Dosing & Uses
Dosage Forms & Strengths
aspirin/citric acid/sodium bicarbonate
effervescent tablet
- 325mg/1000mg/1916mg
Antacid & Analgesic
Indicated for heartburn, acid indigestion, and sour stomach when accompanied with headache or body aches
2 tablets (dissolved in water) PO q4hr PRN; not to exceed 8 tablets/day (see Administration)
Age >60 years old: Do not exceed 4 tablets/day (see Cautions)
Dosage Forms & Strengths
aspirin/citric acid/sodium bicarbonate
effervescent tablet
- 325mg/1000mg/1916mg
Antacid & Analgesia
<12 years old: Safety and efficacy not established
≥12 years: As adults; 2 tablets (dissolved in water) PO q4hr PRN; not to exceed 8 tablets/day (see Administration)
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (1)
- mifepristone
aspirin/citric acid/sodium bicarbonate, mifepristone. Other (see comment). Contraindicated. Comment: Aspirin induced antiplatelet activity may induce excessive bleeding after an abortion w/mifepristone (RU 486).
Serious - Use Alternative (14)
- atazanavir
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of atazanavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Atazanavir solubility decreases as pH increases. Reduced plasma concentrations of atazanavir are expected if antacids or buffered medications are coadministered. Administer atazanavir 2 hr before or 1 hr after these medications.
- baloxavir marboxil
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.
- ibuprofen
ibuprofen decreases effects of aspirin/citric acid/sodium bicarbonate by Other (see comment). Avoid or Use Alternate Drug. Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.
- ibuprofen IV
ibuprofen IV decreases effects of aspirin/citric acid/sodium bicarbonate by Other (see comment). Avoid or Use Alternate Drug. Comment: Ibuprofen decreases the antiplatelet effects of aspirin by blocking the active site of platelet cyclooxygenase. The effect of other NSAIDs on aspirin is not established.
- infigratinib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of infigratinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer infigratinib 2 hr before and after administration of a locally-acting antacid.
- ketorolac
aspirin/citric acid/sodium bicarbonate, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- ketorolac intranasal
aspirin/citric acid/sodium bicarbonate, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- measles, mumps, rubella and varicella vaccine, live
aspirin/citric acid/sodium bicarbonate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- methotrexate
aspirin/citric acid/sodium bicarbonate increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Caution should be exercised when salicylates are given in combination with methotrexate. Risk for drug interactions with methotrexate is greatest during high-dose methotrexate therapy, it has been recommended that any of these drugs be used cautiously with methotrexate even when methotrexate is used in low doses.
- pemetrexed
aspirin/citric acid/sodium bicarbonate increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity.
- probenecid
aspirin/citric acid/sodium bicarbonate decreases effects of probenecid by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Aspirin decreases uricosuric action of probenecid.
- sotorasib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of sotorasib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer sotorasib 4 hr before or 10 hr after administration of a locally-acting antacid.
- ticlopidine
aspirin/citric acid/sodium bicarbonate increases effects of ticlopidine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Enhanced risk of hemorrhage.
- varicella virus vaccine live
aspirin/citric acid/sodium bicarbonate, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
Monitor Closely (252)
- abciximab
aspirin/citric acid/sodium bicarbonate, abciximab. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
aspirin/citric acid/sodium bicarbonate, abciximab. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely. - acalabrutinib
aspirin/citric acid/sodium bicarbonate decreases levels of acalabrutinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Acalabrutinib solubility decreases with increasing gastric pH. Separate dosing by at least 2 hr between administration of antacids and acalabrutinib.
- acebutolol
aspirin/citric acid/sodium bicarbonate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
acebutolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - aceclofenac
aceclofenac and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Use Caution/Monitor.
aceclofenac and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - acemetacin
acemetacin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Use Caution/Monitor.
acemetacin and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - acetazolamide
acetazolamide, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.
acetazolamide, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid). - agrimony
aspirin/citric acid/sodium bicarbonate and agrimony both increase anticoagulation. Use Caution/Monitor.
- albuterol
aspirin/citric acid/sodium bicarbonate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfalfa
aspirin/citric acid/sodium bicarbonate and alfalfa both increase anticoagulation. Use Caution/Monitor.
- alfuzosin
aspirin/citric acid/sodium bicarbonate decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- alteplase
aspirin/citric acid/sodium bicarbonate, alteplase. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- American ginseng
aspirin/citric acid/sodium bicarbonate and American ginseng both increase anticoagulation. Use Caution/Monitor.
- amiloride
amiloride and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Modify Therapy/Monitor Closely.
- amoxicillin
amoxicillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
amoxicillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - ampicillin
ampicillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- anagrelide
aspirin/citric acid/sodium bicarbonate, anagrelide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- antithrombin alfa
aspirin/citric acid/sodium bicarbonate, antithrombin alfa. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
antithrombin alfa and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - antithrombin III
aspirin/citric acid/sodium bicarbonate, antithrombin III. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
antithrombin III and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - arformoterol
aspirin/citric acid/sodium bicarbonate increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- argatroban
aspirin/citric acid/sodium bicarbonate, argatroban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
argatroban and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - asenapine
aspirin/citric acid/sodium bicarbonate decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- atenolol
aspirin/citric acid/sodium bicarbonate decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
atenolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - azficel-T
azficel-T, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Patients taking aspirin may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of aspirin is not recommended. .
