Thirty-five brands of antacids manufactured and marketed by pharmaceutical majors like Biological E Limited, Alkem Laboratories, Glenmark Pharmaceuticals, Meyer Organic Pvt. Ltd., Pharmacia, Concept Pharmaceuticals, Abbott India, Wyeth Lederle, Rhone-Poulenc (India) Ltd., Dabur India Ltd., GlaxoSmithKline, Dr. Reddy's Laboratories Ltd., East India Pharmaceutical Works and Aristo Pharmaceuticals, have been found showing wide variations in the drug standard and relief rate in laboratory test conducted by the Ahmedabad-based Consumer Education and Research Centre.
The Centre has tested the antacids in four categories such as antacid tablets, antacid liquids, antacid antiflatulent liquids and antacid antiflatulent tablets. Another brand was tested from the Ayurvedic category also.
Since there is no reference to antacids in the Indian Pharmacopoeia, the laboratory tested the brands as per the United States Pharmacopoeia (USP) for their Acid Neutralising Capacity (ANC). The brands tested includes Riflux Chewable Tablet and Riflux Forte Chewable Tablet in the Antacid Tablets segment.
Acidin MPS Chewable Tablet, Aciguard Chewable Tablet, Digene Chewable Tablet, Diovol Chewable Tablet, Gelusil MPS Chewable Tablet, Maylox Chewable Tablet, pH4 Chewable Tablet, Solacid Chewable Tablet, Sorbacid Chewable Tablet, Ulgel Chewable Tablet and Visco Chewable Tablet in Antacid Antiflatulent Tablets category, Aludrox Gel, Dey's Milk of Magnesia, Riflux Liquid and Riflux Forte Liquid in Antacid Liquids and Acidin Gel, Acifix Suspension, Digene Gel, Diovol Forte Suspension, Disogel Liquid, Gastracid Liquid, Gelusil MPS Liquid, Maylox Suspension, Nilcid MPS Suspension, Norper Suspension, pH4 Liquid, Relcer Gel, Siloxogene Gel, Solacid Suspension, Sorbacid Liquid, Ulgel Liquid and Visco Liquid in Antacid Antiflatulent Liquids. Eno Fruit Salt was tested in the Ayurvedic category.
Riflux Chewable Tablet did not conform to the ANC test as per USP 24. All others, including Riflux Forte Chewable Tablet, conformed.
A glass stomach test was devised wherein conditions of the stomach were simulated to test the effectiveness of antacids. A two - litre glass beaker was used as a stomach and a standard meal was used to simulate the stomach contents. Trouble in the stomach starts if the pH drops below 3. An effective antacid should quickly raise the pH of the stomach content above 3 which would give immediate relief. With the addition of antacid in a single dose all the brands except Riflux Chewable Tablet started giving relief immediately i.e, the pH increased.
But when the lab checked which brand of antacid gave how many minutes of relief a wide difference was found. The time for lasting relief ranged between a few minutes and 52 minutes. Riflux Chewable Tablet did not give any relief though other brands gave relief by the same method.
In the antacid liquid category Dey's Milk of Magnesia gave relief for 30 minutes. The relief by other brands ranged between 3 and 13 minutes.
In the antacid antiflatulent (antiflatulents give relieffrom gas) liquid category, Digene Gel was the best performer with 27 minutes of relief while Gelusil MPS Liquid gave relief for 25 minutes. Gastracid Liquid gave relief for 24 minutes.
Of the two brands tested in the antacid tablet category, only Riflux Forte Chewable Tablet conformed, giving relief for 13 minutes.
In the antacid antiflatulent tablet category, Visco Chewable Tablet was the best performer giving 22 minutes of relief while Sorbacid Chewable Tablet gave relief for only 3 minutes. However, Eno Fruit Salt gave relief for 52 minutes.