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PubMed2000

Comparative palatability of 22 liquid antacids.

OBJECTIVE: To compare the palatability, acid neutralizing capability, and costs of different antacids. METHODS: Volunteers between the ages of 18 and 60 years were given 22 antacids. All antacids were given during a 4-h period in two groups of 11 antacids each. Subjects sampled each antacid in a manner similar to wine tasting and rated each antacid on its smell, taste, texture and aftertaste using a scale of 1-9; 1 being the worst and 9 the best. RESULTS: A total of 73 adults completed the study. Mylanta Lemon Twist and Mylanta Cherry Crème were the most palatable antacids; however, overall the palatability of all the antacids was poor. Maalox MS Cool Mint and ES Gaviscon were the least palatable. The extra strength antacids had the most acid neutralizing capability, and thus would require smaller doses. Amphogel was the most costly antacid per mEq of acid neutralized. Age and gender did not affect the palatability scores. CONCLUSION: Although the regular strengths of Mylanta Lemon Twist and Mylanta Cherry Crème were the most palatable, the extra strength versions of these products have twice the acid neutralizing capability and thus, half the volume is required for each dose. Therefore, these agents may be the antacids of choice.

Adolescent↗
PubMed1991

Gastric emptying of two radiolabelled antacids.

The rate of gastric emptying of two antacids, magaldrate and Maalox, was investigated using scintigraphy. Successful labelling of the antacids was carried out with 99mTc. The stability of the 99mTc-labelled antacids was satisfactory and there was no difference in antacid capacity between the labelled and unlabelled antacids. The studies were carried out on 15 healthy male volunteers. After an eight hour fast each subject ingested a standardised meal of 95.7 MJ (400 kcal). One hour later 10 ml of one of the two antacids previously labelled with 99mTc was administered. Serial detection by anterior and posterior projection of the amount of antacid retained in the stomach was performed to determine gastric emptying of antacid. One week later the study was repeated under the same conditions with the other antacid also labelled with 99mTc. The mean (SD) percentages of antacid retained in the stomach fit a linear model with a t1/2 of 86.6 (15.3) minutes for magaldrate and 52.3 (5.2) minutes for Maalox (p less than 0.01). When the mean percentages of retention at six time intervals were compared for both antacids, it was found that Maalox emptied much faster (p less than 0.01 at 15 and 30 minutes, p less than 0.02 at 45, 60, 75, and 90 minutes).

Adult↗
PubMed2002

Non-steroidal anti-inflammatory drug and antacid co-prescription in Taiwan: analysis of national insurance claims.

BACKGROUND: Antacids were usually co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs), although no broad evidences were available as to the effects of antacids in preventing NSAID-associated gastropathy. We performed a survey of national insurance claims for outpatient services in Taiwan to determine the extent of this co-therapy nationwide. METHODS: The National Health Insurance Research Database supplied the sampling datasets for analysis. They represented 0.2% of the entire claims for outpatient medical services in 1999. Co-prescribing was assessed as NSAIDs and antacids on the same prescription. The selection and grouping of NSAIDs followed the guidelines of the Anatomical Therapeutic Chemical (ATC) Classification System recommended by the World Health Organization. Only the oral drugs prescribed on regular visits were taken into account. RESULTS: In totally 425,442 prescriptions with 1,825,604 items of drugs, non-aspirin NSAIDs were present in 108,818 (25.6%) prescriptions and antacids in 235,252 (55.3%) prescriptions respectively. Furthermore, antacids were present in 71.3% of prescriptions that contained NSAIDs and in 49.8% of prescriptions that did not contain NSAIDs (p < 0.001). Significant association of NSAIDs and antacids existed in different specialties of prescribing physicians, but the co-prescription rate (antacids in NSAIDs prescriptions) varied from the highest of 92.8% in the neurosurgery to the lowest of 49.8% in the pediatrics. Significant association of NSAIDs and antacids also existed at different levels of health care facilities, where the co-prescription rates were 80.9% at medical centers, 83.5% at regional hospitals, 87.4% at local hospitals, and 66.6% at primary care units. The subgroup of oxicams was more frequently co-prescribed with antacids than other subgroups (odds ratio = 1.51, p = 0.001). CONCLUSIONS: Concomitant prescription of oral non-aspirin NSAIDs and antacids was indeed a popular practice in Taiwan. Beside their effects in alleviating the NSAID-associated dyspepsia, the role of antacids in preventing NSAID-associated peptic ulcers or in masking the warning symptoms of these ulcers demands further evaluation.

