Application of Smecta in the treatment of diseases of the gastrointestinal tract

Compound

One sachet of Smecta contains 3 g of the active substance dioctahedral smectite ( diosmectite ).
The composition of the drug includes as excipients:

• vanilla flavor 0.05 g and orange flavor 0.01 g, sodium saccharinate 0.021 g, dextrose monohydrate 0.679 g (powder for preparing an orange-flavored suspension);
• strawberry flavor 0.032 g, sodium saccharinate 0.007 g, dextrose monohydrate 0.721 g (powder for preparing a strawberry-flavored suspension);
• vanillin 0.004 g, sodium saccharinate 0.021 g, dextrose monohydrate 0.749 g (powder for preparing a vanilla-flavored suspension).

Pharmacodynamics and pharmacokinetics

What is Smecta?

Dioctahedral smectite is a mixed silicate (or, according to other sources, a mixed oxide) of magnesium and aluminum of natural origin.

The action of the drug is aimed at binding and removing various substances (including toxic) and gases from the digestive tract.

Pharmacodynamics

Diosmectite has a stereometric structure and is a highly plastic viscous substance.

These properties explain the selectivity of the sorption effect of the drug (Smecta selectively adsorbs viruses and bacteria from the lumen of the digestive canal) and the high enveloping ability relative to the mucous membrane of the digestive canal.

By interacting with mucin glycoproteins (mucosal secretion of the gastrointestinal tract) and forming polyvalent bonds with them, diosmectite increases the cytoprotective properties of mucus and, consequently, its resistance to irritants: bile salts, hydrogen ions (hydrochloric acid), pathogenic microorganisms, the toxins they produce and other aggressive factors .

Blinded randomized studies of the drug's effectiveness compared with placebo, which included 602 patients aged 1 month to 3 years with a diagnosis of acute diarrhea , showed that in the group receiving Smecta in combination with oral rehydration solutions, the frequency of bowel movements was significantly reduced during the first 72 hours.

Pharmacokinetics

Aluminum contained in smectite is not absorbed from the gastrointestinal tract, including in diseases of the digestive tract, which are accompanied by symptoms of colonopathy and colitis .

Dioctahedral smectite is characterized by a slight swelling effect, in therapeutic doses does not change the physiological time of passage of food through the intestines, does not stain feces, is not metabolized and is excreted unchanged.

The drug is x-ray transparent.

Smecta

Smecta ®

(lat.
Smecta ®
) is a gastroprotective, antidiarrheal, adsorbent drug.
Active substance:
dioctahedral smectite (another name is
diosmectite
).

Dosage form:

sachets containing powder for the preparation of an oral suspension. Each bag contains 3 g of dioctahedral smectite.

Excipients:

dextrose (glucose), sodium saccharin, vanillin.

Indications for use of smecta:

• acute and chronic diarrhea (allergic, drug origin, due to violation of diet and quality food composition)
• diarrhea of ​​infectious origin (as part of complex therapy)
• treatment of symptoms (heartburn, bloating and abdominal discomfort) associated with diseases of the stomach and intestines

Smecta is a drug of natural origin that has a protective effect on the intestinal mucosa and pronounced adsorbing and enveloping properties.
Smecta, being a mucosal barrier stabilizer, forms polyvalent bonds with mucus glycoproteins and increases the duration of its existence, forming a physical barrier that protects the mucous membrane of the digestive tract from the effects of hydrochloric acid and pepsins, bile acids, microorganisms, their toxins, etc.

Smecta has selective sorption properties, which are explained by its discoid-crystalline structure. On the contrary, the swelling effect is expressed to an insignificant extent.

Smecta, due to its effect on the digestive mucous barrier and its increased ability to adhere, protects the mucous membrane of the digestive tract. Smecta in therapeutic doses does not affect intestinal motility. Smecta is not absorbed and is excreted unchanged from the body.

Smecta is recommended for the treatment of peptic ulcers as an adjuvant, which, although it does not affect the amount of acidity in the stomach, has an enveloping and high sorbing ability (sorbs Helicobacter pylori

, bile acids), improves the rheological properties of mucus, increasing its viscosity, increasing the resistance of the mucous membrane to the effects of pepsin and hydrochloric acid. In addition, smecta has a cytomucoprotective effect. It penetrates the mucous (mucin) layer of the intestine, interacts with the glycocalyx, increases the formation of the protective jelly-like layer and improves its quality. The duration of therapy can vary from 4 weeks (for an uncomplicated newly diagnosed single Helicobacter-associated ulcer) to the need for continuous use (for steroid therapy) (Khavkin A.I., Zhikhareva N.S., Rachkova N.S.).