- azilsartan
aspirin/citric acid/sodium bicarbonate, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
aspirin/citric acid/sodium bicarbonate decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - bemiparin
bemiparin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely.
- benazepril
aspirin/citric acid/sodium bicarbonate decreases effects of benazepril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Potential for dangerous interaction. Use with caution and monitor closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
benazepril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - bendroflumethiazide
aspirin/citric acid/sodium bicarbonate increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- betaxolol
aspirin/citric acid/sodium bicarbonate decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
betaxolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - bisoprolol
aspirin/citric acid/sodium bicarbonate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
bisoprolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - bivalirudin
aspirin/citric acid/sodium bicarbonate, bivalirudin. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
bivalirudin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - bosutinib
aspirin/citric acid/sodium bicarbonate decreases levels of bosutinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Bosutinib displays pH-dependent solubility; may use short-acting antacids with administration separated by 2 hr.
- brinzolamide
brinzolamide, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.
- budesonide
aspirin/citric acid/sodium bicarbonate decreases effects of budesonide by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Enteric-coated budesonide dissolves at pH >5.5. Also, dissolution of extended-release budesonide tablets is pH dependent. Coadministration with drugs that increase gastric pH may cause these budesonide products to prematurely dissolve, and possibly affect release properties and absorption of the drug in the duodenum.
- bumetanide
aspirin/citric acid/sodium bicarbonate increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. - cabotegravir
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of cabotegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer antacid products at least 2 hr before or 4 hr after taking oral cabotegravir.
- candesartan
aspirin/citric acid/sodium bicarbonate decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
candesartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
candesartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - captopril
aspirin/citric acid/sodium bicarbonate decreases effects of captopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
captopril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - carbenoxolone
aspirin/citric acid/sodium bicarbonate increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carvedilol
aspirin/citric acid/sodium bicarbonate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
carvedilol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - celecoxib
aspirin/citric acid/sodium bicarbonate and celecoxib both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and celecoxib both increase serum potassium. Use Caution/Monitor. - celiprolol
aspirin/citric acid/sodium bicarbonate decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
celiprolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - chloroquine
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of chloroquine by cation binding in GI tract. Use Caution/Monitor. Separate doses by at least 4 hr
- chlorothiazide
aspirin/citric acid/sodium bicarbonate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpropamide
aspirin/citric acid/sodium bicarbonate increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- chlorthalidone
aspirin/citric acid/sodium bicarbonate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor. - cilostazol
aspirin/citric acid/sodium bicarbonate, cilostazol. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- cinnamon
aspirin/citric acid/sodium bicarbonate and cinnamon both increase anticoagulation. Use Caution/Monitor.
- ciprofloxacin
aspirin/citric acid/sodium bicarbonate decreases levels of ciprofloxacin by Other (see comment). Use Caution/Monitor. Comment: Buffered aspirin may decrease absorption of quinolones. Consider administering 2 hr before or 6 hr after, buffered aspirin administration.
- citalopram
citalopram, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.
- clomipramine
clomipramine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.
- clopidogrel
aspirin/citric acid/sodium bicarbonate, clopidogrel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- cordyceps
aspirin/citric acid/sodium bicarbonate and cordyceps both increase anticoagulation. Use Caution/Monitor.
- cortisone
aspirin/citric acid/sodium bicarbonate, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- cyclopenthiazide
aspirin/citric acid/sodium bicarbonate increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclosporine
aspirin/citric acid/sodium bicarbonate increases toxicity of cyclosporine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.
- dabigatran
dabigatran and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Use Caution/Monitor. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dabrafenib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of dabrafenib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that alter upper GI tract pH (eg, PPIs, H2-blockers, antacids) may decrease dabrafenib solubility and reduce its bioavailability
- dalteparin
aspirin/citric acid/sodium bicarbonate, dalteparin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
dalteparin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - deferasirox
deferasirox, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.
- deferiprone
aspirin/citric acid/sodium bicarbonate decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.
- deflazacort
aspirin/citric acid/sodium bicarbonate, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- desirudin
aspirin/citric acid/sodium bicarbonate, desirudin. Either increases levels of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- dexamethasone
aspirin/citric acid/sodium bicarbonate, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- diclofenac
aspirin/citric acid/sodium bicarbonate and diclofenac both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and diclofenac both increase serum potassium. Use Caution/Monitor. - dicloxacillin
dicloxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
dicloxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - diflunisal
aspirin/citric acid/sodium bicarbonate and diflunisal both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and diflunisal both increase serum potassium. Use Caution/Monitor. - digoxin
aspirin/citric acid/sodium bicarbonate and digoxin both increase serum potassium. Use Caution/Monitor.
