Evaluation of the acid-neutralizing capacity and other properties of antacids marketed in Morocco

Abstract

Aim. The aim of this study was to evaluate the acid-neutralizing capacity (ANC) and other properties of antacid drugs marketed in Morocco.
 Methods. Samples of 12 antacids were collected from pharmacies and were subjected to the test described in the US Pharmacopoeia in order to measure their ANC. Other properties such as price and sodium content were also studied. 
 Results. All the tested brands met the minimal requirement of 5 mEq. However, Aluminum hydroxide/Magnesium hydroxide combinations showed a superior acid-neutralizing capacity over other products and oral suspensions showed better results compared to other pharmaceutical forms. Regarding the cost of antacids, Aluminum hydroxide/Magnesium hydroxide combinations and calcium carbonate/magnesium carbonate combinations showed the most favorable ANC/price ratio. Some of the antacids studied contain a high amount of sodium.
 Conclusion. All the antacids marketed in Morocco meet the USP requirement regarding their ANC. However, the ANC value should be included in the antacids’ labels so that both patients and physicians can choose the most appropriate product. The ANC value should be evaluated according to the dose of the active substance instead of the minimum labeled dosage in order to allow a better result interpretation.

Assessment of the Acid Neutralizing Capacity and Other Properties of Antacid Formulations Marketed in the Gaza Strip

“…The lowest ANC was for the oral suspension (A5) of alginate-based formulation. Similar result was recorded in a study conducted in Morocco (Yafout et al, 2022). The activity of such formulation depends on formation of a raft coating the stomach and protecting it from gastric juice (Bhardwaj et al, 2011, Pawar et al, 2011.…”

“…The lowest ratio of alginate-based formulation (A5) is expected, since the activity is not based on buffering of acid. The low ANC/PMLD ratio of alginate based oral suspension was recorded in other studies (Yafout et al, 2022, Mahmood et al, 2020.…”

“…A1 and A2 antacids should the highest duration of antacid activity. Calcium and magnesium buffering salts in A1 and A2 tablet formulations are characterized by a medium duration of buffering activity (Yafout et al, 2022, Garg et al, 2022.…”

“…To examine the cost effectiveness the ANC/PMLD ratio was calculated. The most favorable formulation should have a high ANC/PMLD ratio (Yafout et al, 2022). The highest value was for A4 followed by A2, which contain calcium carbonate buffering salts.…”

“…These results are in line with earlier studies that have found a wide variation in antacid's cost effectiveness. This factor should be considered when selecting the economically appropriate product (Jacob et al, 2016, Yafout et al, 2022, Mahmood et al, 2020.…”