Smecta is highly effective in the treatment of gastroesophageal reflux in children (1 sachet 1–3 times a day). Usually the drug is taken 40–60 minutes after a meal, when heartburn and retrosternal discomfort most often occur (Khavkin A.I., Privorotsky V.F.). In the treatment of gastroesophaneal reflux disease, after discontinuation of proton pump inhibitors (in children, their use is sometimes limited to 2-3 weeks due to the excessive antisecretory effect), cytoprotectors (smecta, sucralfate, liquiriton) are used 30 minutes before meals 3-4 times a day ( last time at night) for 4 weeks (Belousov Yu.V.).

For acute gastritis, as part of complex therapy, the administration of adsorbents smecta, polyphepan, cholestyramine) is indicated, 5-20 g 2-3 times a day, diluted in large quantities of water, between meals (Shabalov N.P.).

Slide from the report by O.A.
Side “Treatment of GERD, based on physiological parameters and modern clinical recommendations”, made at the conference “Esophagus-2015” WHO position on the use of smecta in children with diarrhea:
At the same time, the WHO training manual “Treatment of diarrhea” (2006), O.

Professional medical publications

, which touches on the treatment of the gastrointestinal tract with smecta
:

• Khavkin A.I., Zhikhareva N.S., Rachkova N.S. Modern principles of therapy for peptic ulcer // Attending physician. – 2005. – No. 2. – p. 30–33.
• Khavkin A.I., Privorotsky V.F. Methodological literature. Modern ideas about gastroesophageal reflux in children. — Moscow Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the Russian Federation.
• Shabalov N.P. Childhood diseases. Chapter 10. Diseases of the digestive system in older children. Acute gastritis.
• Belousov Yu.V. Gastroesophageal reflux disease in childhood. // Medical newspaper “Health of Ukraine”, March 2005, No. 114.
• Storonova O.A., Trukhmanov A.S., Dzhakhaya N.L., Ivashkin V.T. Violations of esophageal clearance in gastroesophageal reflux disease and the possibility of their correction // RZHGGK. 2012. T. XXII. No. 2. pp. 14–21.

On the website in the literature catalog there is a section “Antacids and Adsorbents”, containing articles devoted to the treatment of diseases of the gastrointestinal tract with antacids.
Contraindications:

hypersensitivity to smecta, intestinal obstruction.

Procedure for taking smecta and dose.

Take orally, 3 times a day, diluted. For esophagitis - after meals, in other cases - between meals.

• Adults and older children
  - a single dose of 3 g (one sachet). The contents of the bag are dissolved in water (about 100 ml), gradually adding the powder and stirring it evenly.
• For younger children.
  The daily dose of smecta for children under 1 year old is 3 g, from one year to 2 years old - 6 g, over 2 years old - 6–9 g. The contents of the sachet are dissolved in a baby bottle (50 ml) or mixed with some semi-liquid product (porridge, puree, compote, baby food) and distributed into several doses throughout the day based on the daily dose.

Side effects:

• constipation (goes away with decreasing dose)
• allergic reactions

Special instructions:
the interval between taking smecta and other medications should be from 1 to 2 hours.

Interaction with other drugs:

smecta reduces the rate and extent of absorption of simultaneously taken medications.
Smecta is prescribed, including during pregnancy
and
breastfeeding
.

According to the pharmacological index, smecta belongs to the groups “Antidiarrheal drugs” and “Antacids and adsorbents”. According to ATC, it belongs to the group “Antidiarrheal drugs”, subgroup “Intestinal adsorbents”, code A07BC05.

Manufacturer:

Ipsen Pharma (Beaufour Ipsen International), France.

Other medicines containing active ingredients

Dioctahedral smectite: diosmectin, neosmectin. Back to section

Indications for use of Smecta

Indications for use of Smecta are the same for adults and children, including infants over 4 weeks of age.

According to the annotation, the medicine is effective for diarrhea of ​​drug or allergic origin. It helps against diarrhea caused by a violation of the quality of the composition and/or diet, with “travelers’ diarrhea,” as well as with disorders provoked by infectious diseases (for diarrhea of ​​infectious origin, the drug is used as part of complex therapy).

The remedy can be prescribed for heartburn, abdominal discomfort, bloating and other symptoms of dyspepsia , which accompany many diseases of the digestive system.

In case of irritable bowel syndrome, Smecta does not reduce diarrhea, but significantly alleviates the patient’s condition due to the sorption and removal of excess gases in the intestines.

Smecta for poisoning

Does the drug help with poisoning? If toxic substances enter the body through the stomach - absolutely.