- dipyridamole
aspirin/citric acid/sodium bicarbonate, dipyridamole. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- dobutamine
aspirin/citric acid/sodium bicarbonate increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dong quai
aspirin/citric acid/sodium bicarbonate and dong quai both increase anticoagulation. Use Caution/Monitor.
- dopexamine
aspirin/citric acid/sodium bicarbonate increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxazosin
aspirin/citric acid/sodium bicarbonate decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- drospirenone
drospirenone and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Modify Therapy/Monitor Closely.
- duloxetine
duloxetine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- eltrombopag
eltrombopag increases levels of aspirin/citric acid/sodium bicarbonate by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- elvitegravir
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of elvitegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Elvitegravir plasma concentrations are lower with antacids due to the formation of ionic complexes in the GI tract and not due to changes in gastric pH; separate dose from antacid by at least 2 hr
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
aspirin/citric acid/sodium bicarbonate decreases levels of elvitegravir/cobicistat/emtricitabine/tenofovir DF by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration from antacids by 2 hr.
- enalapril
aspirin/citric acid/sodium bicarbonate decreases effects of enalapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
enalapril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - enoxaparin
aspirin/citric acid/sodium bicarbonate, enoxaparin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
enoxaparin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Use Caution/Monitor. Additive effects are intended when both drugs are prescribed as indicated for unstable angina, non-Q-wave MI, and STEMI - ephedrine
aspirin/citric acid/sodium bicarbonate increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
aspirin/citric acid/sodium bicarbonate increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
aspirin/citric acid/sodium bicarbonate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epoprostenol
aspirin/citric acid/sodium bicarbonate and epoprostenol both increase anticoagulation. Use Caution/Monitor.
- eprosartan
aspirin/citric acid/sodium bicarbonate decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
eprosartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
eprosartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - eptifibatide
aspirin/citric acid/sodium bicarbonate, eptifibatide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- escitalopram
escitalopram, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- esmolol
aspirin/citric acid/sodium bicarbonate decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
esmolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - ethacrynic acid
aspirin/citric acid/sodium bicarbonate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- etodolac
aspirin/citric acid/sodium bicarbonate and etodolac both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and etodolac both increase serum potassium. Use Caution/Monitor. - fenbufen
aspirin/citric acid/sodium bicarbonate and fenbufen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and fenbufen both increase serum potassium. Use Caution/Monitor. - fennel
aspirin/citric acid/sodium bicarbonate and fennel both increase anticoagulation. Use Caution/Monitor.
- fenoprofen
aspirin/citric acid/sodium bicarbonate and fenoprofen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and fenoprofen both increase serum potassium. Use Caution/Monitor. - feverfew
aspirin/citric acid/sodium bicarbonate and feverfew both increase anticoagulation. Use Caution/Monitor.
- fish oil
fish oil, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Patients taking fish oil and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- fludrocortisone
aspirin/citric acid/sodium bicarbonate, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- fluoxetine
fluoxetine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- flurbiprofen
aspirin/citric acid/sodium bicarbonate and flurbiprofen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and flurbiprofen both increase serum potassium. Use Caution/Monitor. - fondaparinux
fondaparinux and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely.
- formoterol
aspirin/citric acid/sodium bicarbonate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- forskolin
aspirin/citric acid/sodium bicarbonate and forskolin both increase anticoagulation. Use Caution/Monitor.
- fosinopril
aspirin/citric acid/sodium bicarbonate decreases effects of fosinopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
fosinopril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - furosemide
aspirin/citric acid/sodium bicarbonate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- garlic
aspirin/citric acid/sodium bicarbonate and garlic both increase anticoagulation. Use Caution/Monitor.
- gefitinib
aspirin/citric acid/sodium bicarbonate decreases levels of gefitinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Separate gefitinib and antacid doses by at least 6 hr.
- gentamicin
aspirin/citric acid/sodium bicarbonate increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ginger
aspirin/citric acid/sodium bicarbonate and ginger both increase anticoagulation. Use Caution/Monitor.
- ginkgo biloba
aspirin/citric acid/sodium bicarbonate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- glimepiride
aspirin/citric acid/sodium bicarbonate increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glipizide
aspirin/citric acid/sodium bicarbonate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glyburide
aspirin/citric acid/sodium bicarbonate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- green tea
green tea increases effects of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Use Caution/Monitor. (Theoretical, due to caffeine content). Combination may increase risk of bleeding.
- griseofulvin
griseofulvin decreases levels of aspirin/citric acid/sodium bicarbonate by unknown mechanism. Use Caution/Monitor.
- heparin
aspirin/citric acid/sodium bicarbonate, heparin. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
heparin and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - horse chestnut seed
aspirin/citric acid/sodium bicarbonate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
- hyaluronidase
aspirin/citric acid/sodium bicarbonate decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Salicylates, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect.
