The Prescrire magazine advises against using medicated clays, in particular Smecta, because they contain lead. Other drugs should be avoided after age 65.
- The 2022 report of the review Prescrire covers 107 drugs, including 88 marketed in France.
- The ANSM recommends not using medicated clays in children under two years old, “because of the possible presence of a tiny amount of lead”.
Not all medications are good to take. Some have a significant risk of side effects, compared to the benefits. Like every year, the specialist journal Prescribe publishes her review of the drugs she recommends”to rule out for better care”. Widely used treatments are on the list: medicated clays.
Intestinal disorders: drugs polluted with lead
“Medicated clays used in various intestinal disorders including diarrhea, gastric burns or gastroesophageal reflux, should be avoided because of their natural lead pollution.“, Explain Prescribe.
The media cites diosmectite (Smecta or other), hydrotalcite (Rennieliquo), beidellitic montmorillonite also called monmectite (Bedelix and in combination in Gelox) and kaolin (in combination in Gastropax and Neutroses). “Lead has neurological, hematological, renal and cardiovascular toxic effects, and reprotoxic effects, most of which increase with exposure dose.recalls the review.
She also points out that these drugs do not systematically relieve gastric problems. In the case of diarrhoea, these products “modify the appearance of stools without acting on fluid loss and the risk of dehydration“. In cases of uncomplicated gastroesophageal reflux disease, she recommends other medications such as clay-free antacids”as a short-term, moderate-dose treatment“, for example the combination of sodium bicarbonate + sodium alginate (Gaviscon or other).
Over the age of 65, anti-vomiting drugs should be avoided
There are other alternatives to these medications, but they are not suitable for all ages. Thus, the High Authority of Health discourages the use of “medicines based on domperidone (Motilium®, Peridys®, Oroperidys®), metoclopramide (Anausin Metoclopramide®, Primperan®, Prokynil LP) or metopimazine (Vogalène®, Vogalib®) and their generics” in the elderly.
For domperidone, the risk lies in the frequent comorbidities in the elderly, such as functional renal failure or cardiac arrhythmia. But there can also be an overdose caused by drug interactions. Metopimazine also exposes to a risk of overdose people with renal or hepatic insufficiency, taking treatments for these specific pathologies.
Medicines: what treatment to relieve vomiting?
To The DispatchSéverine Carré-Pétraud, Editorial Director of Prescribe, offers several alternatives. “The most important thing is to stay hydrated and then adapt your diet., she says. It is recommended to consume well-cooked starchy foods, lean meat and avoid dairy products with the exception of yogurts. “In the context of a mild infection, such as gastroenteritis, diarrhea is not serious. It evolves naturally in a favorable way”she recalls.