Smecta effectively removes toxins that have been absorbed into the gastrointestinal mucosa, while helping to restore the natural balance of intestinal microflora and creating a favorable habitat for its beneficial representatives.

Thanks to the unique structure of diosmectite, which is obtained through complex technological processing from specific clay and shell rock, the drug gently lines the mucous membrane of the digestive tube, strengthening its barrier function and giving damaged cells the opportunity to recover.

Smecta for vomiting

The use of the drug for vomiting is permissible in cases where the gag reflex is not a symptom of severe pathology of the digestive organs.

Before taking Smecta, an adult is recommended to perform a gastric lavage, since this procedure helps remove a significant part of toxic substances from the body and speeds up the effect of diosmectite.

When vomiting in children, the use of sorbent is resorted to, as a rule, in situations where food poisoning .

Why does the powder help animals?

Smecta is used in veterinary practice to alleviate the condition of animals with vomiting, stool disorders and poisoning.

During the studies, it was found that in dogs suffering from diarrhea during the convalescence period, when using the drug as an addition to the diet and main therapy, recovery occurred 2-3 days earlier than in the group of animals that did not receive Smecta.

Application of Smecta in the treatment of diseases of the gastrointestinal tract

About the article

16328

0

Regular issues of "RMZh" No. 16 dated 08/23/2004 p. 972

Category: Pediatrics

Author: Babayan M.L.

For quotation:

Babayan M.L. Application of Smecta in the treatment of diseases of the gastrointestinal tract. RMJ. 2004;16:972.

