Antacid Formulations Research Articles

A Review on Polyherbal Formulation Used in the Treatment of Gastric Acidity

Acidity is a medical condition caused by an excess of acid production. This acid is produced by the stomach glands. Acidity causes symptoms such as stomach ulcers, gastric inflammation, heartburn, and dyspepsia. Acidity is a global issue caused by an imbalance between the acid-secreting mechanisms of the stomach and the proximal intestine. It causes a lot of problems in the lives of many people. An antacid reduces acidity and provides relief. This review article discusses different polyherbal formulations (PHF) used to treat gastric acidity. Due to its role in medicine and therapy, PHF has been used all over the world. The current study discusses a variety of commercial and non-commercial polyherbal formulations used worldwide to treat gastric acidity, as well as their therapeutic potential, clinical and preclinical outcomes, and safety and efficacy. This review will make it easier to learn everything about the previous scientific research as well as the crucial details about the antacid properties of polyherbal preparations, which will encourage young researchers to conduct additional studies in the future to protect people from gastric acidity. Natural herbs and their extracts are used in herbal treatment as an alternative to conventional medication to treat various conditions. It has been demonstrated that several medications contain medicinal components useful for treating ulcers or stomach acidity. The subject of the current work is the claim that a polyherbal formulation can be utilised as an alternative to currently available antacid formulations on the market. As a result, those plants that can reduce stomach acid are chosen, and a formulation is created.

Assessment of the Acid Neutralizing Capacity and Other Properties of Antacid Formulations Marketed in the Gaza Strip

Background: Antacids are frequently used as over-the-counter (OTC) medications to reduce symptoms of dyspepsia and to neutralize stomach acidity. Evaluation of antacids efficacy depends on in vitro testing like acid neutralizing capacity (ANC) and acid neutralization potential (ANP). The purpose of this study was to examine ANC, ANP, and other characteristics of commercially available antacid formulations (both liquid and solid formulations) in the Gaza Strip. Methods: Both liquid (n=2) and solid (n=4) antacid formulations were acquired from the Gaza Strip’s central community pharmacies. Preliminary antacid test (PAT) was carried out to determine if the tested formulation is classified as antacid. The general monograph <301> in USP34/NF29 was used for the estimation of ANC, while ANP was investigated using Rossett Rice procedure. Both tests were conducted to evaluate the efficacy of antacid. In addition, cost effectiveness per formulation and statistical analysis test of data were calculated. Results: All formulations were classified as antacids because they all passed the PAT test (pH of antacid-HCl over 3.5). The ANC of antacids (n=6) varied from 8.74±0.37 to 29.14±0.84 mEq per minimum labeled dose (MLD). The ANC/MLD ratios for solid formulations were higher than those of liquid formulations. No statistically significant difference in ANC/MLD between the two groups was estimated (P˃.0.05). ANP test - the time duration during which an antacid formulation maintains pH above 3.5 - ranged from 43 to 90 minutes. According to this study liquids were inefficient in acid neutralization and expensive as a result. Conclusions: The ANC and ANP results indicated the better neutralizing efficacy and duration of solid antacids in comparison to liquids. A1 and A2 formulations– calcium and magnesium salt based solid antacids had the most appropriate properties in terms of efficacy, onset and duration of neutralizing activity. Antacids in the form of chewable tablets were the most cost-effective formulations. It is recommended to examine more batches of the same antacids and to add ANC data on the label of antacids.

Management of acidity and related symptoms: A market research survey

Context: Acidity is a common medical complaint of gastrointestinal disease. A modern lifestyle brings along with it a host of problems, including acidity and gastrointestinal issues. Aims: To understand the related symptoms and management of patients diagnosed with acidity by surveying general physicians and gastroenterologists across India. Settings and Design: A questionnaire-based survey was conducted between May and December 2021 for a duration of 6 months. Methods and Material: A total of 198 general physicians and gastroenterologists across India were provided a questionnaire via an online link and requested to answer questions about acidity and its symptoms. The answers to the questionnaire were analyzed as summary statistics. Statistical analysis used: Descriptive analysis Results: About 34% were diagnosed with GI disorders and 47% of patients with GI disorders were diagnosed with hyperacidity in routine clinical practice. Heartburn/retrosternal pain (92%) was the most common classical symptom of hyperacidity, followed by epigastric pain (85%), and acid reflux (75%), belching/burping (64%), and flatulence (55%). The majority of doctors (68%) reported that antacids were recommended as the first line of treatment for hyperacidity. Around 80% of respondents reported that anesthetic antacids are most relevant or relevant in managing hyperacidity. Most physicians (89.4%) prescribed the anaesthetic antacid formulation containing magnesium hydroxide, dried aluminium hydroxide gel, simethicone, and oxetacaine in their daily practice, and 82.8% reported very good or extremely good experience with its usage. Conclusions: The survey findings provided insights into understanding the current epidemiology, diagnosis, as well as treatment of hyperacidity across India. Key Message: Acidity and its related symptoms can strongly influence the quality of life. Early identification and appropriate diagnosis can prevent major complications.

