Each tablet contains
Magnesium Hydroxide B.P. .....
Aluminium Hydroxide B.P. .......
Contains Methylparaben 0.1 % w/w
Flat, white, round tablet, 12.9mm in diameter, marked KOTRA logo on one
Axcel Eviline is an antacid/deflatulent for symptomatic treatment of peptic
ulcer, dyspepsia of functional or organic origin, heartburn in hiatus hernia
or pregnancy, flatulence and abdominal distension, gastritis oesophagitis
and other conditions where hyperacidity or flatulence may be present.
Mechanisms of actions
Axcel Eviline is an antacid used to prevent and relief pain in the
symptomatic management of gastric and duodenal ulcers and gastrointestinal
reflux by neutralising hydrochloric acid in the gastric secretions. It does
not reduce the volume of HCL secreted and may increase it but by increasing
the gastric pH which will diminished the activity of pepsin in the gastric
secretions. However if the increase of gastric pH is slight, there may be an
increase in pepsin activity. Therefore, Axcel Eviline indirectly suppress
peptic activity when given in sufficient quantity to elevate the pH of human
gastric contents above 5. Between pH 7 and 8, pepsin is irreversibly
inactivated. The presence of antacid increases the volume of gastric juice
secreted and the output of HCL. Both aluminium and magnesium hydroxide are
classified as non-systemic antacids which neutralise the gastric contents
but do not cause systemic alkalosis, because the cationic moiety in the
intestine form insoluble basic compounds that are not subsequently absorbed.
Both aluminium and magnesium hydroxides react with hydrochloric acid in the
stomach to form aluminium chloride and magnesium chloride respectively.
The insolubility of both the
hydroxide compounds is a desirable property in that fractions of sedimented
unreacted excess remain in the stomach to yield a sustained effect.
Therefore, the product has a prolonged duration of action. The cathartic
effect of magnesium hydroxide is minimized by the aluminium hydroxide, which
have constipating effects. Aluminium hydroxide is an effective absorbent and
interacts with many drugs in the gastrointestinal tract. Polymethylsiloxane,
or simethicone, is an antifoaming agent with water-repellent properties. It
is an adjunct in the treatment of conditions in which gas is a problem, such
as flatulence, functional gastric bloating and postoperative gaseous
Aluminium hydroxide has a very low equivalent weight and hence a high
theoretical neutralising capacity. Proteins, peptides, amino acids and
certain dietary organic acids greatly impair the neutralising capacity of
Aluminium hydroxide. Although both the hydroxide compounds are classified as
non-systemic, some absorption from the gastrointestinal tract does not take
place, 5 - 10% of the magnesium can be absorbed. 17 - 31% of dietary
aluminium is excreted in the urine and a considerable amount is distributed
to bone and lung. In renal failure, the administration of aluminium
hydroxide can elevate the plasma aluminium concentration. Among the
compounds formed in the intestine from aluminium hydroxide are insoluble
aluminium phosphates which pass through the intestinal tract unabsorbed, and
excreted in the faeces. Ordinarily the absorbed magnesium ion is rapidly
excreted by the kidney. The urine may be alkalinized, which can decreased
the excretion of various weakly basic drugs e.g. quinidine.
1 - 2 tablets to be chewed or sucked 3 times daily or as required,
preferably after meals.
No known contraindications.
In renal failure, the administration of aluminium hydroxide can elevate the
plasma aluminium concentration as high as 53mg/ml. Among compounds form in
the intestine from aluminium hydroxide are insoluble aluminium phosphates
which pass through the intestinal tract unabsorbed. This can resulting in
hypophosphatemia, hypophosphaturia and hypopyrophosphaturia. Phosphate
depletion syndrome occasionally observed after chronic aluminium hydroxide
ingestion. Patients on therapeutic regimen for peptic ulcer, usually have
high phosphate intake. Therefore ingestion of aluminium hydroxide for this
patient results in decrease phosphate absorption and accompanied by increase
in calcium absorption which along with resorption of bone salts causes
hypercalciuria. Hypomagnesaemia and hypomagnaesiuria occur. Aluminium
hydroxide is astringent and may cause nausea, vomiting and constipation.
Large doses can cause intestinal obstruction and concretion of fatty acid
salts of aluminium in stool.
Several cases of intestinal
obstruction by a large mass composed of clotted blood has been reported. It
also reduces absorption of other drugs including tetracycline and vitamins
and could delay the absorption of quinidine. Magnesium hydroxide in some
patients has its cathartic effect. Although magnesium hydroxide is
classified as a non-systemic antacid, 5 - 10% of magnesium can be absorbed.
Retention of any absorbed magnesium can cause neurological, neuromuscular
and cardiovascular impairment and even death in persons with renal
insufficiency. Ordinarily the absorbed magnesium ion is rapidly excreted by
the kidney but urine may become alkaline.
Alkalinization of the urine
decrease the excretion of various weakly basic drugs e.g. quinidine.
Magnesium hydroxide increases the absorption of warfarin.
Care should be taken in patients suffering from hypophosphataemia and
impaired renal function. It is probably wise to avoid administration during
the first trimester of pregnancy unless there are compelling reasons for its
use. Undesirable drug interactions may results, including reduced absorption
of tetracycline and vitamins when given concomitantly.
Hypophosphataemia may be avoided by concurrent high phosphate intake. The
effects of hypermagnesaemia may be corrected by the intravenous injection of
10 to 20m1 of 10% Calcium Gluconate Injection.
Keep container well closed. Store below 30°C. Protect from light.
Available in loose pack of 1000's
and blister pack of 100 x 10's and 10 x 10's.