Treatment of diseases of the digestive system is one of the most important areas in modern pediatric practice. Today, the issues of etiology, pathogenesis, diagnosis and therapy of duodenal ulcer and chronic gastroduodenitis continue to be a topic of intense research, since existing theories and concepts do not fully satisfy the needs of practical healthcare [14]. As a rule, damage to the gastrointestinal mucosa is the result of an imbalance of aggressive (endogenous and exogenous) and protective factors [3]. Factors of aggression usually include: excess production of hydrochloric acid and pepsin, impaired motor-evacuation function of the stomach, lysolecithin and bile acids of duodenal contents, some drugs (non-steroidal and steroidal anti-inflammatory drugs), trauma to the mucous membrane of the stomach and duodenum, as well as an infectious factor – Helicobacter pylori. Protective factors include: mucosal-epithelial barrier (sufficient secretion of bicarbonates, gastric mucus, cell integrity), regenerative ability of the surface epithelium of the mucosa, endogenous prostaglandins, sufficient blood supply to the mucous membrane, structural resistance of connective tissue glycoproteins to proteolysis, antroduodenal brake (secretin, somatostatin, gastrin), i.e. a chain of humoral reflexes that ensure inhibition of the release of hydrochloric acid at the end of digestion. Most gastroenterologists associate the development of this process with an imbalance between the proteolytic activity of the contents of the gastroduodenal system and the resistance of the mucous membrane [1}. Many researchers attach decisive importance to the reduction of resistance in the pathogenesis of ulcers of the gastroduodenal system. However, among the numerous factors in the occurrence of chronic inflammatory diseases of the upper digestive tract, infectious disease currently occupies one of the main places [11,13]. The discovery of the bacterium Helicobacter pylori revolutionized ideas about the etiology, pathogenesis and treatment of diseases of the gastroduodenal zone. Along with the concept of “acid-dependent diseases”, a new chapter has appeared in gastroenterology – “HP-associated diseases” [7]. The literature describes several possible mechanisms of damage to the mucous membrane of the digestive organs under the influence of Helicobacter pylori [5,10]. One of these mechanisms involves urease, which is produced in large quantities by H. pylori. Under the influence of urease, urea is hydrolyzed to form ammonia, which protects Helicobacter from the bactericidal effect of hydrochloric acid in gastric juice. The resulting ammonia has a toxic effect on epithelial cells, which leads to an acceleration of the process of proliferation and incomplete differentiation of epithelial cells. Another mechanism involves extracellular mucinase secreted by H. pylori. Mucinase promotes the destruction of the polymer structures of gastric mucus, which disrupts the integrity of the mucous gel, which becomes less viscous and partially loses its protective properties. The consequence of damage to the mucin layer, apparently, is a disruption of the normal passage of H + ions through the mucous membrane, their reverse diffusion occurs, leading to hypochlorhydria, which is usually observed in the presence of H. pylori. As a result of violations of the protective mucous barrier, exposed epithelial cells are exposed to the adverse effects of aggressive factors (hydrochloric acid, pepsin, salts, bile acids, etc.). The third mechanism of the adverse effect of H. pylori on the mucous membrane is the ability of its penetration into the intercellular space and intracellular tubules of parietal cells, which possibly leads to inhibition of secretion and disruption of secretion from the lumen of the glands. It should be noted that all of the above mechanisms of the damaging effect of H. pylori on the mucous membrane of the gastroduodenal region still remain controversial. The pathogenic effect of Helicobacter pylorus occurs under certain conditions, in particular, when local defense mechanisms are violated [6]. In this case, nonspecific protection factors include: the acidic environment of gastric juice, the motor activity of the digestive organs, the aggressiveness of the secretions of the small intestine, the normal microbiocenosis of the large intestine, which prevents infiltration by pathogenic flora. There is evidence that in the presence of H. pylori, violations of non-immune defense mechanisms are possible: increased permeability of the mucous membrane and absorption of antigens, damage to the mucin barrier, etc. [9]. Local immune defense systems include: lymphoid tissue, represented by a variety of lymphoid formations associated with the intestine throughout (GALT system), and individual cellular lymphoid elements localized in the mucous membrane (MALT system) [2]. Thus, therapy for chronic pathology of the upper digestive tract should be comprehensive, individually differentiated, taking into account the etiopathogenesis of the disease, the presence of concomitant pathology, and is aimed at [3]: 1. Reducing the excessive impact of aggressive factors by eliminating them (eradication of H. pylori) and directly neutralizing in the lumen of the stomach and a decrease in the secretory-motor activity of the stomach. 2. Improving the quality of the protective properties of the mucous membrane of the stomach and duodenum by enhancing the formation of mucus, stimulating the secretion of bicarbonates in the antrum of the stomach, improving the trophism of the mucous membrane, normalizing its reparative properties, etc. 3. Impact on the autonomic nervous system in order to correct the disturbed balance between its sympathetic and parasympathetic departments. Gastroesophageal reflux disease (GERD) is also a common gastroenterological pathology. Its frequency in the population is 2–4%. In the structure of gastroenterological pathology, according to some data, the frequency of GERD reaches 60%. GERD is understood as a chronic recurrent disease characterized by certain esophageal as well as extra-esophageal manifestations, the cause of which is the pathological reflux of gastric and/or duodenal contents into the esophagus (reflux). GERD can occur with or without esophagitis. From the point of view of general pathology, reflux, as such, is the movement of liquid contents in any communicating hollow organs in the opposite, anti-physiological direction. This can occur either as a result of functional insufficiency of the valves and/or sphincters of the hollow organs, or due to a change in the pressure gradient in them. Gastroesophageal reflux (GER) means the involuntary flow or reflux of gastric or gastrointestinal contents into the esophagus. Basically, this is a normal phenomenon observed in humans, in which pathological