From the Guidelines
Pico is not a recognized antacid medication, and therefore, it is not recommended for use in treating heartburn or acid indigestion. Instead, common antacids such as calcium carbonate, aluminum hydroxide/magnesium hydroxide, and sodium bicarbonate can be used to provide quick relief of heartburn, acid indigestion, and upset stomach. The study 1 provides guidance on the management of gastroesophageal reflux in pediatric patients, but it does not mention Pico as a recommended antacid. Some key points to consider when using antacids include:
- Taking calcium carbonate products like Tums as needed, typically 1-2 tablets (500-1000 mg) every 4-6 hours as needed, not exceeding 7,500 mg daily
- Using liquid antacids like Maalox or Mylanta, usually dosed at 1-2 tablespoons (15-30 ml) between meals and at bedtime
- Being aware of potential interactions with certain medications, and taking other medications at least 2 hours apart from antacids
- Consulting a healthcare provider before using antacids regularly, especially for those with kidney disease, high calcium levels, or certain other medical conditions. It is essential to note that for persistent symptoms lasting more than two weeks, consulting a healthcare provider is necessary as this could indicate a more serious condition 1.
From the Research
Pico Antacid Overview
- Pico antacid is a type of antacid that is used to neutralize stomach acid and relieve heartburn and indigestion symptoms.
- According to 2, antacids are commonly used self-prescribed medications that consist of calcium carbonate and magnesium and aluminum salts in various compounds or combinations.
Mechanism of Action
- The effect of antacids on the stomach is due to partial neutralisation of gastric hydrochloric acid and inhibition of the proteolytic enzyme, pepsin 2.
- Each cation salt has its own pharmacological characteristics that are important for determination of which product can be used for certain indications 2.
Uses and Efficacy
- Antacids have been used for duodenal and gastric ulcers, stress gastritis, gastro-oesophageal reflux disease, pancreatic insufficiency, non-ulcer dyspepsia, bile acid mediated diarrhoea, biliary reflux, constipation, osteoporosis, urinary alkalinisation and chronic renal failure as a dietary phosphate binder 2.
- However, the development of histamine H2-receptor antagonists and proton pump inhibitors has significantly reduced usage for duodenal and gastric ulcers and gastro-oesophageal reflux disease 2.
- Antacids can still be useful for stress gastritis and non-ulcer dyspepsia 2.
- A study found that ranitidine plus antacid significantly decreased both gastric and oesophageal acidity, and antacid alone and ranitidine plus antacid significantly decreased heartburn severity 3.
- Another study found that effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacids 4.
Interactions and Side Effects
- Antacid drug interactions are well noted, but can be avoided by rescheduling medication administration times 2.
- Most antacids, except sodium bicarbonate, may decrease drug absorption by adsorption or chelation of other drugs 2.
- Ranitidine reduces phosphate binding in dialysis patients receiving calcium carbonate, which can have significant adverse effects 5.
- Most adverse effects from antacids are minor with periodic use of small amounts, but when large doses are taken for long periods of time, significant adverse effects may occur, especially in patients with underlying diseases such as chronic renal failure 2.
Contemporary Relevance
- Antacids remain the mainstay treatment for gastroesophageal reflux-related symptoms based on their efficacy, safety, and over-the-counter availability 6.
- The FDA recommends antacids as the first-line treatment for heartburn in pregnancy 6.
- A narrative review summarizes the mechanism, features, and limitations related to different antacid ingredients and techniques available to study the acid neutralization and buffering capacity of antacid formulations 6.