Adult↗
PubMed1992

Evidence for the interaction between antacid and gastric mucosa using an "artificial stomach" model including gastric mucosa.

In light of evidence that certain aluminum-based antacids adhere to the gastric mucosa, we modified our previously described "artificial stomach" (AS) model by including a piece of hog stomach and compared the antacid activity of six aluminum-containing antacid products in the model with and without gastric mucosa. The activity of three of these, Maalox, Riopan and Supralox, was not significantly different in the two systems. In contrast, the activity of the other three, Aludrox, Phosphalugel and Simeco, was significantly greater with mucosa. Antacid activity of one product from each set (Supralox, Phosphalugel) was evaluated in two in vivo methods in human volunteers. For both antacids, results in vivo were similar to those obtained with the AS-containing mucosa. Without mucosa, in vivo and in vitro results were dissimilar for Phosphalugel, thus validating the modified AS. The difference between the two sets of antacids can be explained by 1) the fact that the Al:Mg ratio in the set affected by mucosa is greater than that of unaffected antacids, and 2) a weaker antacid load than in unaffected Supralox. We suggest that in an acid milieu, aluminum ions in antacids like Aludrox, Phosphalugel and Simeco are bound to sialic acid residues in mucus glycoproteins, thus retarding the transit of these antacids through both the AS and the real stomach and prolonging their activity in both situations. When the Al:Mg ratio is low or when the amount of antacid salts is large, aluminum ions tend to be buried in complexes, giving them less chance to interact with gastric mucus, so they transit the stomach more quickly.

Adult↗
PubMed1985

Acid neutralization capacity of Canadian antacid formulations.

A study was designed to determine the acid neutralization capacities (ANCs) of the new Canadian antacid formulations and to compare these products with standard antacid products in terms of lot-to-lot consistency, ANC, sodium and "calorie" contents, and price to the pharmacist. Twenty-three liquid and 18 tablet antacids were tested. The concentrated liquid antacids (Mylanta-2 Extra Strength, Amphojel 500, Gelusil Extra Strength, Maalox TC and Diovol Ex) were found to have the highest ANCs. Six of the tablet antacids (Amphojel, Amphojel Plus, Camalox, Gelusil-400, Maalox and Mylanta-2) were found to have greater ANCs than 15 of the liquid antacids. Between-lot variation exceeded that of within-lot variation in 10 of the 14 liquid antacids for which this variation could be tested. The concentrated liquid antacids provide the highest ANCs with the lowest dosage volume and sodium and calorie contents. Some tablet antacids have the potential to be used as alternatives to liquid antacids because of their high ANC and patient convenience. The inclusion of ANC on the labels of antacid products would assist in the rational determination of the dose of these products.

Antacids↗
PubMed1998

Evaluation of buffering capacity and acid neutralizing-pH time profile of antacids.

The antacid properties of seven antacids listed in the hospital formulary of a medical center were evaluated with in vitro tests. These included not only the preliminary antacid test and acid-neutralizing capacity test as described in the United States Pharmacopeia (USP XXIII), but also a buffering pH profile test. The preliminary antacid test measured the final pH of a 10-mL solution of 0.5 N HCl 10 minutes after addition of the minimum recommended dose of an antacid, while the neutralizing capacity test measured the amount (mEq) of HCl neutralized by the minimum recommended dose in 15 minutes. The buffering pH profile recorded the pH time course of dynamic simulated gastric fluid neutralization by a dose of an antacid. In the preliminary antacid test, magnesium oxide showed the highest pH (9.52 +/- 0.14, mean +/- standard deviation, n = 3); aluminum phosphate gel yielded a final pH of 2.51 +/- 0.01, thus failing to meet the criteria of an antacid (pH > 3.5). In the acid-neutralizing capacity test, hydrotalcite had the highest neutralizing capacity (28.26 +/- 0.3 mEq), while sodium bicarbonate had the lowest (7.40 +/- 0.12 mEq). In the buffering pH profile test, aluminum-magnesium hydroxide suspensions and hydrotalcite tablets maintained a steady optimum pH (3-5) for around 1.5 hours. One tablet of calcium carbonate, sodium bicarbonate or magnesium oxide could not raise the gastric pH to above 3, but two tablets increased the pH excessively (5.3 to 8.6). The higher dose (two tablets) of aluminum hydroxide hexitol complex could not raise the pH to the optimal level. These findings demonstrate that there is disparity in the antacid effectiveness estimated by the neutralizing capacity test and the buffering pH profile test and suggest that the efficacy of an antacid cannot be accurately predicted from its acid-neutralizing capacity. The dose of antacids greatly influences the neutralizing pH profiles. Aluminum-magnesium compounds appear to provide steadier buffering than carbonate compounds or magnesium oxide.