changes do not develop in surrounding organs. Physiological GER is usually observed after eating and is characterized by the absence of clinical symptoms, short duration of GER episodes, and rare episodes of reflux during sleep. In addition to physiological GER, with prolonged exposure to acidic gastric contents in the esophagus, pathological GER, which is observed with GERD, can occur. Pathological GER is characterized by frequent and prolonged episodes of reflux, observed day and night and causing symptoms indicating damage to the mucous membrane of the esophagus and other organs. In addition, microbial flora that is unusual for it enters the esophagus, which can also cause inflammation of the mucous membranes. A complex of pathological factors is involved in the development of GERD: – an increase in the frequency of reflux of stomach contents into the esophagus as a result of a decrease in the anti-reflux function of the cardiac valve due to: a) decreased tone of the lower esophageal sphincter; b) increasing the number of episodes of his spontaneous relaxation; - prolongation of the contact time of the stomach contents thrown into the esophagus with its mucous membrane due to a decrease in esophageal clearance: a) chemical - due to a decrease in neutralizing (alkalinizing) biological fluids - saliva and bicarbonates of esophageal mucus; b) mechanical – due to a decrease in peristaltic activity and tone of the thoracic esophagus; – damaging effect on the mucous membrane of the esophagus of hydrochloric acid, pepsin, bile, pancreatic enzymes contained in the refluxed gastric refluxate; – reduction of the so-called “tissue resistance” of the esophageal mucosa. There are several components of tissue resistance of the esophagus: pre-epithelial (mucus layer, unstirred aqueous layer, layer of bicarbonate ions); epithelial structural (cell membranes, intercellular junctional complexes); epithelial functional (epithelial Na + /H + transport; intracellular and extracellular buffer systems; cell proliferation and differentiation); postepithelial (blood flow, acid-base balance of tissue) [4,12]. Thus, therapy for GERD, in addition to diet and organization of the daily routine, includes three groups of drugs: 1. Drugs that suppress gastric secretion (antacids, H 2 -histamine blockers, proton pump inhibitors). 2. Drugs that normalize the motor-evacuation function of the digestive tract (prokinetics). 3. Drugs – protectors of the mucous membrane of the esophagus. We see that an integral part of the treatment of these diseases are drugs aimed at improving the protective properties of the mucous membrane. However, until recently, insufficient attention was paid to the correction of protective mechanisms, especially in children. Since the severity of the pathological process in the mucous membrane of the esophagus, stomach and duodenum largely depends on the state of mucin, it is necessary to include cytomucoprotective drugs in the complex therapy of the above diseases. Such a drug is dioctahedral smectite (Smecta). It should be noted that Smecta is quite widely used in the treatment of diarrhea of ​​various etiologies (infectious and non-infectious). There are four pathophysiological types of diarrhea [8]: secretory (Vibrio cholerae, some types of bacteria and viruses); osmotic (enzymepathies, pancreatic insufficiency); motor (irritable bowel syndrome, functional diarrhea); exudative (invasive acute intestinal infections, inflammatory bowel diseases, etc.). Due to its wide spectrum of action, Smecta can be used as an etiotropic, pathogenetic and symptomatic drug, depending on the type of diarrhea. Such a wide spectrum of action of Smecta is ensured by its high fluidity, enveloping and high sorption capacity. At the same time, it is capable of fixing and removing pathogenic microorganisms (Shigella Sonne, salmonella, campylobacter, vibrio cholera) and rotaviruses, their toxins and metabolites, as well as bile acids, intestinal gases, undigested carbohydrates (Fig. 1). In addition, Smecta penetrates the mucous (mucin) layer of the intestine, interacts with the glycocalyx (forms non-covalent strong bonds with mucus glycoproteins), increases the formation of a protective jelly-like layer and improves its quality. This allows Smecta to protect the intestinal mucosa from various irritants, including H + ions, enterobacteria and their toxins. Taking into account the mechanisms of action of Smecta, it can be used as a cytomucoprotective drug for chronic gastritis, duodenitis, peptic ulcer and gastroesophageal reflux disease. The literature contains data on the use of Smecta as monotherapy in children with chronic gastritis and gastroduodenitis (including H. pylori-positive) [7]. In this case, the drug was prescribed in an age-specific dosage for 3 weeks 3 times a day 60 minutes after meals. The clinical effectiveness of the drug was expressed in the reduction of pain and other dyspeptic symptoms (nausea, heartburn, belching and flatulence). Positive dynamics were noted already on the seventh day of using the drug, and the maximum effect was achieved by the end of the second week. The endoscopic picture of the gastric mucosa also improved. After therapy, not a single child had pangastritis or erosion; signs of gastroesophageal and duodenogastric reflux were observed 2.5 times less often. Dynamic studies showed a significant increase in the viscosity of gastric mucus. After treatment, positive dynamics of morphological parameters were also revealed (reduction or disappearance of signs of inflammation, gastric metaplasia in the duodenum and atrophy of the mucous membrane in the stomach). After treatment, H. pylori was not detected or the degree of its contamination decreased. Thus, the use of Smecta in the treatment of chronic gastritis, duodenitis, peptic ulcers and gastroesophageal reflux disease is completely justified, because the drug affects both links in the pathogenesis of these diseases - factors of aggression and defense. Smecta improves the rheological properties of mucus, increasing its viscosity, increasing the resistance of the mucous membrane to the effects of pepsin and hydrochloric acid. In addition, having a high sorption capacity, it promotes the elimination of Helicobacter pyloricus, and also binds and removes substances that are part of gastric and duodenal refluxates (hydrochloric acid, bile acids, lysolecithin, etc.), which have a pronounced cytotoxic effect. The use of cytomucoprotectors, in particular Smecta, which is widely used in the treatment of various types of diarrhea, seems very promising as part of complex therapy for diseases of the upper gastrointestinal tract in children, especially young children, due to the limited use of a number of drugs in them ( proton pump inhibitors, H2-histamine blockers, synthetic analogues of prostaglandins, etc.).