Film-Forming Polymers for Tooth Erosion Prevention.

Different agents have been proposed to prevent the progression of acid induced dental substance losses, which are called erosive tooth wear (ETW), such as fluorides, calcium, and phosphate-based products; however, there is a need for a further increase in efficacy. Recently, the ability of polymers to interact with the tooth surface, forming acid resistant films, has come into the focus of research; nevertheless, there is still the need for a better understanding of their mode of action. Thus, this article provides an overview of the chemical structure of polymers, their mode of action, as well as the effect of their incorporation into oral care products, acid beverages, and antacid formulations, targeting the prevention of ETW. Recent evidence indicates that this may be a promising approach, however, additional studies are needed to confirm their efficacy under more relevant clinical conditions that consider salivary parameters such as flow rate, composition, and clearance. The standardization of methodological procedures such as acid challenge, treatment duration, and combination with fluorides is necessary to allow further comparisons between studies. In conclusion, film-forming polymers may be a promising cost-effective approach to prevent and control erosive demineralization of the dental hard tissue.

Antacids revisited: review on contemporary facts and relevance for self-management.

Heartburn and acid regurgitation are the typical symptoms of gastroesophageal reflux. Despite the availability of several treatment options, antacids remain the mainstay treatment for gastroesophageal reflux-related symptoms based on their efficacy, safety, and over-the-counter availability. Antacids are generally recommended for adults and children at least 12 years old, and the FDA recommends antacids as the first-line treatment for heartburn in pregnancy. This narrative review summarizes the mechanism, features, and limitations related to different antacid ingredients and techniques available to study the acid neutralization and buffering capacity of antacid formulations. Using supporting clinical evidence for different antacid ingredients, it also discusses the importance of antacids as OTC medicines and first-line therapies for heartburn, particularly in the era of the COVID-19 pandemic, in which reliance on self-care has increased. The review will also assist pharmacists and other healthcare professionals in helping individuals with heartburn to make informed self-care decisions and educating them to ensure that antacids are used in an optimal, safe, and effective manner.

Comparison of two marketed effervescent fast relief formulations for antacid activity-an in vitro study

Background: Hyper-acidity is excessive formation of acid (pH=1.5-3.5) in the stomach by parietal cells which causes a burning sensation in the chest. The preservation of gastric acid insult is crucial because of the implications of hyperacidity in gastroesophageal reflux disease (GERD), peptic ulcers and duodenal ulcers. Acidity is controlled by use of some over-the-counter (OTC) antacid formulations containing magnesium or aluminum hydroxides.Methods: In the present study, the preliminary antacid test (PAT), the pH acid neutralizing capacity (ANC), acid neutralizing potential (ANP) along with buffering capacity of two well-known quick release formulations (F1 [Digene Ultra Fizz] and F2 [a standard, commercially available product]) were determined. Results: According to US pharmacopeia USP, both the antacid formulations passed the PAT test. PAT results revealed that the pH of the acid-antacid solution was higher in F1 (8.20±0.02) as compared to F2, (6.53±0.01). The ANC results revealed that F1 (46.89±0.6 mEq/dosage) had higher neutralizing capacity as compared to F2(30.12±1.3 mEq/dosage). Higher ANP was observed for F1 (245 mins), and it was 2.7 times that of F2 (90 min). The onset of action for both the antacids was <2 seconds. Additionally, buffering capacity was evidently observed during ANP analysis in the case of F1. Independent T test performed for all the tests revealed that the data obtained was highly significant (p<0.01).Conclusions: F1 showed high antacid and buffering properties when tested in vitro. The present study highlights the need for future research on specific OTC non-prescribed antacid formulations with respect to their price, efficacy and side effects.

