Gaviscon is probably the most known brand of antacids medicines in the UK. There are however several alternative products and drugs, some of them cheaper and others more effective. Today I will review 15 Gaviscon alternatives which are available over the counter without a prescription.
How do Gaviscon and other antacids work?
Gaviscon is a brand name of an over-the-counter medication, commonly referred to as ‘antacid’, used to relieve symptoms of acid reflux and heartburn.
What is heartburn?
Heartburn is a common condition that causes a burning sensation in the chest or throat and/or the lower or middle chest area. It occurs when stomach acid flows back up into the oesophagus, which is the tube that connects the mouth to the stomach. Symptoms of heartburn are usually present after a meal and may get worse when lying down.
Normally, a muscle called the lower oesophagal sphincter (LES) closes after food passes through it into the stomach. However, if the LES is weak or relaxes too often, stomach acid can flow back up into the oesophagus. This causes irritation and inflammation in the lining of the oesophagus, leading to the uncomfortable burning sensation known as heartburn.
Common triggers of heartburn include:
- certain foods, such as spicy or fatty foods, chocolate,
- coffee, and alcohol,
- smoking,
- obesity, and
- pregnancy.
Treatment for heartburn typically involves:
- lifestyle changes, such as avoiding trigger foods and losing weight
- use of medications such as antacids or proton pump inhibitors.
In some cases, surgery may be necessary to strengthen the LES and prevent reflux.
How does Gaviscon work?
The main active ingredients found in the Gaviscon range include:
- sodium alginate,
- potassium bicarbonate and
- sodium bicarbonate.
Active ingredients vary between Gaviscon products.
Sodium alginate is a natural substance that comes from seaweed. It forms a gel-like substance when it comes into contact with stomach acid, which creates a barrier, a ‘raft’ that helps to prevent stomach acid from flowing back up into the oesophagus. This barrier is believed to be the mechanism by which Gaviscon works.
Potassium and sodium bicarbonate, on the other hand, is an antacid that neutralizes stomach acid, reducing the acidity of the stomach contents.
When Gaviscon is taken, it creates a foam that floats on top of the stomach contents. This foam acts as a physical barrier that prevents stomach acid from refluxing back into the oesophagus. At the same time, the potassium bicarbonate works to neutralize any acid that does manage to escape the barrier. This combination of actions helps to relieve the symptoms of acid reflux and heartburn.
Gaviscon range
Gaviscon range of products includes:
- Gaviscon Original
- Gaviscon Advance
- Gaviscon Double Action
The table below shows the differences between each product and the form of products available to buy from shops and pharmacies.
|
Range |
Active ingredients |
Forms available |
|
Gaviscon Original |
calcium carbonate, sodium alginate, sodium bicarbonate | Oral suspension, chewable tablets |
|
Gaviscon Advance |
potassium bicarbonate, sodium alginate | Oral suspension, chewable tablets, |
|
Gaviscon Double Action |
calcium carbonate, sodium alginate, sodium bicarbonate | Oral suspension, liquid sachets, chewable tablets |
Gaviscon Advance vs Gaviscon Double action, what is the difference?
Gaviscon Advance contains two active ingredients sodium alginate and potassium bicarbonate. These ingredients work together to form a protective barrier on top of the stomach contents, which prevents stomach acid from refluxing back into the oesophagus. The potassium bicarbonate also helps to neutralize any acid that does manage to escape the barrier.
Gaviscon Double Action contains three active ingredients sodium alginate, sodium bicarbonate, and calcium carbonate. The sodium alginate and sodium bicarbonate work in the same way as in Gaviscon Advance, forming a barrier and neutralizing acid. Calcium carbonate, however, is an antacid that directly neutralizes stomach acid.
So, the main difference between Gaviscon Advance and Gaviscon Double Action is that Gaviscon Double Action contains an additional antacid ingredient (calcium carbonate) that directly neutralizes stomach acid, whereas Gaviscon Advance relies on the barrier-forming properties of sodium alginate and the neutralizing effects of potassium bicarbonate. Depending on the severity of symptoms and personal preference, one may work better than the other.
