rebound, diarrhoea, nausea, vomiting.(12-14)
Additional very rare adverse events reported with Double Action Tablets: respiratory effects such as bronchospasm and pruritic rash.(12)
Gaviscon Infant reacts after ingestion to form a viscous gel that stabilises the stomach contents, reducing the incidence of gastro-oesophageal reflux(16)
Gaviscon Infant helps to prevent gastric regurgitation in infants where the sphincter is not fully established.(16)
Please see the full Prescribing Information before prescribing Gaviscon Infant Sachets (view Prescribing Information).
Sachets: Each unit dose sachet of 0.65 g powder contains 225 mg sodium alginate and 87.5 mg magnesium alginate.(16)
- Indicated for use in infants aged 1–2 years with gastric regurgitation, gastro-oesophageal reflux and reflux associated with hiatus hernias.
- Do not use Gaviscon Infant in premature infants or infants under 1 year of age except under medical supervision.
- Powder sachets should be mixed with water or milk feed for oral administration.
The following doses are recommended:
|Gaviscon Infant Dose|
|Infants under 4.5 kg (10 lb)||One sachet|
|Infants over 4.5 kg (10 lb)||Two sachets|
Treatment should not be administered more than six times in any 24-hour period and should not be given to any individual above the age of 2 years.
- For formula-fed infants, mix each sachet into 115 mL (4 fl oz) of feed in the bottle. Shake well and feed as normal. Give Gaviscon Infant at the end of each feed.
- For breastfed infants and infants up to 2 years old, mix each sachet with 5 mL (1 teaspoon) of cooled boiled water until a smooth paste is formed. Add another 10 mL (2 teaspoons) of cooled boiled water and mix. Give Gaviscon Infant part way through each feed.
A meta-analysis showed that Gaviscon Infant reduced the number of reflux events per day more than other products:(17)
Proton Pump Inhibitors
Guardium is a proton pump inhibitor that helps to block the enzyme H+/K+ ATPase in parietal cells, inhibiting both basal and simulated acid secretion(18)
Please see the full Prescribing Information before prescribing Guardium acid reflux control 20mg gastro-resistant tablets (view Prescribing Information).
- Guardium is indicated for short-term treatment of reflux symptoms, such as heartburn and acid regurgitation in adults aged 18 years and over.
- Available as tablets that should be swallowed whole with liquid.
- A treatment duration of up to 2 weeks with one tablet per day is recommended. If symptoms are completely relieved during this period, the treatment should be discontinued.
- Guardium can take up to 2-3 days to take full effect. However, if there is no symptom relief within the full treatment period, refer the patient.
- Moderate amounts of data on pregnant women (300-1000 pregnancy outcomes) indicated no malformative or foetal/neonatal toxicity of esomeprazole. However, as a precautionary measure, avoid using Guardium during pregnancy.
Guardium contains 20 mg of esomeprazole per tablet.(18) A placebo-controlled trial of on-demand therapy for 6 months in patients with endoscopy-negative GORD showed that:(19)
- Esomeprazole (20 mg, n=282; 40 mg, n=293) was more efficacious than placebo (n=146) in treating heartburn, regurgitation and epigastric pain (p<0.005 for both doses)
- 20 mg of esomeprazole was as efficacious as 40 mg esomeprazole in long-term on-demand management of heartburn, regurgitation and epigastric pain in patients
- Common adverse reactions reported: headache, abdominal pain, constipation, diarrhoea, flatulence, nausea/vomiting, fundic gland polyps (benign)
- Uncommon adverse reactions reported: peripheral oedema, insomnia, dizziness, paraesthesia, somnolence, vertigo, dry mouth, increased liver enzymes, dermatitis, pruritus, rash, urticaria
- Rare adverse reactions reported: leukopenia, thrombocytopenia, hypersensitivity reactions, hyponatraemia, agitation, confusion, depression, taste disturbance, blurred vision, bronchospasm, stomatitis, gastrointestinal candidiasis, hepatitis, alopecia, photosensitivity, arthralgia, myalgia, malaise, increased sweating
- Very rare adverse reactions reported: aggression, hallucinations, agranulocytosis, pancytopenia, hepatic failure, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, muscular weakness, interstitial nephritis, gynaecomastia
Histamine 2 receptor antagonists
Gavilast is a histamine 2 receptor antagonist that inhibits basal and stimulated secretion of gastric acid, making the stomach contents less acidic and relieving symptoms of excess acid production for up to 12 hours(20)
Please see the full Prescribing Information before prescribing Gavilast Heartburn and Indigestion 75mg Film-coated Tablets (view Prescribing Information).
- Indicated for adults and children 16 years of age and older. Gavilast is not recommended for children under the age of 16.
- One 75 mg film-coated pill should be swallowed whole with water as soon as symptoms begin to manifest. If symptoms persist for more than 1 hour or return, another tablet should be taken.
- A maximum of two tablets should be administered in 24 hours.
- Tablets should not be taken for more than 6 days without advice of a pharmacist or doctor.
- A doctor or pharmacist should be consulted before use in pregnancy and breastfeeding.