Aluminum Compounds↗
PubMed1976

Correlation of in vitro and in vivo methodology for evaluation of antacids.

The rate and extent of acid consumption of an antacid suspension and tablet were evaluated by in vitro and in vivo techniques. Four different test procedures were used to estimate in vitro antacid reactivity. In vivo effects were determined in the fasted and postcibal states in normal human subjects by a radiotelemetry procedure. The duration of elevation of intragastric pH greater than 3 was in agreement with in vitro estimates of total acid consumption of the antacid. There was also good correlation between onset, extent, and duration of in vivo antacid activity and a modified in vitro Beekman antacid test procedure. There was no significant difference in antacid activity of the tablet or suspension in either in vitro or in vivo test procedures. A wide variation in antacid activity was observed between subjects and also in the fasted versus postcibal states. These studies emphasize the requirements for standardization of antacid products by comparactive in vitro and in vivo evaluations to facilitate individualized dose titration of the antacid in each patient and correlation of the acid secretion rate in various types of GI disease with the antacid dose.

Aluminum Hydroxide↗
PubMed1995

Gastric emptying of two radiolabelled antacids with simultaneous monitoring of gastric pH.

The aim of this study was to assess the gastric emptying rate of two antacids using an scintigraphic technique and simultaneous monitoring of gastric pH in 16 healthy male volunteers. Ten ml of Talcid (hydrotalcite 1 g) and Maalox (Mg-Al-hydroxide), with a similar neutralization capacity, were labelled with technetium-99m using a pyrophosphate bridge. Labelled antacids were given on separate days (within 2 weeks), 1 h after a standard meal. Intragastric pH was measured for at least 4 h, using ambulatory pH-metry with a dual-crystant antimony catheter. Continuous monitoring was started 1 h prior to the meal (baseline) and lasted 3 h (post-prandial, post-antacid and final periods). The antacid capacity of labelled and unlabelled antacids was similar. The mean percentages of antacids retained in the stomach fitted a linear model. The mean half-emptying time of Talcid was 63.9 +/- 27.9 min, while that of Maalox was 57.3 +/- 23.9 min (P = NS). The recordings of gastric pH (mean values of pH for each period) showed a similar profile for both antacids. The mean pH (Maalox vs Talcid) was 1.69 vs 2.07 in the baseline period, 1.95 vs 1.93 in the post-prandial period, 1.79 vs 1.15 in the post-antacid period (P = NS) and 0.4 vs 0.52 in the final period (P < 0.05 vs prior periods). In conclusion, the gastric emptying of Talcid and Maalox was similar and pH profiles were parallel and remained unchanged for the two antacids within the first hour of intake. A significant decrease in pH was observed 1 h after intake of the antacids, suggesting a possible rebound effect.

Adult↗
PubMed1986

Cimetidine blocks antacid-induced hypergastrinemia.

The effects on fasting serum gastrin concentrations of hourly doses of magnesium and aluminum hydroxide antacid, with and without intravenous cimetidine, were determined in 8 patients with duodenal ulcer disease. Gastrin levels rose significantly over 10 h when antacid was given either as a bolus of 30 ml every hour or as a constant infusion of 0.5 ml/min (36 +/- 5 pg/ml and 33 +/- 6 pg/ml to 108 +/- 32 pg/ml and 109 +/- 22 pg/ml, respectively, p less than 0.05). This effect was specific for some component of the antacid and not for neutralization of acid per se, inasmuch as sodium bicarbonate, infused to keep gastric pH at levels at or above those of antacid, produced no significant rise in serum gastrin concentration. When intravenous cimetidine was administered simultaneously with intragastric antacid, gastrin levels did not rise. This occurred even though intragastric pH levels were actually higher with cimetidine plus antacid than with antacid alone. The ability of intravenous cimetidine to block antacid-induced hypergastrinemia was counteracted by infusing simultaneously both hydrochloric acid and antacid into the stomach. Since hydrochloric acid reacts with magnesium and aluminum hydroxide to form ionic magnesium and aluminum chloride, cimetidine most likely blocks antacid-induced hypergastrinemia by reducing acid secretion from the stomach and thereby limiting the generation of ionic magnesium and aluminum.