Gaviscon alternatives
Products, which are alternatives to Gaviscon contain a combination of one or more of the same ingredients.
Gaviscon alternatives: Antacids
1. Peptac as an alternative to Gaviscon
Peptac is one of the best-priced liquid antacid products which can be used for symptoms of heartburn and indigestion. Peptac comes in 500ml bottles in two flavours:
- Peptac Peppermint Liquid
- Peptac Aniseed Liquid
Peptac contains the following active ingredients:
- Sodium Bicarbonate
- Sodium Alginate
- Calcium Carbonate
It is the same combination of active ingredients found in Gaviscon Original liquid.
Learn more about Peptac alternative antacids for heartburn.
Peptac can be bought from most high street pharmacies, although it is usually kept as part of dispensing stock rather than a product which is shown for sale. When priced right, Peptac can be purchased for around £4-£5 for a 500ml bottle. Peptac is a significantly cheaper option than Gaviscon Original.
Other products which are the same as Peptac and produced by the same manufacturer, but marketed by different companies include:
- Acidex Oral Suspension and Acidex Advanced
- Tesco Heartburn & Indigestion relief
- Boots Heartburn Relief Peppermint Flavour
- LloydsPharmacy Heartburn and Indigestion Liquid
- Rennie Liquid Heartburn Relief Oral Suspension
- LloydsPharmacy Heartburn and Indigestion Liquid
2. Milk of Magnesia
Milk of Magnesia is a brand name of an over-the-counter medication used as a laxative and an antacid. Its active ingredient is magnesium hydroxide, which works by drawing water into the intestines and helping to soften and lubricate stool.
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As a laxative, Milk of Magnesia is used to relieve constipation by promoting bowel movements. It is typically taken orally in liquid form, and it can take several hours to produce an effect.
As an antacid, Milk of Magnesia is used to relieve symptoms of acid indigestion, heartburn, and sour stomach. It works by neutralizing stomach acid and decreasing the production of acid in the stomach. This can provide relief from the discomfort associated with these conditions.
3. Maalox
Maalox contains aluminium hydroxide and magnesium hydroxide, both used to help with heartburn and indigestion. The main active ingredients are different to the active ingredients found in the Gaviscon range, which makes it a great alternative product. Maalox is not commonly dispensed in high street pharmacies or sold as part of regular stock. Some pharmacies may agree to order Maalox from pharmaceutical wholesalers on an individual basis for the same or next-day delivery. Alternatively, Maalox can be purchased online, for example, at Amazon.co.uk.
3. Maalox Plus
Similarly to Maalox, Maalox Plus contains aluminium hydroxide and magnesium hydroxide which act as an antacid to neutralise stomach acid. Maalox Plus contains additionally a third active ingredient – simeticone.
Simeticone is an antiflatulent/antifoaming agent, which is used to help with bloating and discomfort caused by trapped wind. Patients who experience symptoms of heartburn and bloating (trapped wind) may find this alternative product even more effective than the Gaviscon range of products.
Maalox Plus is not usually kept on display, patients may need to make a request for the pharmacy team to order this product. Alternatively, visit Amazon.co.uk to get Maalox Plus.
Gaviscon alternatives: Chewable tablets
Although more convenient than liquid preparations, chewable antacid tablets work slower and are less effective in neutralising stomach acid (iffgd, 2019). Neferthen lees patient may get a sufficient response from chewable forms of antacids. The two most popular brands of chewable antacids are the Rennie range of antacid tablets and Tums.
4. Rennie
Rennie’s range of antacid tablets contains calcium carbonate and magnesium carbonate. Although the combination of active ingredients is not the same as with the Gaviscon range of liquid antacids and tablets, Rennies contain commonly used antacid compounds and will help with symptoms of indigestion and heartburn.
Rennies are commonly available in supermarkets and pharmacies.
5. Tums
Tums are definitely standing out from the crown of antacid products with its range of unique flavours for their range including assorted fruit and assorted berries flavours with advertised ‘delicious taste’. Tums contain calcium carbonate as an active ingredient.