Gavilast contains 75 mg per tablet. In a randomised, double-blind, parallel group, multicentre study, 75 mg of ranitidine was shown to be:(21)
- Clinically more effective (p<0.05) than placebo for all measured efficacy endpoints in relieving heartburn and reducing antacid consumption
- Superior to placebo in providing heartburn relief within 30 minutes of dosing that lasted for up to 12 hours
- Very rare adverse events reported: hepatitis, acute pancreatitis and diarrhoea, blood count changes, agranulocytosis or pancytopenia, anaphylactic shock, bradycardia, AV-block, headache, dizziness, involuntary movement disorders, reversible mental confusion, depression and hallucinations, erythema multiforme, alopecia, musculoskeletal symptoms, reversible blurred vision, vasculitis, acute interstitial nephritis, reversible impotence, breast symptoms and conditions
- Rare events reported: transient and reversible changes in liver function tests, hypersensitivity reactions, skin rash, elevation of plasma creatinine
- Uncommon adverse events reported: abdominal pain, nausea, constipation.
- Strugala V, Avis J, Jolliffe IG, et al. The role of an alginate suspension on pepsin and bile acids – key aggressors in the gastric refluxate. Does this have implications for the treatment of gastro-oesophageal reflux disease? J Pharm Pharmacol 2009;61:1021–28
- Woodland P, Batista-Lima F, Lee C, et al. Topical protection of human esophageal mucosal integrity. Am J Physiol Gastrointest Liver Physiol 2015;308(12):G975–80
- Sweis R, Kaufman E, Anggiansah A, et al. Post-prandial reflux suppression by a raft-forming alginate (Gaviscon Advance) compared to a simple antacid documented by magnetic resonance imaging and pH-impedance monitoring: mechanistic assessment in healthy volunteers and randomised, controlled, double-blind study in reflux patients. Aliment Pharmacol Ther 2013;37(11):1093–102
- Rohof WO, Bennink RJ, Smout AJ, et al. An alginate-antacid formulation localizes to the acid pocket to reduce acid reflux in patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2013;11(12):1585–91
- Leiman DA, Riff BP, Morgan S, et al. Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis. Dis Esophagus 2017;30(5):1–9
- EMC. Gaviscon Original Aniseed Relief. 2014. Available: https://www.medicines.org.uk/emc/product/623/smpc [accessed August 2019]
- EMC. Gaviscon Peppermint Flavour Tablets. 2016. Available: https://www.medicines.org.uk/emc/product/4856/smpc [accessed August 2019].
- Dettmar PW, Gil-Gonzalez D, Fisher J, et al. A comparative study on the raft chemical properties of various alginate antacid raft-forming products. Drug Dev Ind Pharm 2018;44(1):30–39
- EMC. Gaviscon Advance Peppermint Flavour Oral Suspension. 2014. Available: https://www.medicines.org.uk/emc/product/6715/smpc [accessed August 2019].
- EMC. Gaviscon Advance Mint Chewable Tablets. 2014. Available: https://www.medicines.org.uk/emc/product/73/smpc [accessed August 2019].
- Strugala V, Bassin J, Swales VS, et al. Assessment of the Safety and Efficacy of a Raft-Forming Alginate Reflux Suppressant (Liquid Gaviscon) for the Treatment of Heartburn during Pregnancy. ISRN Obstet Gynecol 2012;2012:481870
- EMC. Gaviscon Double Action Tablets. 2017. Available: https://www.medicines.org.uk/emc/product/383/smpc [accessed September 2019].
- EMC. Gaviscon Double Action Liquid Sachets. 2018. Available: https://www.medicines.org.uk/emc/product/3959/smpc [accessed September 2019].
- EMC. Gaviscon Double Action Mint Oral Suspension. 2018. Available: https://www.medicines.org.uk/emc/product/5609/smpc [accessed September 2019].
- Thomas E, Wade A, Crawford G, et al. Randomised clinical trial: relief of upper gastrointestinal symptoms by an acid pocket-targeting alginate-antacid (Gaviscon Double Action) - a double-blind, placebo-controlled, pilot study in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2014;39(6):595–602
- EMC. Gaviscon Infant Sachets. 2015. Available: https://www.medicines.org.uk/emc/product/6581/smpc [accessed September 2019].
- Kwok TC, Ojha S, Dorling J. Feed thickener for infants up to six months of age with gastro-oesophageal reflux. Cochrane Database Syst Rev 2017;12:CD003211
- EMC. Guardium acid reflux control 20mg gastro-resistant tablets. 2019. Available: https://www.medicines.org.uk/emc/product/10345/smpc [accessed September 2019]
- Talley NJ, Venables TL, Green JR, et al. Esomeprazole 40 mg and 20 mg is efficacious in the long-term management of patients with endoscopy-negative gastro-oesophageal reflux disease: a placebo-controlled trial of on-demand therapy for 6 months. Eur J Gastroenterol Hepatol 2002;14(8):857–63
- EMC. Gavilast Heartburn and Indigestion 75mg Film-coated tablets. 2017. Available: https://www.medicines.org.uk/emc/product/2497/smpc [accessed September 2019]
- Pappa KA, Gooch WM, Buaron K, et al. Low-dose ranitidine for the relief of heartburn. Aliment Pharmacol Ther 1999;13(4):459–65