Acid-neutralising capacity and pharmacoeconomic studies of commercially available antacids in the Qassim Region of Saudi Arabia

Background: Antacids are common over-the-counter medications for relief in common dyspeptic symptoms. However, antacid use has decreased with the availability powerful acid suppressant medications such as histamine H2 blockers, proton-pump inhibitors and prostaglandin analogues. Of late, a resurgence in the usage of antacids has been noted because of the improved profiles of newer antacid formulations, for example, the addition of pain-relieving component, oxetacaine (a local anaesthetic), anti-flatulent (alginate base compounds), in some antacid preparations. Aims and Objectives: The study investigated the efficacy (in terms of acid-neutralising capacity [ANC]) and cost-effectiveness of commercially available antacid formulations (both liquid and solid formulations). Materials and Methods: ANC was carried out using simple titrimetric methods and cost-effectiveness of antacid preparations was based on cost (in Saudi riyal) per milliequivalents of the acid neutralised. Results: ANC/gram was highest for antacid A1 (Moxal Plus solid) and lowest for antacid A3 (Fawar effervescent powder). The ANC/gram varied greatly among different antacid products and it ranged from 3.48 to 13.18. In general, solid antacids showed a high ANC/gram compared to the liquid antacids. Furthermore, solid antacids were also found to be cost-effective compared to liquid dosage forms. In terms of efficacy, the newer antacid containing simethicone (A1) was found to be more cost-effective followed an antacid containing calcium carbonate (A2) and magnesium carbonate. Conclusion: In conclusion, mentioning ANC on antacid formulation labels may help to guide the choice of appropriate antacid, while cost-effectiveness study would govern the prescribing pattern of an antacid.

Preliminary in-vitro evaluation of marketed formulations for antacid activity

Background: Hydrochloric acid (pH 1.5-3.5) being the major component of gastric acid is produced by parietal cells of stomach. Its secretion is a complex and relatively energetically expensive process. The preservation of acidity of stomach is evidently important because of its implications in peptic and duodenal ulceration.Methods: In the present study, we attempted to compare the activity of 13 (F1-F13) antacid formulations (5-liquid, 4- quick releases and 4- tablets) by using acid-base neutralization studies. Preliminary antacid test (PAT) was performed to define whether the given formulation falls under the category of antacid wherein the pH of the antacid-acid (HCl) solution should be higher than pH of 3.5. The chosen antacids were further subjected to acid neutralizing capacity (ANC) (reaction between the sample of antacid and amount of acid neutralized by the formulation) and acid neutralizing potential (ANP) which explains the time duration during which a given sample of antacid can maintain pH above 3.5).Results: Out of the 13 samples tested, two formulations of pastels (F6, F12) were rejected as per the standard protocol of classifying formulations as antacids after screening for PAT. Sample F5 was found to have the highest ANC. F7 also showed highest ANC among the tablets tested. Also, F13 showed better ANC and ANP as in comparison to other quick releases.Conclusions: Digene products (F5, F7, and F13) showed better antacid properties. This data would provide insights into development of drug, comparison between antacids depending on their chemical formulation and determination of dosage to avoid plausible side effects.

Two placebo-controlled crossover studies in healthy subjects to evaluate gastric acid neutralization by an alginate–antacid formulation (Gaviscon Double Action)

Objective: To investigate the intragastric acid neutralization activity of a combined alginate-antacid formulation. Significance: Published studies have investigated the reflux-suppressing alginate component of Gaviscon Double Action (Gaviscon DA; RB, UK) but intragastric acid neutralization activity of the antacid component has not been evaluated in vivo. Methods: Intragastric pH monitoring, using a custom-made 10-electrode catheter, was evaluated in a two-part exploratory study in healthy subjects; Part I (n = 6) tested suitability of the catheter using antacid tablets (Rennie; Bayer, Germany); Part II (n = 12) evaluated gastric acid neutralization activity of Gaviscon DA liquid (20 ml) versus placebo in fasted subjects using a randomized, open-label, crossover design. The primary endpoint was the percentage of time that intragastric pH ≥4 was measured during 30 min post-treatment. A confirmatory study of identical design was subsequently conducted (n = 20). Results: Monitoring pH using the multielectrode catheter was a viable approach, directly detecting changes in intragastric pH following a single dose of antacid tablets. In the exploratory study, the percentage of time that pH ≥4 during 30 minutes post-treatment was 46.8% with Gaviscon DA liquid versus 4.7% with placebo (p = 0.0004). These findings were supported by the confirmatory study, where pH ≥4 was recorded 50.8% of the time with Gaviscon DA versus 3.5% with placebo (p = 0.0051). In this study, Gaviscon DA was safe and well tolerated. Conclusions: These studies demonstrate the effective acid neutralizing capacity of Gaviscon DA versus placebo in healthy, fasted subjects. This adds to the evidence base for the combination of alginates and antacids. Trial registration: EU Clinical Trials Register identifier: 2014-003158-15. Trial registration: EU Clinical Trials Register identifier: 2016-000539-42.