- hydralazine
aspirin/citric acid/sodium bicarbonate decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- hydrochlorothiazide
aspirin/citric acid/sodium bicarbonate increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
aspirin/citric acid/sodium bicarbonate, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- ibuprofen
aspirin/citric acid/sodium bicarbonate and ibuprofen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ibuprofen both increase serum potassium. Use Caution/Monitor. - ibuprofen IV
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ibuprofen IV by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ibuprofen IV both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ibuprofen IV both increase serum potassium. Use Caution/Monitor. - icosapent
icosapent, aspirin/citric acid/sodium bicarbonate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Icosapent may prolong bleeding time; monitor periodically if coadministered with other drugs that affect bleeding.
- indapamide
aspirin/citric acid/sodium bicarbonate increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
aspirin/citric acid/sodium bicarbonate and indomethacin both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and indomethacin both increase serum potassium. Use Caution/Monitor. - irbesartan
aspirin/citric acid/sodium bicarbonate decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
irbesartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
irbesartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - isoproterenol
aspirin/citric acid/sodium bicarbonate increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketoprofen
aspirin/citric acid/sodium bicarbonate and ketoprofen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ketoprofen both increase serum potassium. Use Caution/Monitor. - ketorolac
aspirin/citric acid/sodium bicarbonate and ketorolac both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ketorolac both increase serum potassium. Use Caution/Monitor. - ketorolac intranasal
aspirin/citric acid/sodium bicarbonate and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - labetalol
aspirin/citric acid/sodium bicarbonate decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
labetalol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - ledipasvir/sofosbuvir
aspirin/citric acid/sodium bicarbonate decreases levels of ledipasvir/sofosbuvir by Other (see comment). Use Caution/Monitor. Comment: Ledipasvir solubility decreases as pH increases; drugs that increase gastric pH are expected to decrease levels of ledipasvir; separate antacid and ledipasivr/sofosbuvir administration by 4 hr.
- levalbuterol
aspirin/citric acid/sodium bicarbonate increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levomilnacipran
levomilnacipran, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.
- lisdexamfetamine
aspirin/citric acid/sodium bicarbonate will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- lisinopril
aspirin/citric acid/sodium bicarbonate decreases effects of lisinopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
lisinopril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - lithium
aspirin/citric acid/sodium bicarbonate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.
- lornoxicam
aspirin/citric acid/sodium bicarbonate and lornoxicam both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and lornoxicam both increase serum potassium. Use Caution/Monitor. - losartan
aspirin/citric acid/sodium bicarbonate decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
losartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
losartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - meclofenamate
aspirin/citric acid/sodium bicarbonate and meclofenamate both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and meclofenamate both increase serum potassium. Use Caution/Monitor. - mefenamic acid
aspirin/citric acid/sodium bicarbonate and mefenamic acid both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and mefenamic acid both increase serum potassium. Use Caution/Monitor. - meloxicam
aspirin/citric acid/sodium bicarbonate and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and meloxicam both increase serum potassium. Use Caution/Monitor. - mesalamine
mesalamine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.
- metaproterenol
aspirin/citric acid/sodium bicarbonate increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methazolamide
methazolamide, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.
- methotrexate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- methyclothiazide
aspirin/citric acid/sodium bicarbonate increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methylphenidate
aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.
- methylprednisolone
aspirin/citric acid/sodium bicarbonate, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- metolazone
aspirin/citric acid/sodium bicarbonate increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
aspirin/citric acid/sodium bicarbonate decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
metoprolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - milnacipran
milnacipran, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- mistletoe
aspirin/citric acid/sodium bicarbonate increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moexipril
aspirin/citric acid/sodium bicarbonate decreases effects of moexipril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
moexipril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - moxisylyte
aspirin/citric acid/sodium bicarbonate decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- mycophenolate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
aspirin/citric acid/sodium bicarbonate and nabumetone both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and nabumetone both increase serum potassium. Use Caution/Monitor. - nadolol
aspirin/citric acid/sodium bicarbonate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nadolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - nafcillin
nafcillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
nafcillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - naproxen
aspirin/citric acid/sodium bicarbonate and naproxen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and naproxen both increase serum potassium. Use Caution/Monitor. - nebivolol
aspirin/citric acid/sodium bicarbonate decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nebivolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - nefazodone
nefazodone, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- neratinib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of neratinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate antacid and neratinib dosing by 3 hr.
- nettle
aspirin/citric acid/sodium bicarbonate increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nilotinib
aspirin/citric acid/sodium bicarbonate decreases levels of nilotinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Avoid this interaction by administering antacids 2 hr after or 2 hr before nilotinib.
- nitroglycerin rectal
aspirin/citric acid/sodium bicarbonate will increase the level or effect of nitroglycerin rectal by Other (see comment). Use Caution/Monitor. The pharmacological effects of nitroglycerin may be enhanced by concomitant administration of aspirin.
- norepinephrine
aspirin/citric acid/sodium bicarbonate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olmesartan
aspirin/citric acid/sodium bicarbonate decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
olmesartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
olmesartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - omadacycline
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- omega 3 carboxylic acids
omega 3 carboxylic acids, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3 acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
- omega 3 fatty acids
omega 3 fatty acids, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- oxacillin
oxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
oxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - oxaprozin
aspirin/citric acid/sodium bicarbonate and oxaprozin both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and oxaprozin both increase serum potassium. Use Caution/Monitor. - panax ginseng
aspirin/citric acid/sodium bicarbonate and panax ginseng both increase anticoagulation. Use Caution/Monitor.
