Neutralax® (Tablets, Suspension) Instructions for Use
ATC Code
A02AX (Antacids in combination with other agents)
Active Substances
Magnesium hydroxide (Ph.Eur.)
Algeldrate (Rec.INN)
Clinical-Pharmacological Group
Antacid drug
Pharmacotherapeutic Group
Antacid agent
Pharmacological Action
A combined agent, the action of which is due to its constituent components: it has antacid, adsorbent, enveloping, carminative, and choleretic effects.
The laxative effect of magnesium hydroxide balances the effect of algeldrate, which has the opposite effect on intestinal motility.
It neutralizes free hydrochloric acid in the stomach and reduces the activity of gastric juice. The residence time in the stomach is about 1 hour.
Pharmacokinetics
Absorption is low.
Indications
Acute gastritis; hyperacid gastritis; acute duodenitis; gastric ulcer and duodenal ulcer (in the acute phase); symptomatic ulcerative lesions of the stomach and duodenum of various origins; erosions of the mucous membrane of the upper gastrointestinal tract; reflux esophagitis; hiatal hernia; acute pancreatitis; exacerbation of chronic pancreatitis; hyperphosphatemia.
Discomfort, gastralgia, heartburn (after excessive consumption of ethanol, nicotine, coffee, medication use, dietary errors); fermentative or putrefactive dyspepsia (as part of combination therapy).
ICD codes
| ICD-10 code | Indication |
| E83.3 | Disorders of phosphorus metabolism and phosphatases |
| K21.0 | Gastro-esophageal reflux disease with esophagitis |
| K25 | Gastric ulcer |
| K26 | Duodenal ulcer |
| K27 | Peptic ulcer |
| K29 | Gastritis and duodenitis |
| K30 | Functional dyspepsia (digestive disorder) |
| K44 | Diaphragmatic hernia |
| K85 | Acute pancreatitis |
| K86.1 | Other chronic pancreatitis |
| R10.1 | Pain localized to the upper abdomen |
| R12 | Heartburn |
| ICD-11 code | Indication |
| 5C64.3 | Disorders of phosphorus or phosphatase metabolism |
| DA22.Z | Gastro-esophageal reflux disease, unspecified |
| DA24.Z | Unspecified esophagitis |
| DA42.Z | Gastritis, unspecified |
| DA51.Z | Duodenitis, unspecified |
| DA60.Z | Gastric ulcer, unspecified |
| DA61 | Peptic ulcer of unspecified site |
| DA63.Z | Duodenal ulcer, unspecified |
| DA7Z | Diseases of stomach or duodenum, unspecified |
| DC31.Z | Acute pancreatitis, unspecified |
| DC32.0 | Calcific pancreatitis |
| DC32.1 | Paraduodenal pancreatitis |
| DC32.2 | Hereditary chronic pancreatitis |
| DC32.4 | Chronic idiopathic pancreatitis |
| DC32.5 | Tropical pancreatitis |
| DC32.Z | Chronic pancreatitis, unspecified |
| DC33 | Autoimmune pancreatitis |
| DD50.0 | Diaphragmatic hernia |
| DD90.0 | Globus sensation |
| DD90.1 | Functional dysphagia |
| DD90.3 | Functional dyspepsia |
| DD90.Z | Functional disorders of esophagus or gastroduodenal system, unspecified |
| GB90.48 | Disorders of calcium or phosphate excretion |
| MD81.10 | Pain localized in the upper abdomen |
| MD95 | Heartburn |
Dosage Regimen
| The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen. |
Tablets, Suspension
Orally, 5-10 ml (suspension, gel) or 2-3 tablets 1-2 hours after meals and at bedtime; for gastric ulcer – 30 minutes before meals; if necessary, the single dose can be increased to 15 ml or 3-4 tablets.
After achieving the therapeutic effect – maintenance therapy with 5 ml or 1 tablet 3 times/day for 2-3 months.
For children from 4 to 12 months – 7.5 ml, for children over 1 year – 15 ml 3 times/day.
For prevention, take 5-10 ml or 1-2 tablets before possible irritating effects on the gastrointestinal mucosa.
To increase effectiveness, the tablets should be chewed or held in the mouth until completely dissolved. The suspension or gel should be homogenized before use by shaking the bottle or thoroughly kneading the sachet between the fingers. Squeeze the contents of the sachet into a spoon or into the mouth.
Adverse Reactions
From the digestive system: nausea, vomiting, change in taste sensations, constipation.