<i> In vitro</i> interaction between artemether and some antacids and edible clay

In vitro interaction between artemether and some antacids and edible clay was investigated. Adsorption studies using three antacids namely, magnesium trisilicate, aluminium hydroxide, magnesium hydroxide as well as edible clay were carried out to determine extent of adsorption of artemether onto the adsorptive materials. A commercial artemether tablet brand was evaluated for some tablet properties and used to determine the effects of the adsorptive materials on tablet disintegration time and dissolution. Adsorption of artemether by the adsorbents followed the rank order; magnesium trisilicate (79.98%) > magnesium hydroxide (74.21%) > aluminium hydroxide (70.90%) > edible clay (37.10%). The adsorption of the drug onto the adsorptive materials was proportional to the drug concentration. The tablet parameters (weight, hardness, friability and content of active) of the commercial tablets met official BP specifications. There was significant increase ( p = 0.0012) in the disintegration times of the tablets in the presence of the antacids, edible clay and a commercial antacid suspension Emtrisil ® , however there was retardation of dissolution in the presence of the adsorptive materials. The percentage amount of artemether dissolved in 60 min and the order of dissolution retardation was as follows: Emtrisil ® (49.58%) > magnesium trisilicate (52.20%) > magnesium hydroxide (58.92%) > aluminium hydroxide (62.67%) > edible clay (67.42%) as against 88.86% in 0.1 N HCl solution. Co-administration of artemether with adsorptive antacid formulations and concomitant consumption of edible clay with artemether should be strongly discouraged. Keywords : artemether, adsorption, antacids, edible clay, dissolution

The effect of thermal treatment on the acid neutralizing capacity of newberyite: structural assessment and kinetics of the HCl neutralization reaction

The newberyite MgHPO4·3H2O antacid activity has never been investigated before. Crystalline and heated Newberyite, at 200 °C, was tested as a neutralizing of hydrogen chloride acid (HCl 0.1 M to simulate gastric juice). Results show that the substrate has a basic behavior and may be used as an active ingredient in the antacid formulation. HCl Neutralization 0.1 M depends of newberyite concentration and pH1 was reached when 0.5 M was used. The crystalline and heated newberyite antacid power was compared with that of some commercial antacids. The newberyite heated pushed pH to 4 after 4 min when the crystalline product was brought it to 3 after 15 min. The antacid neutralizing capacity (ANC) was evaluated using direct and reverse titration methods. ANC values increased when particle sizes decreased. The heated product at 200 °C increased strongly the ANC and the maximum value reached was 13 meq/g. The kinetic study of neutralization reaction was carried out by pHmetry. The rate constants are depending of newberyite quantity and the optimal neutralization of HCl 0.1 M was obtained for 0.5 g. The resulting structural transformations have been investigated. XRD showed that the product became amorphous after heating at 200 °C. FT-IR and Raman spectroscopy agree on departure of the three crystallization water molecules, when MgHPO4·3H2O was heated. Surface area measurement was determined by Brunauer, Emmett and Teller and indicates that the product hasn’t an important porosity. Scanning electron microscopy coupled with energy dispersive spectrometry elementary analysis was also carried out and confirmed FT-IR and Raman spectroscopy results.

