Kremil-S Cool Relief

Na alginate 500 mg (as dry 425 mg), Na bicarbonate 213 mg, Ca carbonate 325 mg

Gastroesophageal reflux eg, acid regurgitation, heartburn, & indigestion due to reflux of stomach contents.

Adults & childn ≥12 yr 10-20 mL up to qid. Childn 6-11 yr 5-10 mL.

Should be taken on an empty stomach: Taken after meals & before bedtime.

Hypersensitivity. Low Na diet; CHF, renal failure, edema, or cirrhosis.

Hypercalcemia, nephrocalcinosis. Discontinue if symptoms worsen or do not improve after 7 days. Renal failure. Not recommended in childn <6 yr.

Na alginate: Anaphylactic reaction/shock; bronchospasm; flatulence; urticaria. Na bicarbonate: Hypokalemia, metabolic alkalosis; arrhythmia; apnea; bloating, flatulence; tiredness. Ca carbonate: Alkalosis, decreased appetite, hypercalcemia, metabolic alkalosis, milk-alkali syndrome; dizziness, headache; burping, constipation, flatulence, nausea, rebound hyperacidity, vomiting; weakness.

May decrease absorption of other minerals eg, Ca, Zn, Mn, chromium & Mg. May interfere w/ absorption of other medicines. Decreased absorption of tetracyclines; digoxin, indomethacin, Fe salts; antifungals (eg, ketoconazole, itraconazole); azithromycin, nitrofurantoin, rifampicin, phenytoin, chloroquine, phenothiazine antipsychotics (eg, chlorpromazine) & bisphosphonates (eg, alendronate, etidronate, risedronate). May decrease excretion of weakly basic drugs (eg, quinidine, chlorpromazine, propranolol, diazepam) & increase excretion of acidic drugs (eg, phenytoin, pentobarbital, warfarin). Changes in urine pH, increased urinary excretion & decreased of blood conc of salicylates eg, aspirin. Formation of insoluble metal ion chelates w/ fluoroquinolones (eg, ciprofloxacin, norfloxacin & ofloxacin) & penicillamine (for RA). Na alginate: May decrease absorption of Ca, Zn, Mn, chromium, & Mg if used concomitantly. Na bicarbonate: Increased rate of naproxen absorption.

Antacids, Antireflux Agents & Antiulcerants

A02A - ANTACIDS ; Used in the treatment of acid-related disorders.

Non-Rx