Remmaks-KV tab. zhev. mint No. 18

Pharmacological properties

Pharmacodynamics. remmaks-apartment is a combination of two antacids: calcium of a carbonate and magnesium of a carbonate which have local effect due to stomach acid neutralization does not depend on system absorption. calcium the carbonate has long and strong neutralized activity. this effect amplifies thanks to magnesium to a carbonate which also has powerful neutralized activity. the general neutralized capacity of in vitro medicine is 16 meq h + (titration to a final point rn 2.5).

Pharmacokinetics. At healthy faces the beginning of neutralization fast. Use of 2 tablets of medicine on an empty stomach leads to increase rn more than on 1 unit within 5 min. and to increase rn stomach contents above the basic line rn which is reached within 2 min.

In a calcium stomach a carbonate and magnesium a carbonate react with gastric juice and form water and soluble mineral salts.

in the form of the soluble salts. Level of absorption of calcium and magnesium from these connections depends on a medicament dose. The maximum level of absorption — 10% of calcium and 15–20% of magnesium. At healthy faces a small amount of the absorbed calcium and magnesium is distinguished with kidneys. At disturbance of their function the concentration of calcium and magnesium can increase in blood plasma. In intestines insoluble compounds which are removed with a stake are formed of soluble salts.

to Adults and children 15 years for relief of symptoms connected with hyperoxemia of gastric juice (for example heartburn, a gastroesophageal reflux), leading to disturbance of digestion and dyspepsia are aged more senior than

Indication.

Use

Drug for oral administration at adults and children is aged more senior than 15 years. the usual daily dose makes 1–2 chewable tablets in the period of pain or heartburn; in case of pain the dose can be raised for the short period to 5 tablets a day. duration of treatment should not exceed 10 days.

Contraindication

Increased individual sensitivity to medicament components;

• hypercalcemia;
• nephrocalcinosis;
• profound renal failure (clearance of creatinine of 30 ml/min.);
• hypophosphatemia.

Side effects

from the immune system: reaction of hypersensitivity, including rashes, urticaria, a Quincke's disease, an anaphylaxis.

Disturbance of metabolism and food: at patients, especially with impaired renal function, prolonged use of medicament in high doses can lead to a gipermagniyemiya (at use of the antacids containing magnesium) or to a hypercalcemia and an alkalosis which is shown in the form of symptoms from a stomach and muscle weakness.

from a GIT: nausea, vomiting, discomfort in a stomach and diarrhea.

from the musculoskeletal system and connective tissue: muscle weakness.

Side effects noted only at milk and alkaline a syndrome (Burnett's syndrome): gastrointestinal disorders (ageusia); general disorders (calcification and asthenia); disorders from nervous system (headache); disturbances from kidneys and urinary tract (azotemia).

Special instructions

If the symptoms caused by hyperoxemia of gastric juice do not disappear or amplify in 10 days of treatment, it is necessary to perform examination to find out their nature and to reconsider a way of treatment. the course of treatment of remmaks-apartment should not exceed 10 days: undesirable consequences revealed in interaction with diuretic tiazida or at the patients using a large number of milk or dairy products, especially during long treatment. at use of 4-5 tablets in day the course of treatment has to be short, treatment should be stopped right after disappearance of symptoms.

Is recommended to see a doctor in a case: degrowth of a body, problems with swallowing or constant sensation of discomfort in a stomach, digestion disturbance if it appeared for the first time or changed the character, a renal failure (it is necessary to control the level of calcium and magnesium).

Calcium a carbonate and magnesium a carbonate should not be applied at a hypercalcuria. This medicine should be applied with care the patient with impaired renal function. If calcium the carbonate and magnesium a carbonate needs to be applied at these patients, then it is regularly necessary to check the maintenance of level of calcium, phosphorus and magnesium in blood plasma.

Patients with diabetes: 1 tablet RemMaks-KV contains saccharin and also 400 mg of sorbite (for tablets with mint and crimson tastes) and 390 mg of sorbite (for tablets with an orange flavor). Patients can apply medicine with diabetes.

Use during pregnancy and feeding by a breast. So far after prescribing of calcium of a carbonate and magnesium of a carbonate during pregnancy the increase in risk of a malformation of a fruit is noted. RemMaks-KV it is possible to appoint during pregnancy if to use medicament according to the instruction, but long reception in high doses needs to be avoided. It is also necessary to consider that presence of salts of magnesium can cause diarrhea, and presence of calcium in the raised doses which apply a long time increases risk of a hypercalcemia with calcification of different bodies, in particular kidneys.

needs to be considered that during pregnancy and feeding a carbonate and magnesium a carbonate provide with a calcium breast a significant amount of calcium in addition to the volume arriving with food. Therefore pregnant women have to limit reception of RemMaks-KV up to 1 week and during use of medicament to avoid constant consumption of milk (1 l contains up to 1.2 g of elementary calcium) and also dairy products for prevention of excess of calcium which can lead to a syndrome so-called milk alkaline (Burnett's syndrome), the rare, but serious illness demanding medical care.

Children. Not to apply at children aged up to 15 years.

Ability to influence speed of response at control of vehicles or work with other mechanisms. Does not influence.

Interaction

Other medicines is recommended to be applied for 1–2 h to or after reception of remmaks-quarter

in case of a concomitant use of the medicament RemMaks-KV with antibiotics (tetracycline, hinolona) and cardiac glycosides (digoxin), phosphates, decrease in absorption of the last happens compounds of fluorine and ferriferous products.

Thiazide diuretics reduce excretion with urine of calcium and increase its level in blood serum. Because of the increased risk of a hypercalcemia at simultaneous use of thiazide diuretics it is regularly necessary to check calcium level in blood serum.

needs Also to take a break of 2 h between use of RemMaks-KV and the following drugs: antihistamines, atenolol, metoprolol or propanolol, chloroquine, diflyunizat, digoxin, diphosphonates, feksofenadin, glucocorticoids (Prednisolonum and dexamethasone), indometacin, ketokonazol, phenothiazide neuroleptics, Penicillaminum, thyroxine.

Overdose

Prolonged use of calcium of a carbonate and magnesium of a carbonate in high doses, especially sick with a renal failure, can lead to a renal failure, a gipermagniyemiya, a hypercalcemia and an alkalosis that is shown in the form of symptoms from a GIT (nausea, vomiting, a constipation) and muscle weakness. in these cases it is necessary to stop use of medicament and to provide sufficient intake of liquid in an organism. in hard cases of overdose (for example at Burnett's syndrome) it is necessary to consult with the doctor as additional rehydration can be necessary (for example infusions). in case of overdose perhaps also development of diarrhea.

Storage conditions

In original packing at a temperature not above 25 °C.