- parecoxib
aspirin/citric acid/sodium bicarbonate and parecoxib both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and parecoxib both increase serum potassium. Use Caution/Monitor. - paroxetine
paroxetine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- pau d'arco
aspirin/citric acid/sodium bicarbonate and pau d'arco both increase anticoagulation. Use Caution/Monitor.
- pegaspargase
pegaspargase increases effects of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- penbutolol
aspirin/citric acid/sodium bicarbonate decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
penbutolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - penicillin G aqueous
penicillin G aqueous, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
penicillin G aqueous, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - perindopril
aspirin/citric acid/sodium bicarbonate decreases effects of perindopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
perindopril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - pexidartinib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of pexidartinib by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate pexidartinib by 2 hr before or after taking a locally-acting antacid.
- phenindione
phenindione and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely.
- phenoxybenzamine
aspirin/citric acid/sodium bicarbonate decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phentolamine
aspirin/citric acid/sodium bicarbonate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phytoestrogens
aspirin/citric acid/sodium bicarbonate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
- pindolol
aspirin/citric acid/sodium bicarbonate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
pindolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - pirbuterol
aspirin/citric acid/sodium bicarbonate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- piroxicam
aspirin/citric acid/sodium bicarbonate and piroxicam both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and piroxicam both increase serum potassium. Use Caution/Monitor. - pivmecillinam
pivmecillinam, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
pivmecillinam, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - potassium acid phosphate
aspirin/citric acid/sodium bicarbonate and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
aspirin/citric acid/sodium bicarbonate and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
aspirin/citric acid/sodium bicarbonate and potassium citrate both increase serum potassium. Use Caution/Monitor.
- pralatrexate
aspirin/citric acid/sodium bicarbonate increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor.
- prasugrel
aspirin/citric acid/sodium bicarbonate, prasugrel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- prazosin
aspirin/citric acid/sodium bicarbonate decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- prednisolone
aspirin/citric acid/sodium bicarbonate, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- prednisone
aspirin/citric acid/sodium bicarbonate, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- probenecid
aspirin/citric acid/sodium bicarbonate decreases effects of probenecid by unknown mechanism. Use Caution/Monitor.
- propranolol
aspirin/citric acid/sodium bicarbonate decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
propranolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - protamine
protamine and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely.
- quinapril
aspirin/citric acid/sodium bicarbonate decreases effects of quinapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
quinapril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - ramipril
aspirin/citric acid/sodium bicarbonate decreases effects of ramipril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
ramipril, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - reishi
aspirin/citric acid/sodium bicarbonate and reishi both increase anticoagulation. Use Caution/Monitor.
- reteplase
aspirin/citric acid/sodium bicarbonate, reteplase. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- rilpivirine
aspirin/citric acid/sodium bicarbonate decreases levels of rilpivirine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Coadministration of antacids with rilpivirine may cause significant decreases in rilpivirine plasma concentrations because of increased gastric pH. If antacids must be administered, they should be given at least 2 hr before or at least 4 hr after rilpivirine. For the combination product dolutegravir/rilpivirine, antacids should be given at least 4 hr before or at least 6 hr afterwards.
- riociguat
aspirin/citric acid/sodium bicarbonate decreases levels of riociguat by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration by at least 1 hour.
- rivaroxaban
aspirin/citric acid/sodium bicarbonate, rivaroxaban. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
rivaroxaban, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Aspirin are known to increase bleeding. Bleeding risk may be increased when aspirin is used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss. - sacubitril/valsartan
sacubitril/valsartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
sacubitril/valsartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
aspirin/citric acid/sodium bicarbonate decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - salicylates (non-asa)
aspirin/citric acid/sodium bicarbonate and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor. - salmeterol
aspirin/citric acid/sodium bicarbonate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salsalate
aspirin/citric acid/sodium bicarbonate and salsalate both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and salsalate both increase serum potassium. Use Caution/Monitor. - sarecycline
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- sertraline
sertraline, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- Siberian ginseng
aspirin/citric acid/sodium bicarbonate and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
- silodosin
aspirin/citric acid/sodium bicarbonate decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
aspirin/citric acid/sodium bicarbonate, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of aspirin/citric acid/sodium bicarbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of aspirin/citric acid/sodium bicarbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sofosbuvir/velpatasvir
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of sofosbuvir/velpatasvir by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Velpatasvir solubility decreases as gastric pH increases (practically insoluble at pH >5). Separate administration of sofosbuvir/velpatasvir from antacids by at least 4 hr.
- sotalol
aspirin/citric acid/sodium bicarbonate decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
sotalol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - sparsentan
aspirin/citric acid/sodium bicarbonate decreases effects of sparsentan by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer sparsentan 2 hours before or after administration of antacids. Antacids may decrease sparsentan exposure which may reduce efficacy of sparsentan.