Adult↗
PubMed1998

Modification of fluorescent properties of norfloxacin in the presence of certain antacids.

Modification of the fluorescent properties of norfloxacin samples in the presence of different antacids in terms of dissolution rates has been reported in a previous paper. The formation of chelates with Al3+ and Mg2+ ions has been previously suggested as a mechanism of interaction. In the present paper, the chelation was studied with different types and amounts of antacids and the stability of the non-absorbable chelates with each antacid was studied. Six dose fractions of each antacid were used in samples with the same norfloxacin concentration (9 microg ml(-1)). All samples were measured using both UV/Vis-spectrophotometry and spectrofluorimetry, and compared to a standard solution of norfloxacin (10 microg ml(-1)) without antacids, used as a reference in the calibration of the spectrofluorimeter. The results showed that the fluorescence signal features remarkable differences depending on the kind and the concentration of antacid, as well as on the time of contact. It was found that increasing amounts of antacids increased the fluorescence signal of norfloxacin samples. The evolution of the fluorescence signal in function of the antacid concentration showed a maximum and a posterior decrease. It was observed that, for a higher concentration of antacid in the medium, a higher signal was obtained and lower stability of the compound norfloxacin-antacid was observed. The data obtained strongly indicated that the binding of Al3+ and Mg2+ ions to the carboxylic groups of norfloxacin produced non-absorbable chelates. This effect might reduce the drug bioavailability.

Antacids↗
PubMed1984

Is there a place in the United Kingdom for intensive antacid treatment for chronic peptic ulceration?

Sixty nine patients with chronic duodenal or juxtapyloric ulceration were studied in a prospective double blind randomised trial to compare the efficacy of antacid and placebo at high (30 ml seven times daily) and low (10 ml as required) doses. After four weeks ulcers had healed in 12 out of 18 patients (67%) receiving "low dose" antacid compared with in six out of 17 patients (35%) receiving low dose placebo; ulcers had also healed in six out of 19 patients (32%) receiving "high dose" antacid compared with in two out of 15 patients (13%) receiving high dose placebo. Overall, the effect of antacid was superior to that of placebo in healing ulcers (p less than 0.05) and the effect of low dose treatment was superior to that of high dose treatment (p less than 0.01). There were no significant differences between antacid and placebo at eight weeks. Antacid was better than placebo in relieving pain, but the difference was not significant. Poor compliance and high incidence of diarrhoea made high dose antacid an impractical treatment. Low dose antacid was associated with a significantly better rate of healing than high dose antacid and was far better tolerated. This low dosage of antacid should be considered to be an active treatment in trials of ulcer healing.

Adolescent↗
PubMed1994

Antacid provides better restoration of glandular structures within the gastric ulcer scar than omeprazole.

Mucosa of healed gastric ulcers displays histological abnormalities that are possibly the basis of ulcer recurrence. The influence of antacid and omeprazole treatment was studied on the quality of ulcer healing. Sixty four rats with gastric cryoulcers were treated daily either with placebo, antacid, omeprazole, or antacid plus omeprazole. Ulcer size was measured three times per week with a novel video endoscopic method. Prostaglandin generation (day 6), cell proliferation (day 8 and 15), height and cell composition of ulcer margin (day 8), and mucosal scar (day 15) were quantitatively assessed. Antacid, omeprazole, and antacid plus omeprazole significantly accelerated ulcer healing predominantly during days 3-8. Compared with placebo, the height of ulcer margin and mucosal ulcer scar was significantly increased in antacid (+7 and +9% respectively) and significantly decreased in omeprazole (-33 and -22% respectively) and antacid plus omeprazole (-26 and -18% respectively) treated rats. The number of bromodeoxyuridine labelled cells (+42%, day 8), epithelial cell mass (+42%, day 15), and the ratios of epithelial cells/connective tissue (+73%, day 15) and epithelial cells/gland lumen (+100%, day 15) were significantly increased in antacid treated rats. In conclusion, both antacid and omeprazole accelerate ulcer healing but antacid provides a better quality of healing. This advantage is lost by cotreatment with omeprazole.

Aluminum Hydroxide↗
PubMed1990

Antacids: new perspectives in cytoprotection.

