Related guidance: NICE CG184 (2014):Dyspepsia

NICE encourages people who need long-term management of dyspepsia symptoms to reduce their use of prescribed medication stepwise: by using the effective lowest dose, by trying ‘as-needed’ use when appropriate, and by returning to self-treatment with antacid and/or alginate therapy (unless there is an underlying condition or co-medication that needs continuing treatment).

Advise people that it may be appropriate for them to return to self‑treatment with antacid and/or alginate therapy (either prescribed or purchased over-the-counter and taken as needed).

Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
AntacidsMucogel®Suspension: £2.99 (500ml)Low sodium and cost-effective treatment for dyspepsia.
At dose of 10-20ml tds & at bedtime provides equivalent magnesium intake required for hypomagnesaemia as an alternative to magnesium glycerophosphate.
AlginatesGreen crossPeptac®
- suitable for self-care
Aniseed and peppermint flavour
Liquid: £1.95 (500ml)Contains 3.1mmol of sodium per 5ml so should be avoided in patients where restriction of sodium intake is desirable. Available OTC
Green crossAcidex Advance® - suitable for self-care
Aniseed and peppermint flavour
Liquid: £2.21 (250ml)
£4.42 (500ml)
Recommended dose: 5-10ml.
Contains 2.3mmol sodium & 1mmol potassium per 5ml dose
Severe hypomagnesaemia has been reported infrequently in patients treated with PPIs, although the exact incidence is unknown.
Where this is a clinical concern prescribers may also decide to use a magnesium containing product such as magnesium trisilicate or Gastrocote® (with alginate).
NB: Magnesium salts tend to be laxative in effect.