- spironolactone
spironolactone and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Modify Therapy/Monitor Closely.
aspirin/citric acid/sodium bicarbonate decreases effects of spironolactone by unspecified interaction mechanism. Use Caution/Monitor. When used concomitantly, spironolactone dose may need to be titrated to higher maintenance dose and the patient should be observed closely to determine if the desired effect is obtained. - succinylcholine
aspirin/citric acid/sodium bicarbonate and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfamethoxazole
aspirin/citric acid/sodium bicarbonate, sulfamethoxazole. Either increases effects of the other by plasma protein binding competition. Use Caution/Monitor. Due to high protein binding capacity of both drugs, one may displace the other when coadministered leading to an enhanced effect of the displaced drug; risk is low with low dose aspirin.
- sulfasalazine
aspirin/citric acid/sodium bicarbonate and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and sulfasalazine both increase serum potassium. Use Caution/Monitor. - sulindac
aspirin/citric acid/sodium bicarbonate and sulindac both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and sulindac both increase serum potassium. Use Caution/Monitor. - telmisartan
aspirin/citric acid/sodium bicarbonate decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
telmisartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
telmisartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - temocillin
temocillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
temocillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - tenecteplase
aspirin/citric acid/sodium bicarbonate, tenecteplase. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- terazosin
aspirin/citric acid/sodium bicarbonate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- terbutaline
aspirin/citric acid/sodium bicarbonate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ticagrelor
aspirin/citric acid/sodium bicarbonate, ticagrelor. Other (see comment). Use Caution/Monitor. Comment: Maintenance doses of aspirin above 100 mg decreases effectiveness of ticagrelor. Therefore, after the initial loading dose of aspirin (usually 325 mg), use ticagrelor with a maintenance dose of aspirin of 75-100 mg.
- ticarcillin
ticarcillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
ticarcillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - timolol
aspirin/citric acid/sodium bicarbonate decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
timolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - tirofiban
aspirin/citric acid/sodium bicarbonate, tirofiban. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
- tobramycin inhaled
tobramycin inhaled and aspirin/citric acid/sodium bicarbonate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
- tolazamide
aspirin/citric acid/sodium bicarbonate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolbutamide
aspirin/citric acid/sodium bicarbonate increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolfenamic acid
aspirin/citric acid/sodium bicarbonate and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and tolfenamic acid both increase serum potassium. Use Caution/Monitor. - tolmetin
aspirin/citric acid/sodium bicarbonate and tolmetin both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and tolmetin both increase serum potassium. Use Caution/Monitor. - tolvaptan
aspirin/citric acid/sodium bicarbonate and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
aspirin/citric acid/sodium bicarbonate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trazodone
trazodone, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- triamcinolone acetonide injectable suspension
aspirin/citric acid/sodium bicarbonate, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- triamterene
triamterene and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Modify Therapy/Monitor Closely.
- valproic acid
aspirin/citric acid/sodium bicarbonate increases levels of valproic acid by plasma protein binding competition. Use Caution/Monitor.
- valsartan
aspirin/citric acid/sodium bicarbonate decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
valsartan and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.
valsartan, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - venlafaxine
venlafaxine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- vismodegib
aspirin/citric acid/sodium bicarbonate will decrease the level or effect of vismodegib by Other (see comment). Use Caution/Monitor. Drugs that increase gastric pH alter vismodegib solubility and therefore reduce bioavailability; effect on efficacy unknown
- vitamin K1 (phytonadione)
aspirin/citric acid/sodium bicarbonate increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- vorapaxar
aspirin/citric acid/sodium bicarbonate, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
- zotepine
aspirin/citric acid/sodium bicarbonate decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Minor (124)
- aceclofenac
aceclofenac will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
acemetacin will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
aspirin/citric acid/sodium bicarbonate will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- alendronate
aspirin/citric acid/sodium bicarbonate, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.
- aluminum hydroxide
aluminum hydroxide, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- amikacin
aspirin/citric acid/sodium bicarbonate increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aminohippurate sodium
aspirin/citric acid/sodium bicarbonate will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- anamu
aspirin/citric acid/sodium bicarbonate and anamu both increase anticoagulation. Minor/Significance Unknown.
- ascorbic acid
aspirin/citric acid/sodium bicarbonate decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.
ascorbic acid will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
ascorbic acid increases levels of aspirin/citric acid/sodium bicarbonate by decreasing renal clearance. Minor/Significance Unknown. - balsalazide
aspirin/citric acid/sodium bicarbonate will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bismuth subsalicylate
bismuth subsalicylate increases effects of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Minor/Significance Unknown.
- bumetanide
aspirin/citric acid/sodium bicarbonate, bumetanide. Other (see comment). Minor/Significance Unknown. Comment: Salicylates are less likely than other NSAIDs to interact w/bumetanide.