There is increasing evidence that aluminum-containing antacids are able to protect the gastric mucosa against various ulcerogenic and necrotizing agents including 0.6 M HCl, 0.2 M NaOH, and absolute alcohol. Since gastric mucosal necrosis produced by alcohol is independent of luminal acid and cannot be reduced by H2-receptor antagonists, the protective action of antacids is accomplished by mechanism(s) other than acid-neutralizing ability. In addition, since acidified antacids can protect the gastric mucosa even better than an antacid with intact neutralizing capacity, it is clear that such action is independent of acid-neutralizing ability and therefore has all the features of cytoprotection. Whereas the cytoprotective action of antacids in experimental conditions is well established, the mechanisms of antacid-induced mucosal protection are not known. The clinical relevance of antacid-induced protection also requires further elucidation. Antacids have advantages over the H2 blockers in protecting the gastric mucosa against alcohol-induced necrosis and in preventing stress-induced ulcers in critically ill patients. Although more work is needed to clarify the mechanisms of cytoprotective action of antacids, the recent experimental findings gave a new life to and new potential clinical applications for antacids.

Animals↗
PubMed1990

Assessment of antacid characteristics of drugs containing a combination of aluminium and magnesium salts using the "artificial stomach" model.

Antacid characteristics of three drugs containing aluminium and magnesium salts (combination of clay with aluminium and magnesium hydroxides, aluminium and magnesium hydroxide mixture and hydrotalcite) have been studied in a dynamic situation simulated by the "artificial stomach" model, simultaneously taking into account both gastric fluxes, a constant secretory flux and variable emptying fluxes. Therapeutic doses of the drugs were added 1. to 100 ml of 0.1 N HCl, without or with 1% or 5% meat extract, and 2. 100 ml of pooled human gastric juice (96 mmol/l, pH 1.1). In addition, antacid activity of 0.5 g aluminium and magnesium hydroxides, taken alone or in combination, were evaluated when added to 100 ml of 0.1 N HCl. In aqueous HCl solution or in human gastric juice, the three antacid drugs exhibited 1. a neutralising activity characterised by pH-rise and 2. a buffering capacity close to pH 3.8. In addition, hydrotalcite exhibited also buffering capacity at pH 1.2. The antacid-induced capacity, expressed as H+ mmol, to recover initial pH were very similar, indicating that antacid physiochemical properties are similar in HCl solution or in gastric juice. H+ consumption depended upon emptying fluxes. The same antacid characteristics were observed when antacids were mixed with 1% meat extract while 5% meat extract resulted in a modification of antacid characteristics. Therefore the antacid capacities of respective mixtures were of smaller magnitude (50-60%) than the sum of the activities of antacids plus meat extracts.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum Hydroxide↗
PubMed1983

Why do apparently healthy people use antacid tablets?

Proprietary antacids represent a multimillion dollar business in this country. Marketing surveys have shown that approximately one-half of American adults have used antacids. Twenty-seven percent of adults take 2 or more doses per month. Seventy-five percent of total antacid consumption is by heavy users, defined as greater than 6 doses per week (less than 5% of adults). We investigated why apparently healthy people are heavy antacid users. Thirty-seven heavy users were evaluated. The median duration of antacid use was 20 years, and most took antacids 2-6 times per day, concentrated through the work week. The primary diagnosis was reflux esophagitis in 31 (84%), peptic ulcer disease in one, and nonulcer dyspepsia in five. Ninety-five percent had symptoms consistent with reflux esophagitis. Thirty-three completed a 1 month double-blind, randomized cross-over trial of antacid tablets (14 mEq neutralizing capacity per tablet) versus placebo. Twenty-nine correctly identified the antacid product (p less than 0.0001). Twenty-three subjects underwent Bernstein tests and endoscopy; 21 had positive Bernstein tests, 13 had definite esophagitis as determined endoscopically. We conclude 1) heavy proprietary antacid tablet use in the adult male is not an expression of functional disease but is due to reflux esophagitis, 2) tablet use can be effective symptomatic treatment, and 3) history is an adequate evaluation for most heavy antacid tablet users.

Antacids↗
PubMed1982

Evaluation of antacid suspensions containing aluminum hydroxide and magnesium hydroxide.