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Contraindications

The drug has very few contraindications for use. Thus, Smecta is not prescribed for intestinal obstruction , known hypersensitivity to the components of the powder, food intolerance to fructose, deficiency of the sucrase-isomaltase complex, malabsorption syndrome (malabsorption) of glucose and galactose .

It is also not recommended to take the suspension in case of osmotic diarrhea . This is explained by the fact that additional sorption of nutrients can provoke an increase in malabsorption syndrome.

The medicine is prescribed with caution to patients of severe chronic constipation .

Side effects

During clinical trials, it was found that the drug can cause constipation . This phenomenon occurs quite rarely and goes away after an individual change in the dosage regimen.

Some patients may experience vomiting and flatulence .

During the post-registration period, cases of hypersensitivity reactions were recorded, which included the appearance of skin rashes, urticaria , itching , and angioedema . The frequency of these side effects is unknown.

Smecta powder, instructions for use

How to give Smecta to an adult

An adult with acute diarrhea at the beginning of treatment should take up to six sachets of powder per day. After stabilization of the condition, the daily dose is reduced to three sachets.

For other indications, the patient is given three sachets of Smecta per day.

How to dilute Smecta (3 g) for adults and how to take it - before or after meals?

The medicine is available in powder. You should drink it after first dissolving it in liquid.

The method of using Smecta is very simple: the powder is diluted in 100 ml of water to obtain a suspension. This should be done immediately before taking the medicine.

The instructions for use of Smecta indicate that in case of inflammatory lesions of the esophageal mucosa, it is recommended to drink the suspension after meals, for other indications - one hour before or two hours after meals.

How long does it take for the drug to work?

The medicine begins to act from the first dose (for diarrhea, the effect develops after 6-12 hours, for poisoning - after 2-3 hours, for esophagitis - within half an hour).

To consolidate the effect, it is recommended to continue treatment for at least three days.

How to dissolve Smecta for an infant

If it is necessary to use the drug for newborns, it should be diluted in 50 ml of expressed milk or in a similar volume of formula for artificial feeding.

How to breed Smecta for children over one year of age

For older children, the powder can be diluted in milk, compote, vegetable/fruit puree or juice for baby food. Before pouring Smecta into the liquid, the latter must be heated to a temperature slightly above room temperature.

Dissolve 3 g of powder gradually, with stirring. The optimal volume of liquid is 50 ml.

How to take Smecta powder for a child under one year old

Smecta is given to children under one year of age using a bottle. After the baby drinks the mixture, it is recommended to hold him in an upright position for some time. Do not rock or shake.

Instructions for use of Smecta for children

Children's dosage is determined depending on age and indications for use.

The daily dose of Smecta for children under one year of age is usually one sachet per 100 ml of liquid. Children 13-24 months old are given two sachets of powder per 200 ml of liquid per day. Dosage for children from 2 to 12 years old: three sachets per 300 ml of liquid.

How to drink Smecta for diarrhea

For diarrhea, infants aged from 4 weeks to 12 months are given two sachets of Smecta in the first three days, then the child is transferred to taking one sachet per day.

Children over one year of age should be given four sachets per day in the first three days, and then two sachets per day.

For other indications, following the recommendations in the instructions for Smecta for children, during the day a child under one year old is given one sachet per day, children from 12 months to 2 years old - one or two sachets, children over two years of age - 2-3 sachets per day.

Directions for use for vomiting

When vomiting, children under one year of age should be given one sachet of Smecta per day as a one-time dose. To relieve unpleasant symptoms, an adult should take the drug three times a day (one sachet for each dose).

If constipation occurs, children should reduce the dose.

Veterinary use, dosage for dogs and cats

Dosage for a cat with diarrhea is 3-5 ml 3-4 times a day. To prepare the suspension, half the packet is mixed with 25 ml of warm water. The kitten is given 2 ml at a time.

Before giving the kitten or cat the suspension, the animal must be wrapped in a terry towel and its mouth opened. The medicine is drawn up with a disposable syringe (without a needle), released from the syringe into the air, unscrew the upper lip, insert the syringe with the nose in a place where there are no teeth, and gently press the plunger.

If the first attempt to give the cat the medicine was unsuccessful and some of the medicine spilled out, you should additionally give the animal half of the previous dose.

For diarrhea in a dog, the contents of the sachet are dissolved in 10 ml of water. You need to drink one sachet 3 times a day

For persistent diarrhea, the drug is given every 3 hours.

In case of poisoning, the contents of the sachet are diluted in ¼ glass of warm water. The animal should be fed 1 teaspoon per 5 kg of weight.

Treatment is combined with diet. It is optimal not to feed the cat/dog on the first day after the symptoms of poisoning appear. In this case, the animal must receive a sufficient amount of fluid.

If after 2 procedures of administering the drug the condition does not improve, the pet should be shown to a doctor.

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special instructions

Diarrhea (especially in children) increases the risk of electrolyte imbalance and dehydration. To avoid this, the child is usually prescribed Regidron and Smecta together. Instead of Regidron, you can use the following drugs: Citraglucosolan , Disol , Trisol , Reosolan , Gidrovit , etc.

Oral rehydration salt solution helps replenish electrolytes lost during vomiting and diarrhea, the glucose it contains improves salt absorption, and citrates help correct the balance in metabolic acidosis .