6. Bisodol
Bisodol antacid tablets are part of the Rannie range. Bisodol chewable tablets contain three active ingredients: Calcium Carbonate, Magnesium Carbonate and Simeticone. In addition to the management of heartburn and indigestion Bisodol chewable tables help to manage trapped wind, thanks to simeticone, which is included in the formulation.
7. ENO
ENO offer an alternative form of antacid medication. ENO comes in form of powers which are mixed with water and consumed. ENO contains sodium carbonate, sodium bicarbonate and citric acid, which can be used in the relief of heartburn and indigestion. ENO powders can be bought online, as high street pharmacies do not stock this product.
Gaviscon alternative products: proton pump inhibitors (PPIs)
Proton pump inhibitors (PPIs) are the most effective drugs in the management of heartburn/indigestion. PPIs work in a completely different way from antacids such as Gaviscon.
Antacids work by neutralizing stomach acid that has already been produced, providing short-term relief from symptoms. They are typically taken as needed, after meals or at the onset of symptoms.
PPIs, on the other hand, work by reducing the amount of acid that the stomach produces in the first place.
In general, PPIs tend to be more effective than antacids for treating acid reflux, especially for individuals with more severe or frequent symptoms. PPIs can also help heal the oesophagus from damage caused by acid reflux.
All PPIs control symptoms of heartburn and digestion with a single dose. Symptom control is usually long-lasting as opposed to antacid products and lasts for up to 24 hours.
PPIs are available over the counter and on prescription (wider choice). Over the counter PPIs include the following drugs:
- Esomeprazole
- Omeprazole
- Pantoprazole (now discontinued)
Facts to consider before using PPIs
Delayed onset of action
The general advice for PPIs is that it can take 2-3 days to see full symptom control, although most patients should see the benefits of treatment within one hour of taking PPI.
Age restrictions
All PPIs available without a prescription over the counter are restricted to adults aged 18 and over. When prescribed, PPIs can be used by the younger population.
Drugs interaction
PPIs interact with several drugs. Check the product information leaflet for more details or speak to the pharmacist before use.
Side effects
The use of proton pump inhibitors is associated with more common side effects as compared to antacids such as Gaviscon. Common side effects may include:
- Headaches
- Abdominal pain
- Constipation
- Diarrhoea
- Flatulence
- Nausea/vomiting
Limit on the duration of treatment
Patients who do not achieve relief of symptoms within 2 weeks of starting the treatment should seek advice from their GP. Over the counter proton pump inhibitors are used for the short-term treatment of heartburn and indigestion.
Over the Counter Esomeprazole
8. Nexium Control
- Nexium Control gastro-resistant tablets contain esomeprazole, Always read the label
- Just one Nexium Control tablet a day helps to prevent heartburn from recurring, by reducing stomach acid at the source
- Nexium Control Heartburn & Indigestion tablets is a medicine that provides relief all day and all night
- Do more than treat the burning pain of heartburn with Nexium Control, tackle it at its source, Its target, zero heartburn to help you get a good night’s sleep
- Nexium Control are proton pump inhibitor acid reflux tablets, They work by reducing the amount of acid produced by your stomach
Over the counter esomeprazole is mostly known under the brand name Nexium Control. Nexium Control can be purchased in a variety of places including, supermarkets, shops, pharmacies and online stores and chemists.
Nexium Control comes in form of capsules and tablets, each containing 20mg of esomeprazole. A single dose of Nexium Control provides relief of symptoms for up to 24 hours.