Antacid Studies of Newly Developed Polyherbal Formulation

A lot of herbal plants are used across the globe to remedy various diseases. Herbal treatment is an alternative form for medicine where natural herbs and their extracts are used to cure a situation. Some drugs are proved to contain pharmaceutical ingredients suitable for treatment of stomach acidity or ulcers. The present work deals with the claim that a polyherbal formulation can be formulated which can be used as an alternative to already existing antacid formulations in the market. Therefore, some selected herbs with the tendency to neutralize acid in the stomach are selected and a formulation is formed. Microemulsion of oil showed higher stability with droplet size in the range of 110-410nm. The product then screened for in vitro antacid properties which showed significant positive response

In vitro interaction between Zidovudine and some adsorptive antacids

The in vitro interaction between zidovudine and three antacids and a commercial product was investigated. The extent of adsorption of zidovudine by the antacids, and the effects of the antacids on the disintegration time and dissolution of the drug from tablets were studied. Adsorption of the drug by the antacids followed the order; magnesium trisilicate > aluminium hydroxide > magnesium hydroxide. Retardation of dissolution amongst the antacids and commercial product was of the order; Jawasil® > magnesium trisilicate > aluminium hydroxide > magnesium hydroxide. Also, the degree of retardation of dissolution from the tablets increased as the amount of adsorbent increased. Co-administration of zidovudine and adsorptive antacid formulations should be avoided in clinical practice since it can lead to a decrease in the bioavailability of zidovudine, ultimately leading to therapeutic failure. DOI: http://dx.doi.org/10.3329/dujps.v13i1.21853 Dhaka Univ. J. Pharm. Sci. 13(1): 1-6, 2014 (June)

STABILIZATION OF ANTACID FORMULATION WITHOUT SORBITOL.

The aim of present study was to develop Stabilized Antacid formulation without using sorbitol base. Sedimentation, Redispersibility and caking were the major problem in the stabilization of the antacid formulation. It was very challenging to achieve Antacid formulation without using sorbitol. This challenge achieved by taking nine different (F1-F9) trails batches using Sodium alginate and Xanthan Gum (G). Formulation (F9) obtained from the above trail batches were selected on the basis of three months accelerated stability data.

Clinically Significant Drug Interactions with Antacids

One may consider that drug-drug interactions (DDIs) associated with antacids is an obsolete topic because they are prescribed less frequently by medical professionals due to the advent of drugs that more effectively suppress gastric acidity (i.e. histamine H(2)-receptor antagonists [H2RAs] and proton pump inhibitors [PPIs]). Nevertheless, the use of antacids by ambulant patients may be ever increasing, because they are freely available as over-the-counter (OTC) drugs. Antacids consisting of weak basic substances coupled with polyvalent cations may alter the rate and/or the extent of absorption of concomitantly administered drugs via different mechanisms. Polyvalent cations in antacid formulations may form insoluble chelate complexes with drugs and substantially reduce their bioavailability. Clinical studies demonstrated that two classes of antibacterials (tetracyclines and fluoroquinolones) are susceptible to clinically relevant DDIs with antacids through this mechanism. Countermeasures against this type of DDI include spacing out the dosing interval - taking antacid either 4 hours before or 2 hours after administration of these antibacterials. Bisphosphonates may be susceptible to DDIs with antacids by the same mechanism, as described in the prescription information of most bisphosphonates, but no quantitative data about the DDIs are available. For drugs with solubility critically dependent on pH, neutralization of gastric fluid by antacids may alter the dissolution of these drugs and the rate and/or extent of their absorption. However, the magnitude of DDIs elicited by antacids through this mechanism is less than that produced by H2RAs or PPIs; therefore, the clinical relevance of such DDIs is often obscure. Magnesium ions contained in some antacid formulas may increase gastric emptying, thereby accelerating the rate of absorption of some drugs. However, the clinical relevance of this is unclear in most cases because the difference in plasma drug concentration observed after dosing shortly disappears. Recent reports have indicated that some of the molecular-targeting agents such as the tyrosine kinase inhibitors dasatinib and imatinib, and the thrombopoietin receptor agonist eltrombopag may be susceptible to DDIs with antacids. Finally, the recent trend of developing OTC drugs as combination formulations of an antacid and an H2RA is a concern because these drugs will increase the risk of DDIs by dual mechanisms, i.e. a gastric pH-dependent mechanism by H2RAs and a cation-mediated chelation mechanism by antacids.