For adults, rehydration agents are prescribed if necessary. The amount of rehydration depends on the course of the disease, the age of the patient and the intensity of diarrhea.

Analogues of Smecta

Level 4 ATC code matches:
Polyvinylpyrrolidone

Polysorb

Polyphepan

Enterosgel

Atoxyl

Neosmectin

Filtrum-STI

Lactofiltrum

Enterodesis

Synonyms for Smecta are Diosmectite and Neosmectin . When choosing an analogue for children, preference is given to the drug Neosmectin.

The following mechanisms of action have a similar mechanism of action: Activated carbon , Microcel , Laktofiltrum , Lignosorb , Polysorb MP , Filtrum-STI , Polyphepan , Enterodes , Entegnin , Enterosorb Enterosgel , Enterumin , - 1 .

Which is better, Neosmectin or Smecta?

Neosmectin is a complete analogue of the drug Smecta. The difference between these products is that the first is produced by the Russian company Pharmstandard-Leksredstva OJSC, while Smecta is produced by the French company Ipsen Pharma.

Smecta or Activated Carbon - which is better?

Smecta and Activated Carbon are preparations with sorption properties.

However, Smecta has a number of advantages in comparison with the latter. Firstly, this drug is distinguished by its selectivity of action: it removes toxic substances, hydrochloric acid, excess bile acids and viruses, but does not take the substances it needs from the body.

Activated carbon, along with pathogenic microorganisms and poisons of biological origin, also removes beneficial bacteria, without which the stomach and intestines subsequently cannot function normally. Diosmectite helps create the most optimal conditions in the body for the development of beneficial microflora.

Secondly, acting very gently, the drug envelops the walls of the digestive canal, protecting them from aggressive factors, while Activated Carbon, which has a rigid structure, can further injure them.

Smecta for children, instructions for newborns

Smecta for newborns is often an indispensable drug, since most digestive problems arise in the first weeks of a baby’s life.

The manufacturer's instructions do not contain instructions on how to give Smecta to infants under 4 weeks of age, so most young mothers naturally have questions about whether Smecta can be given to newborns and whether this drug will harm the baby.

The answer is clear - you can (after all, diosmectite is nothing more than well-purified clay, which is not absorbed or metabolized in the body), but only under the supervision of the attending physician and with his approval.

The drug is prescribed for eating disorders accompanied by bloating and abdominal pain, the development of diarrhea and vomiting syndrome. It is also recommended to be given for jaundice .

The dosage of Smecta for newborns is selected by the doctor.

There is no difference in how to dilute Smecta for a newborn baby and an older child. The dose recommended by the doctor is slowly, stirring constantly, poured into 50 ml of warm milk, water or formula for artificial nutrition and stirred until smooth.

The specified volume of liquid must be given to the child in several doses.

Most mothers leave positive reviews about the use of the drug in newborns, but note that children prone to constipation should be given Smecta with caution.

Reception by children

Smecta can be given to children from infancy. Often, babies have problems with the digestive system in the first days of life.

The instructions say that you can give the medicine from 4 weeks. The remedy can be given for malnutrition, which leads to abdominal pain and bloating, vomiting and diarrhea. Also effective for jaundice.

The optimal dose is determined only by a doctor. You need to dilute the powder in warm milk or water (50 ml), stirring until you get a homogeneous consistency. The specified volume must be divided into several doses.

For diarrhea

If a baby has diarrhea at the age of 1-12 months, then in the first 72 hours you need to give 2 sachets, after which you can give 1 sachet per day. Children from 1 year old can be given 4 sachets in the first 3 days, and after that - 2 sachets per day.

When vomiting

For vomiting in children under 1 year of age, give 1 sachet per day. A child over one year old can be given 3 sachets per day. If constipation occurs, the dose should be reduced.

Use with alcohol

Diosmectite reduces the rate of absorption of alcohol.

To reduce the effect of intoxication, immediately before the feast you should take 2-3 sachets of the drug.

To prevent the development of hangover syndrome , Smecta is taken after drinking alcohol.

If there is vomiting within 30 minutes after taking the suspension, the drug is repeated in a double dose. In case of poisoning with alcohol surrogates, it is necessary to induce vomiting, then take three sachets of Smecta and call an ambulance.

Which is better for poisoning: Smecta or activated carbon

Coal tablets, like Smecta, are a sorbent. However, they remove toxins not only from the intestinal lumen, but also those that have managed to be absorbed into the blood. In addition, charcoal blocks the absorption of toxic substances into the blood from the gastrointestinal tract.