9. Guardium Acid Reflux Control
- GUARDIUM PROVIDES CONVENIENT, LONG LASTING RELIEF* FROM FREQUENT HEARTBURN SYMPTOMS - Burning pain in your chest? For sufferers of frequent heartburn, Guardium gets to work in 1 hour* for 24 hours of zero heartburn; Frequent heartburn can be classified as suffering from these symptoms twice a week or more; *Full effects may take 2-3 days
- ONE TABLET FOR 24H PROTECTION - This box of Guardium by the makers of Gaviscon contains 14 tablets; take one tablet a day for 24 hours protection from heartburn and acid reflux
- BLOCKS THE ACID PUMPS IN YOUR STOMACH - Guardium by the makers of Gaviscon works by blocking the acid pumps in your stomach, making it less acidic, tackling the problem at its source therefore helping to reduce heartburn
- GUARDIUM AND GAVISCON ADVANCE CAN BE USED TOGETHER - Guardium can be used for 24h protection and Gaviscon Advance can be used for fast relief of reflux symptom such as heartburn
- GUARDIUM, BY THE MAKERS OF GAVISCON - Guardium is manufactured by the same company that makes Gaviscon
Guardium acid reflux control is the latest addition to proton pump inhibitors available over the counter without a prescription. Guardium acid reflux gastro-resistant tablets contain 20mg of esomeprazole.
10. Esomeprazole (Galpharm)
Esomeprazole 20mg capsules (Galpharm) are available in Tesco, including Tesco’s online groceries. Galpharm esomeprazole capsules are priced very competitively. 14 esomeprazole capsules cost £10, whereas a pack of 7 is just around £6.00. Galpharm esomeprazole capsules are also sold under some supermarket brands of esomeprazole, for example ASDA Heartburn & Acid Reflux Control which are even cheaper than Galpharm esomeprazole.
Over the Counter Omeprazole
11. Omeprazole 10mg tablets (Boots)
Omeprazole 10mg tablets are sold by Boots Pharmacy. Acid Reflux 10 mg Gastro-Resistant tablets can be purchased in-store and online at Boots.com. A pack of 14 tablets cost £14.99 (prices taken March 2023).
12. Pyrocalm Control
Pyrocalm Control is another brand of over the counter omeprazole tablets. Each Pyrocalm Control tablet contains 20mg of omeprazole. Pyrocalm Control can be purchased from pharmacies and online.
Related post: Omeprazole alternative medicines.
13. Pantoloc Control – Pantoprazole (Discontinued)
Pantoloc Control was the only proton pump inhibitor which contains pantoprazole. Each Pantoloc Control tablet contain 20mg of pantoprazole.
Gaviscon alternative products: H2-receptor antagonists
14. Ranitidine (Discontinued)
H2-receptor antagonists such as ranitidine as effective in reducing stomach acid and controlling the symptoms of indigestion. The only H2-receptor antagonist that was available over the counter was ranitidine 75mg tablets, also sold under the brand name Zantac 75 Relief.
All ranitidine products (over the counter and prescription only) have been recalled and withdrawn from UK and other markets, due to safety concerns. There is plenty of ranitidine alternative drugs, however, no other H2-receptor antagonists are available without a prescription in the UK.
Related post: Ranitidine alternative drugs.
15. Prescription options for H2-receptor antagonist.
Prescription-only options include:
- Cimetidine
- Nizatidine
All the above drugs are in and out of stock due to increased demand caused by a lack of ranitidine on the market.
Conclusion
Patients have a great choice of Gaviscon alternative medicines. There is a wide choice of alternative antacid products which come in form of liquids and tablets. Peptac liquid (available also under different brand names, see post for more details) resembles the closest alternative to Gaviscon as it contains a combination of the same active ingredients. Patients who suffer from indigestion/heartburn may however get benefit from the use of any antacids discussed in this post.
Proton pump inhibitors are the most effective in the management of heartburn and indigestion symptoms. PPIs became easily available to patients with most supermarkets, pharmacies and online vendors selling one or more drugs in this category. PPIs, however, should only be used as a short-term treatment of acid reflux.
Patients who experience symptoms of heartburn/indigestion ongoingly, or patients who fail to respond to treatment should contact their GP for advice. When prescribed PPIs can be used ongoingly, under the care of a GP.
References
eMC (2020). SmPC: Phillips’ Milk of Magnesia. Available at: https://www.medicines.org.uk/emc/product/173 Accessed on 16/03/2023
iffgd (2019). Antacids. Available at: https://www.iffgd.org/diet-treatments/antacids.html Accessed on 16/03/2023