- calcium carbonate
calcium carbonate, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- cefadroxil
cefadroxil will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefazolin
cefazolin will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefepime
cefepime will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefixime
cefixime will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefprozil
cefprozil will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ceftazidime
ceftazidime will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ceftibuten
ceftibuten will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
aspirin/citric acid/sodium bicarbonate will increase the level or effect of celecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cephalexin
cephalexin will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
aspirin/citric acid/sodium bicarbonate will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
aspirin/citric acid/sodium bicarbonate increases effects of chlorpropamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate. - chlorthalidone
chlorthalidone will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chromium
aspirin/citric acid/sodium bicarbonate increases levels of chromium by unspecified interaction mechanism. Minor/Significance Unknown.
- cortisone
cortisone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- creatine
creatine, aspirin/citric acid/sodium bicarbonate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.
- cyanocobalamin
aspirin/citric acid/sodium bicarbonate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- danshen
aspirin/citric acid/sodium bicarbonate and danshen both increase anticoagulation. Minor/Significance Unknown.
- deflazacort
deflazacort decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- devil's claw
aspirin/citric acid/sodium bicarbonate and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- dexamethasone
dexamethasone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- diclofenac
aspirin/citric acid/sodium bicarbonate will increase the level or effect of diclofenac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diclofenac topical
diclofenac topical, aspirin/citric acid/sodium bicarbonate. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.
- diflunisal
aspirin/citric acid/sodium bicarbonate will increase the level or effect of diflunisal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diltiazem
diltiazem increases effects of aspirin/citric acid/sodium bicarbonate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.
- eplerenone
aspirin/citric acid/sodium bicarbonate decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- ethanol
ethanol increases toxicity of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.
- etodolac
aspirin/citric acid/sodium bicarbonate will increase the level or effect of etodolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenbufen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of fenbufen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenoprofen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of fenoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- feverfew
aspirin/citric acid/sodium bicarbonate decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- flurbiprofen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of flurbiprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- folic acid
aspirin/citric acid/sodium bicarbonate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- furosemide
aspirin/citric acid/sodium bicarbonate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- ganciclovir
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- gentamicin
aspirin/citric acid/sodium bicarbonate increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- glimepiride
aspirin/citric acid/sodium bicarbonate increases effects of glimepiride by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- glipizide
aspirin/citric acid/sodium bicarbonate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- glyburide
aspirin/citric acid/sodium bicarbonate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- hydrochlorothiazide
hydrochlorothiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- ibuprofen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- imidapril
aspirin/citric acid/sodium bicarbonate decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- indapamide
indapamide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
aspirin/citric acid/sodium bicarbonate will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- insulin aspart
aspirin/citric acid/sodium bicarbonate increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin detemir
aspirin/citric acid/sodium bicarbonate increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin glargine
aspirin/citric acid/sodium bicarbonate increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin glulisine
aspirin/citric acid/sodium bicarbonate increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin lispro
aspirin/citric acid/sodium bicarbonate increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin NPH
aspirin/citric acid/sodium bicarbonate increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- insulin regular human
aspirin/citric acid/sodium bicarbonate increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.
- ketoprofen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac intranasal
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- L-methylfolate
aspirin/citric acid/sodium bicarbonate decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- lornoxicam
aspirin/citric acid/sodium bicarbonate will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meclofenamate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
aspirin/citric acid/sodium bicarbonate will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meloxicam
aspirin/citric acid/sodium bicarbonate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
aspirin/citric acid/sodium bicarbonate will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methylprednisolone
methylprednisolone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- metolazone
metolazone will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nabumetone
aspirin/citric acid/sodium bicarbonate will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- naproxen
aspirin/citric acid/sodium bicarbonate will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- neomycin PO
aspirin/citric acid/sodium bicarbonate increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- noni juice
aspirin/citric acid/sodium bicarbonate and noni juice both increase serum potassium. Minor/Significance Unknown.
- ofloxacin
ofloxacin, aspirin/citric acid/sodium bicarbonate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- oxaprozin
aspirin/citric acid/sodium bicarbonate will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
aspirin/citric acid/sodium bicarbonate will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- paromomycin
aspirin/citric acid/sodium bicarbonate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- penicillin VK
penicillin VK, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Minor/Significance Unknown.
- pentazocine
aspirin/citric acid/sodium bicarbonate, pentazocine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Possible risk of renal papillary necrosis w/chronic Tx.
- piperacillin
piperacillin will increase the level or effect of aspirin/citric acid/sodium bicarbonate by plasma protein binding competition. Minor/Significance Unknown. Salicylic acid could be displaced from protein binding sites or it could itself displace other protein-bound drugs and result in an enhanced effect of the displaced drug
- piroxicam
aspirin/citric acid/sodium bicarbonate will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- prednisolone
prednisolone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- prednisone
prednisone decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- rivastigmine
rivastigmine increases toxicity of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Minor/Significance Unknown. Increased GI symptoms.
