Generic Name: citric acid/sodium bicarbonate
Brand and Other Names: Alka-Seltzer Heartburn Relief
Drug Class: Antacids, Combos
What is citric acid/sodium bicarbonate, and what is it used for?
Citric acid/sodium bicarbonate is a combination antacid tablet medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion.
Both citric acid and sodium bicarbonate react with the hydrochloric acid in the stomach and neutralize it, increasing the pH level and alkalinity of the stomach. Citric acid/sodium bicarbonate is available over the counter (OTC) as effervescent tablets that can be dissolved in water and swallowed.
Citric acid reacts with hydrochloric acid in the stomach to form sodium citrate which neutralizes the acid. Sodium and bicarbonate separate in the stomach and bicarbonate reacts with hydrogen ions to form water and carbon dioxide, thus also neutralizing the hydrochloric acid. Both citric acid and sodium bicarbonate can neutralize the acid that is already present in the stomach but has no effects on the acid-producing capacity of the stomach.
Warnings
- Do not use citric acid/sodium bicarbonate in patients with hypersensitivity to any of the components in the formulation.
- Use with caution if you are on a sodium-restricted diet.
- Citric acid/sodium bicarbonate tablet contains phenylalanine, an amino acid. Use with caution if you have phenylketonuria, a disorder with inability to breakdown phenylalanine.
- Citric acid/sodium bicarbonate alters the pH in the stomach which may affect the absorption of other drugs if taken concurrently.
What are the side effects of citric acid/sodium bicarbonate?
Side effects of citric acid/sodium bicarbonate include:
- Gas (flatulence)
- Abdominal bloating
- Nausea
- Vomiting
- Diarrhea
- Fluid retention
- Excessive alkalinity of body fluids (alkalosis)
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
SLIDESHOW
Digestive Disorders: Common Misconceptions See SlideshowWhat are the dosages of citric acid/sodium bicarbonate?
Citric Acid/Sodium Bicarbonate
Effervescent Tablet
1000 mg/1940 mg
Indigestion/Heartburn
Adults:
- Dissolve 2 tablets in water and drink effervescent solution every 4 hours as needed
- Not to exceed 8 tablets/24 hours
Geriatric:
- Dissolve 2 tablets in water and drink the effervescent solution every 4 hours as needed
- Adults over 60 years: Not to exceed 4 tablets/24 hours
Pediatric:
Children below 12 years
- Safety and efficacy not established
Children 12 years and above
- Dissolve 2 tablets in water and drink effervescent solution every 4 hours as needed
- Not to exceed 8 tablets/24 hours
Administration
- Fully dissolve tablets in 4 oz of water before drinking
Overdose
- