Ciprofloxacin Injection USP 200 mg/10Oml

Zerocid is a pleasantly flavored antacid- anti-flatulence suspension, administered for the reduction of acidity, heartburn & flatulence.

Composition

Each 5ml Contains:
Dried Aluminum Hydroxide BP-250mg
Magnesium Hydroxide          BP-250mg
Simethicone                           BP-50mg

Dosage 

Adults: 15ml, two times daily.
 Children: 2-5 Years: 5ml 3 Times Daily, 5-12 Years: 5-10ml 3-4 Times Daily.

List of excipients

 Sorbitol, Guargum, Potassium citrate, Citric acid, Saccharin sodium, Bronopol, Propyl paraben, Peppermint oil Indications: It is administered for the reduction of acidity, flatulence and relief from post operative gaseous distension, dyspepsia, and reflux esophagitis, gastric and duodenal ulcers.

Actions

Zerocid act by neutralizing hydrochloric acid secreted by gastric parietal cells. Antacids such as magnesium hydroxide and aluminum hydroxide, being relatively insoluble in water, are long-acting if retained in the stomach. Magnesium salts increase intestinal motility, whereas aluminum decreases it; thus, antacids containing former tend to be laxative whereas those containing latter may be constipating. Zerocid contains the right balance of aluminum & magnesium compounds so as not to significantly change bowel function.
Simethicone is used for the relief of flatulence and abdominal discomfort due to excess GIT gas in disorders such as dyspepsia and gastroesophageal reflux disease.

Adverse effects and Precautions

 Aluminum hydroxide, like other aluminum compounds, is astringent and may cause constipation; large doses can cause intestinal obstruction.
Excessive doses or even normal doses in patients with low-phosphate diets may lead to phosphate depletion accompanied by increased bone resorption and hypercalciuria with the risk of osteomalacia.

Aluminum salts are not, in general, well absorbed from the GIT, and systemic effects are therefore rare in patients with normal renal function. However, care is necessary in patients with chronic renal impairment.

Magnesium hydroxide may cause diarrhea, an effect that is dose dependent. Hypermagnesemia may occur, usually in patients with renal impairment.

Pharmacokinetics

Aluminum salts given by mouth slowly react with the hydrochloric acid in the stomach to form soluble aluminum chloride, some of which is absorbed. The presence of food or other factors that decrease gastric emptying prolongs the availability of aluminum hydroxide to react and may increase the amount of aluminum chloride formed Absorbed aluminum is eliminated in the urine, and patients with renal failure are therefore at particular risk of accumulation (especially in bone and the CNS). and aluminum toxicity. 

The aluminum compounds remaining in the GIT, which account for most of a dose, form insoluble, poorly absorbed aluminum salts in the intestines including hydroxides, carbonates, phosphates and fatty acid derivatives, which are excreted in the feaces. Magnesium hydroxide, given by mouth, reacts relatively rapidly with hydrochloric acid in the stomach to form magnesium chloride and water. About 30% of the magnesium ions are absorbed from the small intestine, as described for magnesium salts.

Drug interactions

Aluminum and magnesium compounds used as antacids interact with many other drugs, both by alterations in gastric pH and emptying, and by direct adsorption and formation of complexes that are not absorbed. Interactions can be minimized by giving the aluminum and magnesium compound and any other medication 2 to 3 hours apart. The absorption of aluminum from the GIT may be enhanced if aluminum compounds are taken with citrates or ascorbic acid.

Overdosage

Overdosage of this drug can cause intestinal obstruction.

Contra indications

Zerocid should preferably not to be taken at the same time as other drugs as they may impair their absorption. Antacids may also damage enteric coatings designed to prevent dissolution in the stomach. Most drug interactions can be avoided by taking Zerocid 2 hours before or after ingestion of other drugs.

Storage: Store in a cool and dry place, not above 30°C. Keep out of the reach of children.

Shelf life: 2 Years from the date of manufacture.

Presentation: Suspension of 200ml round bottle.
Date of Publication: Nov 2011.
FDA Reg No.: FDB/SD.135-1092.
Manufactured in Ghana by: M&G Pharmaceuticals Ltd,D 446/1, Bannerman Road, James Town, Accra.