- rose hips
aspirin/citric acid/sodium bicarbonate decreases levels of rose hips by increasing renal clearance. Minor/Significance Unknown.
rose hips will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
rose hips increases levels of aspirin/citric acid/sodium bicarbonate by decreasing renal clearance. Minor/Significance Unknown. - salicylates (non-asa)
aspirin/citric acid/sodium bicarbonate will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salsalate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sodium bicarbonate
sodium bicarbonate, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- sodium citrate/citric acid
sodium citrate/citric acid, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- streptomycin
aspirin/citric acid/sodium bicarbonate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulfadiazine
aspirin/citric acid/sodium bicarbonate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfamethoxazole
aspirin/citric acid/sodium bicarbonate increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfasalazine
aspirin/citric acid/sodium bicarbonate will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulfisoxazole
aspirin/citric acid/sodium bicarbonate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- sulindac
aspirin/citric acid/sodium bicarbonate will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- teniposide
aspirin/citric acid/sodium bicarbonate increases levels of teniposide by unspecified interaction mechanism. Minor/Significance Unknown.
- tiludronate
aspirin/citric acid/sodium bicarbonate decreases levels of tiludronate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- tobramycin
aspirin/citric acid/sodium bicarbonate increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- tolazamide
aspirin/citric acid/sodium bicarbonate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- tolbutamide
aspirin/citric acid/sodium bicarbonate increases effects of tolbutamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- tolfenamic acid
aspirin/citric acid/sodium bicarbonate will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
aspirin/citric acid/sodium bicarbonate will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- trandolapril
aspirin/citric acid/sodium bicarbonate decreases effects of trandolapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases levels of aspirin/citric acid/sodium bicarbonate by increasing renal clearance. Minor/Significance Unknown.
- triamterene
aspirin/citric acid/sodium bicarbonate increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.
triamterene, aspirin/citric acid/sodium bicarbonate. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity. - valganciclovir
aspirin/citric acid/sodium bicarbonate will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- vancomycin
aspirin/citric acid/sodium bicarbonate increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.
- verapamil
verapamil increases effects of aspirin/citric acid/sodium bicarbonate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.
- willow bark
aspirin/citric acid/sodium bicarbonate will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
willow bark increases effects of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Minor/Significance Unknown. Willow bark contains salicylic acid, which may have additive effects/toxicity with salicylate drugs. - zafirlukast
aspirin/citric acid/sodium bicarbonate increases levels of zafirlukast by unknown mechanism. Minor/Significance Unknown.
- zoledronic acid
aspirin/citric acid/sodium bicarbonate decreases levels of zoledronic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Flatulence
Rebound hyperacidity
Stomach cramps
Vomiting
Warnings
Contraindications
Hypocalcemia, hypochloremia, respiratory alkalosis
Hypersensitivity to aspirin or any component
Immediately before or after heart surgery
Concomitant administration with prescription medication for diabetes, gout, or arthritis
Cautions
Children and teenagers who have or are recovering from chickenpox or flu-like symptoms should not use this product; when using this product, if changes in behavior with nausea and vomiting occur, consult a doctor because these symptoms could be an early sign of Reye's syndrome, a rare but serious illness
Aspirin may cause severe allergic reactions, including facial swelling, shock, asthma (wheezing), or hives
NSAIDs may cause stomach bleeding; risk of bleeding increases with presence of stomach ulcers or bleeding problems, age 60 or older, take higher dose or take for longer time than directed, having 3 or more alcoholic drinks every day while using this product, taking blood thinner or steroid drug
Use caution and ask a healthcare practitioner if history of stomach aches, including heartburn, experiencing high blood pressure, liver cirrhosis, heart disease, or kidney disease, currently taking a diuretic, history of or currently experiencing asthma, on a sodium restriction diet
Discontinue use and ask a healthcare practitioner if allergic reaction occurs, experiencing symptoms of stomach bleeding, including vomiting blood, bloody or black stools, experiencing stomach ache that does not improve, symptoms get worse or last >10 days, ringing ears or loss of hearing occurs, new symptoms occur
Pregnancy & Lactation
Pregnancy
Ask a healthcare professional; important not to use aspirin during the last 3 months of pregnancy unless prescribed by a physician; may cause complications in the unborn child or during delivery
Lactation
Ask a healthcare professional
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Gastric acid neutralization and analgesia by inhibiting prostaglandin synthesis by cyclooxygenase
Pharmacokinetics
Onset: PO, as antacid: 15 min
Duration: PO: 1-3 hr
Bioavailability: 4-45%, food increases absorption 10-30%
Protein Bound: 45%
Metabolism: in the presence of stomach acid, bicarbonate ion forms carbon dioxide and water, sodium and excess bicarbonate are absorbed into plasma
Excretion: reabsorbed by kidney, <1% excreted in urine
Administration
Oral Administration
Fully dissolve 2 tablets in 4 oz of water before orally ingesting
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Alka-Seltzer Extra Strength oral - | 500-1,985-1,000 mg effervescent tablet | ![]() | |
Medi-Seltzer oral - | 324 mg effervescent tablet | ![]() | |
Alka-Seltzer Original oral - | 325-1,916-1,000 mg effervescent tablet | ![]() | |
Effervescent Pain Relief Antacid oral - | 325-1,916-1,000 mg effervescent tablet | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
aspirin-sodium bicarbonate-citric acid oral
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.