Contraindicated in severe renal failure, hypophosphataemia and in patients who must control sodium intake e.g. congestive heart failure, hypertension, cirrhosis of the liver.

Should not be administered to patients with metabolic or respiratory alkalosis, hypocalcaemia or hypochlorhydria.

Hypersensitivity to any of the ingredients.

The product should be used with caution in patients with fluid retention. In view of the sodium hydrogen carbonate content, the product should also be administered extremely cautiously to patients with renal impairment, to patients receiving corticosteroids or patients with respiratory acidosis, eclampsia, or aldosteronism.

If renal function is impaired hypermagnesaemia may result giving the symptoms described under (4.9) overdose.

The following warnings and precautions appear on the labels:

Keep out of the reach and sight of children.

Do not give to children under 5 years old unless your doctor tells you to.

Once opened use within 28 days.

If symptoms persist consult your doctor.

This medicine contains 73.5mg sodium (main component of cooking/table salt) in each 5ml dose. This is equivalent to 3.7% of the recommended maximum daily dietary intake of sodium for an adult.

It also contains sodium methyl and sodium propyl parahydroxybenzoates (E219 and E217) which may cause allergic reactions (possibly delayed).

 Interaction with other medicinal products and other forms of interaction

Antacids may interact with a number of other drugs by altering their absorption and, sometimes, their elimination, thereby reducing their effectiveness. Antacids may also damage enteric coatings designed to prevent dissolution in the stomach. In order to minimise the risk of interactions, this product should not be taken within two to four hours of other medications (allow at least 4 hours before or 2 hours after erlotinib).

Examples of other medications which may be affected include, but are not limited to ACE inhibitors, salicylates e.g. aspirin, atazanavir, azithromycin, barbiturates, bile acids, bisphosphonates, cephalosporin antibiotics, fluoroquinolone antibiotics, chloroquine and hydroxychloroquine, deflazacort, digoxin, dipyridamole, eltrombopag, erlotinib, fexofenadine, gabapentin, iron preparations, isoniazid, itraconazole, ketoconazole, lansoprazole, levothyroxine, lithium, methenamine, mycophenolate, nitrofurantoin, penicillamine, phenothiazines, phenytoin, proguanil, rifampicin, rosuvastatin, sulpiride, tetracyclines, tipranavir, ulipristal (avoid use with antacids).

There is a risk of metabolic alkalosis when oral magnesium salts are given with polystyrene sulphonate resins.