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Kremil-S Tablet
Aluminum Hydroxide 178Mg+Magnesium Hydroxide 233Mg
Available in:
 Kremil-S Tablet (R) TAB 100
 Kremil-S Tablet (R) TAB 500
 

Kremil-S Tablet

178 mg/233 mg/30 mg Chewable Tablet

Kremil-S Extra Strength

356 mg/466 mg/20 mg Chewable Tablet

Antacid / Antiflatulent

FORMULATIONS

Kremil-S Tablet

Each chewable tablet contains:

Aluminum Hydroxide ………………………………………. 178 mg

Magnesium Hydroxide …………………………………….. 233 mg

Simeticone …………….……………………………………….30 mg


Kremil-S Extra Strength

Each chewable tablet contains:

       Aluminum Hydroxide ………………………………………. 356 mg

Magnesium Hydroxide …………………………………….. 466 mg

       Simethicone ………..………………………………………….20 mg

PRODUCT DESCRIPTIONS


Kremil-S Reformulated Chewable Tablet is a light pink, round, speckled, tutti-fruitti flavored chewable tablet with “Kremil” engraved on one side and plain on the other.

Kremil-S Extra Strength Chewable Tablet is a white, round, flat, bevel-edged, speckled, tutti-fruitti flavored, chewable tablet with “Kremil Extra” engraved on one side and plain on the other.

WHAT IS IN THE MEDICINE?

These products contain a combination of antacids, aluminum hydroxide and magnesium hydroxide, which effectively increase gastric pH by neutralizing the acid produced in the stomach.  

These products also contain simethicone, a water-repellant with low surface tension used to relieve bloating and gassiness by causing small bubbles to coalesce to large bubbles, which are passed more easily.

WHAT IS THE MEDICINE USED FOR?

  • For the symptomatic relief of hyperacidity associated with peptic ulcer, gastritis, esophagitis, and dyspepsia
  • As an antiflatulent to alleviate the symptoms of gassiness, including postoperative gas pain, associated with hyperacidity
  • As adjunct to H2-blockers or proton pump inhibitors for the rapid relief of ulcer symptoms.

HOW MUCH AND HOW OFTEN SHOULD YOU USE THIS MEDICINE?
Tablets may be chewed then swallowed without water or swallowed whole with water.

                      Kremil-S Reformulated

                           Kremil-S Extra Strength

                              Recommended Adult Dose: to be taken one hour after each meal and at bedtime

                              1 to 2 tablets

                                           1 tablet

                                                                 Or, as prescribed by a doctor.

WHEN SHOULD YOU NOT TAKE THIS MEDICINE?

·          Allergy to any ingredient in the products

·          If you have:

o        Kidney disease

o        Intestinal obstruction

o        Appendicitis

o        Fecal impaction

o        Gastric outlet obstruction

o        Constipation

o        Phosphate depletion and low serum phosphate

o        Osteomalacia (softening of the bones)

UNDESIRABLE EFFECTS

The combination of aluminum hydroxide and magnesium hydroxide balances the side effects of diarrhea from magnesium hydroxide and constipation from aluminum hydroxide.

Excessive doses of aluminum hydroxide and magnesium hydroxide may result in high aluminum and magnesium levels in the blood in patients with kidney impairment


WHAT OTHER MEDICINE OR FOOD SHOULD BE AVOIDED WHILE TAKING THIS MEDICINE?

Antacids decrease the absorption of tetracycline and iron.  Take tetracycline 1 hour before or 2 hours after antacids and 2 hours before or 3 hours after iron-containing preparations.


Antacids may decrease the absorption of orally administered digoxin, or indomethacin, isoniazid, quinolones (e.g., ciprofloxacin, ofloxacin), ketoconazole.  Doses of these drugs should be spaced as far apart as possible from doses of antacids.

Antacid-induced changes in urine pH increase urinary excretion and decrease blood concentration of salicylates such as aspirin.

Antacid-induced increases in urine pH may decrease excretion of weakly basic drugs (e.g., quinidine, chlorpromazine, propranolol, diazepam) and increase excretion of weakly acidic drugs (e.g., phenytoin, pentobarbital, warfarin).

Aluminum-magnesium antacid combination is reported to increase the absorption of dicumarol, diazepam and pseudoephedrine.

Magnesium and aluminum hydroxide administration may decrease the rate of chlordiazepoxide absorption.


Antacids reduce the bioavailability of bisphosphonates (e.g., alendronate, etidronate, risedronate).


WHAT SHOULD YOU DO IF YOU MISS A DOSE?

If you miss a dose, just give the next dose and the subsequent doses at the recommended time or schedule.

Do not double the dose unless recommended by a doctor.


HOW SHOULD YOU KEEP THIS MEDICINE?

Keep the product out of reach and sight of children.

Store at temperatures not exceeding 30°C.


SIGNS AND SYMPTOMS OF OVERDOSAGE

Aluminum hydroxide may accumulate in bones, lungs and nerve tissues in patients with kidney failure. Large doses or chronic use of aluminum may also cause phosphorus depletion which is characterized by anorexia, malaise, and muscle weakness. Prolonged use may cause kidney stones, osteomalacia (softening of the bones), and osteoporosis.

Hypotension, nausea, vomiting, ECG change, respiratory or mental depression, and coma have been also reported with large doses of magnesium in patients with severe kidney disease.

Simethicone overdosage is not expected to cause any clinically important effects. 

WHAT TO DO IF YOU HAVE TAKEN MORE THAN THE RECOMMENDED DOSAGE?

If you have taken more than the recommended dosage, consult a doctor.


CARE THAT SHOULD BE TAKEN WHEN TAKING THIS MEDICINE?

Patients with advanced kidney disease are at risk of aluminum and magnesium accumulation and toxicity.  Do not use these products in such patients.

Do not use after the expiry date on the label.

Phenylketonurics: This product contains phenylalanine as one of the metabolites of aspartame.

WHEN SHOULD YOU CONSULT YOUR DOCTOR?

Ask a doctor before use if you are:

·         Pregnant or breastfeeding

·         Taking other medicines; antacids may interact with certain medicines.

Stop use and ask a doctor if you need to take this product for more than 14 days.

Availability: Box of 4’s, 100’s and 500’s (in flex foil)

 
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