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Acid neutralization capacity and cost-effectiveness of antacids sold in various retail pharmacies in the United Arab Emirates

Shery Jacob, Annie Shirwaikar, Shijna Anoop, Reham Khaled, Mariyam Imtiaz, Anroop Nair
Published in : HAMDAN MEDICAL JOURNAL ; Vol 9, No 2 (2016)
DOI : 10.7707/hmj.452

Abstract


The objective of this research was to determine the acid neutralization capacity (ANC) at 37°C±2°C (as per United States Pharmacopeia 30 and the National Formulary 25) of antacid preparations sold in various retail pharmacies in the United Arab Emirates. Another important objective was to quantify the sodium and calorific content of antacids, as well as overall monthly consumption, and cost of therapy of different antacids from different manufacturers. The tablet and liquid antacids fall into four statistically different ANC groups. Three of the tablet antacids have an ANC similar to that of liquid antacid medications described as being in the high-ANC class. Of the five liquid antacids tested, only two were found to have a high ANC between four production lots at 5% level of significance. The ANC of the most effective liquid antacid was twice that of the lowest. However, this variation in capacity for neutralization is not observed in the product description of antacid brands. A standard dose is one to two teaspoons: one teaspoon will neutralize 20.2–35.92mEq and two teaspoons will neutralize 40.44–71.84mEq depending on the antacid selected. It is apparent from the results of quantification that maximum ANC combined with a minimum dosage volume–weight ratio is achieved by antacids from the high- or intermediate/high-ANC group. Consumption of these categories of antacids is beneficial as they contain less sodium and fewer calories and they are less expensive for pharmacists and/or the public. The monthly cost of daily high-dose therapy is much lower for high-ANC tablet antacids than for low-ANC tablet antacids. In conclusion, if antacids are to be used optimally, it is imperative that the ANC is specified on the product label.

 


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