With long-term use in high doses: hypophosphatemia, hypocalcemia, hypercalciuria, osteomalacia, osteoporosis, hypermagnesemia, hyperaluminemia, encephalopathy, nephrocalcinosis, impaired renal function.
In patients with concomitant renal failure: thirst, decreased blood pressure, hyporeflexia.
Contraindications
Hypersensitivity to algeldrate and magnesium hydroxide; chronic renal failure; pregnancy; Alzheimer’s disease; hypophosphatemia.
With caution in children under 12 years of age, during lactation (breastfeeding).
Use in Pregnancy and Lactation
Use during pregnancy is contraindicated.
Use with caution during lactation (breastfeeding).
Use in Renal Impairment
Contraindicated in chronic renal failure.
Pediatric Use
Use with caution in children under 12 years of age.
Special Precautions
With long-term administration, ensure sufficient intake of phosphorus salts with food.
For adequate selection of a single dose, it is advisable to conduct an acute pharmacological test (after administration of the suspension through a gastric tube and subsequent rinsing with 10 ml of water, the pH of the gastric juice is assessed after 1 hour; if the pH is below 3.5, an increase in dose is necessary).
Drug Interactions
Reduces and slows the absorption of digoxin, indomethacin, salicylates, chlorpromazine, phenytoin, H2-histamine receptor blockers, beta-blockers, diflunisal, ketoconazole and itraconazole, isoniazid, tetracycline antibiotics and quinolones (ciprofloxacin, norfloxacin, ofloxacin, enoxacin, grepafloxacin, etc.), azithromycin, cefpodoxime, pivampicillin, rifampin, indirect anticoagulants, barbiturates (they should be taken 1 hour before or 2 hours after taking antacids), fexofenadine, dipyridamole, zalcitabine, chenodeoxycholic and ursodeoxycholic acids, penicillamine and lansoprazole.
M-cholinoreceptor blockers, by slowing gastric emptying, enhance and prolong the effect of the drug.
Storage Conditions
Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.
Dispensing Status
Over-the-Counter
Important Safety Information
This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.
Medical DisclaimerBrand (or Active Substance), Marketing Authorisation Holder, Dosage Form
Chewable tablets 400 mg+400 mg: 40 pcs.
Marketing Authorization Holder
Pharmaceutical Laboratories Galenica, JSC (Morocco)
Dosage Form
| Neutralax® | Chewable tablets 400 mg+400 mg: 40 pcs. |
Dosage Form, Packaging, and Composition
Chewable tablets white, round, flat-cylindrical, with a bevel and a score on one side, with a minty odor; marbling is allowed.
| 1 tab. | |
| Algedrate* | 400 mg |
| Magnesium hydroxide* | 400 mg |
* active substance: premix (SPI Parma Inc. SAS, France) – 1134 mg, incl.: Algedrate (aluminum hydroxide) – 400 mg, Magnesium hydroxide – 400 mg, sucrose – 195.44 mg, sorbitol – 125.42 mg, mannitol – 10.09 mg, sodium saccharin – 3.06 mg.
Excipients: sucrose – 41.43 mg, sodium carboxymethyl starch (primogel) – 13.91 mg, peppermint leaf oil – 2.36 mg, magnesium stearate – 8.29 mg.
10 pcs. – blisters (4) – cardboard packs.
Oral suspension: 250 ml bottle
Marketing Authorization Holder
Pharmaceutical Laboratories Galenica, JSC (Morocco)
Dosage Form
| Neutralax® | Oral suspension: 250 ml bottle |
Dosage Form, Packaging, and Composition
Oral suspension white, homogeneous after simple shaking, with a menthol odor.
| 100 ml | |
| Algedrate* | 22.44 g |
| Magnesium hydroxide** | 13 g |
* Algedrate (aluminum hydroxide gel) recalculated as Al(OH)3 – 3.5 g.
** Magnesium hydroxide (Magnesium hydroxide paste) recalculated as Mg(OH)2 – 4 g.
Excipients: mannitol – 0.25 g, methylparahydroxybenzoate (nipagin) – 0.1 g, propylparahydroxybenzoate (nipasol) – 0.05 g, anhydrous citric acid – 0.1 g, anhydrous sorbitol – 0.8 g, sodium saccharin – 0.028 g, hydrogen peroxide 30% solution – 0.09 ml, peppermint leaf oil – 0.01 ml, hyetellose (hydroxyethylcellulose) – 0.22 g, purified water – up to 100 ml.
250 ml – dark glass bottles (1) – cardboard packs.