Liquid antacid suspensions containing aluminum hydroxide and magnesium hydroxide were evaluated for composition, antacid properties, and product quality. The equivalent aluminum oxide and magnesium hydroxide content was determined by chelatometric titration, and sodium content was determined by flame photometry. Antacid properties measured were acid-consuming capacity, antacid effectiveness (preliminary antacid test, acid-neutralizing capacity test), and pH-stat titration. Content uniformity, consistency of the antacid properties, and microbiological content were examined for each product. Data are presented for 36 products for which samples from four or more lots were obtained. The ratio of percentage of equivalent aluminum oxide to percentage of magnesium hydroxide ranged from 1:0.6 to 1:3.5; this range allows for selection of the desired balance between the laxative effect of magnesium hydroxide and the constipating effect of aluminum hydroxide. Based on a daily dose of 280 meq of antacid, the sodium content of the products tested ranged from less than 2% to approximately 45% of the 500 mg per day of sodium allowed in a sodium-restricted diet. The concept of bioavailability was related to the amount of the antacid reacting at pH 3, 37 degrees C during the estimated gastric residence time of 15 minutes. Antacid suspensions are available which will react almost completely (neutralizing greater than 90% of the theoretical quantity of acid) during the estimated gastric residence time. Approximately 4% of the samples contained unacceptable numbers of bacteria. An antacid suspension cannot be adequately evaluated by a single test; choice of a product should be based on an evaluation that integrates several characteristics including sodium content, time and volume required to neutralize a given amount of acid, and uniformity of content.

Aluminum Hydroxide↗
PubMed1984

Lack of influence of an intensive antacid regimen on theophylline bioavailability.

We examined the influence of a large-volume, therapeutic antacid regimen, administered for three full days, on the steady-state bioavailability of a conventional-release and sustained-release theophylline product, Aminophyllin and Theodur, respectively. Nine stable asthmatics voluntarily completed a four-phase investigation requiring a total stay of 12 days in the Clinical Research Unit. The treatments consisted of administration of the formulations mentioned with and without antacids to each patient in a randomized sequence. Four patients participated in an additional phase where antacids were administered q2h around the clock for three days. After coadministration of theophylline plus antacids for two days, theophylline therapy was discontinued while numerous blood samples were obtained over 22 hr and analyzed for theophylline content via radioimmunoassay. Antacids had no predictable, consistent influence on theophylline absorption rate as determined by the absorption rate constant, the time to maximal theophylline concentration, or the lag time for theophylline absorption. Antacids had no detectable influence on theophylline elimination half-life and had no consistent, statistically significant effect on the extent of theophylline bioavailability, according to measurements of maximal concentration, AUC measured over the appropriate steady-state dosing interval, or elimination-rate adjusted AUC. The substantial intraindividual changes for all parameters of theophylline bioavailability that occurred for control and treatment phases likely represent spontaneous, random between-day variability in theophylline disposition independent of antacid administration, as evidenced by the comparability of the percent coefficient of variation for parameters of bioavailability across all phases. Our data demonstrate that therapeutic antacid administration has no effect on steady-state theophylline bioavailability and does not alter the intrinsic variability in theophylline absorption. Based on the results of our data, it is unlikely that a clinically significant (greater than 20%) decrease in theophylline absorption would occur in any patient treated intensively with antacids concurrently.

Adult↗
PubMed2001

Concomitant prescription of non-steroidal anti-inflammatory drugs and antacids in the outpatient setting of a medical center in taiwan: a prescription database study.

OBJECTIVE: Although antacids were ineffective in preventing serious gastrointestinal complications caused by non-steroidal anti-inflammatory drugs (NSAIDs), many physicians in Taiwan still prescribe antacids concomitantly with NSAIDs. A survey of an outpatient prescription database was performed to measure the extent of such a combination and to explore its associated factors. METHODS: One month of the outpatient prescription data in the polyclinic of a medical center in Taiwan served to estimate the frequency of concomitant antacid prescription with NSAIDs. The age of patients, duration of NSAID prescriptions, concomitant prescription of corticosteroid or ulcer-healing drugs, and inter-departmental variations were compared between the NSAID prescriptions with and without antacids. RESULTS: Antacids were present in 87.3% of prescriptions with NSAIDs but only in 34.4% of prescriptions without NSAIDs (P<0.001). The prescription of antacids was significantly associated with the prescription of NSAIDs. The age of patients and duration of NSAID prescriptions did not influence the co-prescription of NSAIDs and antacids. Significant inter-departmental variations were noted in which the surgeons and orthopedic doctors tended to co-prescribe antacids with NSAIDs more often than the internists. CONCLUSION: The physicians in Taiwan tended to prescribe NSAIDs together with antacids. The rationality of this co-prescription deserves further investigation.

Academic Medical Centers↗