There is no doubt about the effectiveness of activated carbon. But an important distinguishing feature of filter tablets is one undeniable disadvantage - a single dose for administration is calculated based on the patient’s weight using the formula: 1 g of coal per 1 kg of weight. If we take into account that 1 tablet contains a quarter of a gram, it turns out that there are 4 tablets per 1 kg of the patient’s weight. If the patient is an adult who weighs 50 kg, then a single dose for him should be 200 tablets. Not everyone can drink such an amount of activated carbon.

Small doses, which are practiced by the average citizen, are not able to save in case of serious poisoning and stop diarrhea.

Smecta during pregnancy and breastfeeding

Can pregnant women use Smecta?

The drug can be used in pregnant women. According to the instructions for Smecta, during pregnancy there is no need to adjust the regimen and dosage of the drug.

In pregnant women, the drug is used to reduce the severity of heartburn, normalize digestion, prevent the development of intestinal candidiasis against the background of reduced immunity , and also to prevent toxicosis .

It has been scientifically and practically proven that diosmectite does not have a negative effect on the process of prenatal development and is completely safe for the fetus.

If necessary, unless the doctor gives other instructions, you can take Smecta one sachet three times a day. Five days are usually enough to reduce the acidity of gastric juice and normalize the production of digestive enzymes.

Can a nursing mother take Smecta powder?

The drug is approved for use during lactation and can be used in standard doses.

Smecta: how to dilute and take

Taking the drug released in a sachet does not require special preparation. Simply tear the edge of the package and squeeze the contents into your mouth. If desired, you can drink it with water or another drink.

The powder is usually diluted in the following proportion: 1 sachet per 100 ml of liquid. Mix the contents of the sachet with the drink immediately before taking it, shaking it thoroughly.

Eating does not have a significant effect on the effect of the drug. However, it should be understood that any digestive upset due to poisoning must be accompanied by fasting.

Reviews about Smecta

Smecta is an original medicine containing a naturally occurring substance, diosmectite, as an active substance. The latter, being a silicate of Mg and Al, differs favorably from other silicon compounds in its structure and properties.

The diosmectite molecule has a stereometric configuration and is characterized by increased plastic viscosity, due to which the drug not only effectively adsorbs harmful substances, but also has a protective effect on the mucous membrane of the digestive tube.

Most of the reviews are reviews of Smecta for children, and, in particular, for infants and newborns. Acting quickly and gently, the drug relieves symptoms of poisoning, relieves heartburn, and eliminates infectious digestive problems. Therefore, according to most mothers, in families with children, it must be in first aid kits.

The main advantages of Smecta are:

• “children’s” dosage form and pleasant taste;
• the ability to significantly reduce the duration of the disease and, accordingly, the costs of treatment (this fact is confirmed by numerous studies and, in particular, studies conducted by SIGEP specialists);
• good tolerance;
• few restrictions on use.

To date, there is encouraging data on the effectiveness of the drug in the treatment of gastroesophageal reflux in children in the first 4 weeks of newborn life, as well as on its use for prophylactic purposes to prevent the development of chronic diarrhea during radiation therapy in patients with cancer .

Which is better: Smecta or Imodium

Imodium, unlike Smecta, is not a sorbent. The direct purpose of Imodium is to paralyze the intestinal muscles so that it stops the evacuation of food. Imodium stops diarrhea by shutting down the motility of the rectum. The rapid movement of feces stops, but the cause of the disorder does not disappear. Therefore, it makes sense to take Imodium when loose stools are caused not by poisoning, but by increased excitability or neurological reasons.

Important! Imodium is contraindicated for children under 6 years of age, since decreased peristalsis can lead to intestinal rupture at this age, and, as a consequence, the death of the child.

It makes no sense to compare the benefits of taking two drugs, since the direction of their actions is completely different. Smecta is indicated for use in cases of poisoning, intestinal infections, and toxic damage to the mucous membranes of the rectum. While Immodium does not fight the pathogen in any way, but only corrects the mechanical activity of the digestive organ.

How much does it cost at Smecta pharmacy?

The price of Smecta in a pharmacy may vary depending on the number of portioned sachets in the package.

The price of Smecta in Russian pharmacies is about 130 rubles. for package No. 10. The cost of package No. 30 is about 280 rubles. One portioned bag can be purchased for an average of 15 rubles.

The cost of package No. 12 in Ukraine is about 110 UAH; you can buy a package of 30 sachets for about 230 UAH. The price for 1 sachet is about 10 UAH.

If it is necessary to use the drug for children (in particular, for newborns), take into account the likelihood of constipation. In predisposed children, the drug is used in a reduced dose, so it is advisable to buy it not in packaging, but individually.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

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