TOM’S LIVER SALT

Sodium Bicarbonate B.P 2.28 g
Citric acid BP 1.785 g
Magnesium Sulphate B.P 0.93 g
Read all of this leaflet carefully before you take this medicine.

• Keep this leaflet. You many need to read it again.
• If you have further question, please ask your Pharmacist or your Doctor.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

In this leaflet:

1. What Tom’s Liver Salt is and what it is used for:
2. Precautions and warning before you take Tom’s Liver Salt 
3. How to take Tom’s Liver Salt
4. Possible side effects.
5. Symptoms and treatment of over dosage
6. How to store Tom’s Liver Salt  
7. Further information

1. WHAT TOM’S LIVER SALT IS AND WHAT IT IS USED FOR 
Tom’s Liver Salt is an oral antacid with additional laxative action. It contains sodium bicarbonate which neutralizes stomach acid and magnesium sulphate whose effect on the GIT induces peristalsis, hence evacuation of the bowel.

2. PRECAUTIONS AND WARNING BEFORE YOU TAKE TOM’S LIVER SALT
Contraindication:
Do not take Tom’s Liver Salt if you are allergic or hypersensitive to any of the ingredients of Tom’s Liver Salt.

You have metabolic or respiratory alkalosis, renal failure, acute gastro-intestinal condition like diarrhea, and in hypocalcaemia in which alkalosis may produce tetany, hypertension, seizures or HF. It should not be given to patients with symptoms of appendicitis, intestinal obstruction, inflammatory bowel disease or abdominal pain of unknown origin. Tom’s liver salt is also contraindicated in patients with acute ingestion of mineral acids. 

Pregnancy and lactation:
• Safety of bicarbonates hasn’t been established for use during pregnancy and it is not known if it appears in breast milk, hence Tom’s liver salt should be used cautiously in such persons, especially during the first trimester.

Take special care with Tom’s Liver Salt
• If you have heart failure, renal insufficiency or other edematous or sodium retaining conditions. Frequent use by persons on a low sodium diet (as in hypertension, cardiac or renal dysfunction) should be avoided because of the sodium content.

Driving and using Machines 
• Tom’s liver salt has no effect on mental alertness.

Taking other medicines:
• Please inform your Pharmacist or Doctor if you are taking or about to take any other medicine including those obtained without a prescription.

Possible interactions with food and drugs
• Tom’s liver salt should not be taken together with enteric coated medicines, catecholamines or milk. Magnesium sulphate as with other magnesium salts may interfere with the absorption of tetracycline and alkalinisation of the urine may modify excretion of drugs for which the excretion is pH sensitive.

3. HOW TO TAKE TOM’S LIVER SALT
• You should take your medicine exactly as your Doctor or Pharmacist directs you.
• Dissolve or mix with a glass of water before taking. 

Adults (including the elderly): As an antacid, one 5 g sachet in a glass of water. As a laxative, one 5 g sachet twice daily; before breakfast and at bedtime.

Children (aged over 6 years): Half the adult dose. 

Consult your physician if symptoms persist for more than 3days.

4. POSSIBLE SIDE EFFECT
Like all medicines, Tom’s Liver Salt can cause side effects, although not everybody gets them. Belching, flatulence and diarrhea have been occasionally reported after extensive usage. 

5. SYMPTOMS AND TREATMENT OF OVER DOSAGE
Signs of overdose include depressed consciousness and obtundation from hypernatremia, tetany from hypocalcaemia, arrhythmias from hypokalaemia, and seizures from alkalosis. Treatment is symptomatic and supportive. Recommend correcting fluid, electrolyte and pH abnormalities. Vital signs, fluid and electrolytes should be monitored closely.

6. HOW TO STORE TOM’S LIVER SALT
Keep your medication out of reach and sight of children. Store it in the original package in a cool, dry place below 30 0C. Check the expiry date and do not use if it has passed. 

7. FURTHER INFORMATION
Each sachet contains 2.28 g of Sodium Bicarbonate and 0.93g of Magnesium Sulphate. The other ingredients in Tom’s Liver Salt are citric acid, aspartame and Lemon Flavour.

Date of publication / review: This publication is subject to review every two years (effective January, 2010) and upon receipt of new product information.

Manufacturer:
Trade winds Chemist Limited
PLT 9B BLK1, Ayigya industrial area
Kumasi