Influence of Type and Neutralisation Capacity of Antacids on Dissolution Rate of Ciprofloxacin and Moxifloxacin from Tablets

Dissolution rate of two fluoroquinolone antibiotics (ciprofloxacin and moxifloxacin) was analysed in presence/absence of three antacid formulations. Disintegration time and neutralisation capacity of antacid tablets were also checked. Variation in disintegration time indicated the importance of this parameter, and allowed evaluation of the influence of postponed antacid-fluoroquinolone contact. The results obtained in this study showed decreased dissolution rate of fluoroquinolone antibiotics from tablets in simultaneous presence of antacids, regardless of their type and neutralisation capacity.

Assay of bismuth in combined medicinal formulations using an ion-selective electrode

An ion-selective electrode (ISE) with a plasticized membrane reversible to the ethylenediaminetetraacetic bismuthate (III) anion ([Bi(EDTA)]−) is described and a method for the direct potentiometric estimation of bismuth (III) in antacid formulations is presented. The active group of the ion exchanger for the [Bi(EDTA)]− anion-reversible ISE was the tridodecylmethylammonium cation.

Comparison of Two Antacid Preparations on Intragastric Acidity – A Two-Centre Open Randomised Cross-Over Placebo-Controlled Trial

Background: Rennie® and Riopan Gel® are 2 of the most well-known and popular over-the-counter antacids; for heartburn symptoms, pain relief is fast with both preparations. A direct comparison with respect to intragastric acidity has not been done yet. The aim of our study was therefore to compare the effects of both preparations on intragastric acidity of fasting volunteers. Methods: The study was conducted as an open, randomised, placebo-controlled, 2-centre cross-over study. On different days, 24 healthy adult volunteers (11 males and 13 females) received equimolar acid-neutralising amounts of either Riopan Gel (800 mg magaldrate) or 2 tablets of Rennie (680 mg calcium carbonate and 80 mg magnesium carbonate) or no drug (control) with a wash-out period of at least 4 days between applications. The intragastric pH was measured for 3 h by intragastric pH-metry. The primary endpoint was the median time lag before intragastric pH >3.0 was reached for 10 consecutive min after drug administration. Results: For both antacids, the median pH during the first 30 min after drug administration was statistically significantly different from placebo (p < 0.05), but there was a statistically significant increase in pH during the first 5 min for Riopan Gel only. Conclusion: Compared to placebo, both antacids (Rennie and Riopan Gel) have short-lasting effects on intragastric acidity. There is no statistically significant difference between the 2 preparations, except in the first 5 min, indicating a faster onset of action for Riopan Gel. We conclude that the antacid formulation (tablet or liquid) has little influence on intragastric acidity.

Non-chewable antacid formulations: Effect of different disintegrating agents on their acid Neutralization properties

Aim of the present work is to develop non-chewable antacid tablets using different disintegrating agents viz., microcrystalline cellulose, sodium starch glycolate (Primogel®), and cross-linked sodium carboxymethylcellulose (cros-car-mellose sodium®). These agents were used alone, and in combinations, both 50% intra-granularly, and 50% extra-granularly. To cover all these variables in the formulations, seven different formulations were designed. Use of different disintegrating agents have shown varying effect on disintegration time and pattern. The disintegration time for formulation I and III did not comply with the official disintegration test in distilled water, as well as in simulated gastric fluid. All formulations, except formulation I and III, showed nearly equivalent to 30 min of Rosset-Rice time for neutralization. The graphical representation shows that when the base is available in full strength, it neutralizes the acid at a faster rate, and then the amount of base goes on reducing progressively, resulting in decrease in the rate of neutralization. Based on't' values, formulation II and VI show that the theoretical acid-consuming capacity, and the observed acid- consuming capacity values are almost equal.

A method of calculating the thixotropic area of non-Newtonian dispersions

Thixotropic area is one of the parameters for evaluating the rheology of thixotropic (non-Newtonian) dispersions. A method of determining this parameter has been suggested. This method involves the resolution of a polynomial, which represents the ascending curve of the rheogram. The area under the curve is determined by integrating the resolved equation within specified limits of shear stress. The difference between this area and the area of a trapezium formed by the descending curve, the vertical lines drawn from the specified limits of shear stress and the shear stress axis, forms the thixotropic area of the dispersion. Key words: Non-Newtonian dispersions, thixotropic area, aluminium hydroxide gel, antacid formulation. Journal of Pharmaceutical and Allied Sciences Vol.2(2) 2004: 237-243