Gastric reflux, heartburn, flatulence associated with gastric reflux, heartburn of pregnancy, all cases of epigastric and retrosternaldistress where the underlying cause is gastric reflux.

For oral administration.
Adults and children over 12 years: 10-20ml after meals and at bedtime.
Children under 12 years: Should be given only on medical advice.
Elderly: No dosage modification is required in this age group.
Hepatic Impairment: No dose modification necessary.
Renal Insufficiency: Caution if highly restricted salt diet is necessary (see section 4.4).

This medicinal product is contraindicated in patients with known or suspected hypersensitivity to the active substances or to anyof the excipients listed in section 6.1, including methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216)(see section 4.4).

If symptoms do not improve after 7 days, the clinical situation should be reviewed.
This medicinal product contains 285.2 mg (12.4 mmol) sodium per 20 ml dose, equivalent to 14.26 % of the WHO recommendedmaximum daily intake for sodium.
The maximum daily dose of this product is equivalent to 57 % of the WHO recommended maximum daily intake for sodium.
This product is considered high in sodium. This should be particularly taken into account for those on a low salt diet (e.g. in somecases of congestive heart failure and renal impairment).
Each 10 ml dose contains 160 mg (1.6 mmol) of calcium carbonate. Care needs to be taken in treating patients withhypercalcaemia, nephrocalcinosis and recurrent calcium containing renal calculi.
Contains methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216) which may cause allergic reactions(possibly delayed).

A time-interval of 2 hours should be considered between Gaviscon intake and the administration of other medicinal products,especially tetracyclines, digoxine, fluoroquinolone, iron salt, ketoconazole, neuroleptics, thyroid hormones, penicillamine, beta-blockers (atenolol, metoprolol, propanolol), glucocorticoid, chloroquine and biphosphonates (diphosphonates) and estramustine.See also 4.4.

Pregnancy:
Clinical studies in more than 500 pregnant women as well as a large amount of data from post-marketing experience indicate nomalformative nor feto/ neonatal toxicity of the active substances.
Gaviscon can be used during pregnancy, if clinically needed.
Breast feeding:
No effects of the active substances have been shown in breastfed newborns/infants of treated mothers. Gaviscon can be usedduring breast-feeding.
Fertility:
Pre-clinical investigations have revealed alginate has no negative effect on parental or offspring fertility or reproduction.
Clinical data do not suggest that Gaviscon has an effect on human fertility.

None.

Adverse reactions have been ranked under headings of frequency using the following convention: very common (1/10), common(1/100 and <1/10), uncommon (1/1000 and <1/100), rare (1/10,000 and <1/1000), very rare (< 1/10,000) and not known (cannotbe estimated from the available data).

System Organ Class	Frequency	Adverse Event
Immune System Disorders	Very rare	Anaphylactic and anaphylactoid reactions. Hypersensitivity reactions such as urticaria.
Respiratory, Thoracic and Mediastinal Disorders	Very rare	Respiratory effects such as bronchospasm.

Reporting of Suspected Adverse Reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

Symptoms
Symptoms are likely to be minor; some abdominal discomfort may be experienced.

Management
In the event of overdose symptomatic treatment should be given.

On ingestion the product reacts rapidly with gastric acid to form a raft of alginic acid gel having a near neutral pH and whichfloats on the stomach contents,
quickly and effectively impeding gastro-oesophageal reflux, for up to 4 hours. In severe casesthe raft itself may be refluxed into the oesophagus, in preference to the stomach contents, and exert a demulcent effect.

The mode of action of the product is physical and does not depend on absorption into the systemic circulation.

No preclinical findings relevant to the prescriber have been reported.

Carbomer
Methyl parahydroxybenzoate
Propyl parahydroxybenzoate
Saccharin sodium
Peppermint oil
Sodium hydroxide
Water

Not applicable.

Three years for 600 ml pack size. Two years for 100 ml, 150 ml, 200 ml, 250 ml, 300 ml, and 500 ml pack sizes.

Do not store above 30°C. Do not refrigerate or freeze.

Amber glass Winchester bottle with a polypropylene cap with a polyethylene tamper-evident band lined with expandedpolyethylene wad containing 100 ml, 150 ml, 200 ml, 250 ml, 300 ml, 500ml and 600ml.

No special instructions.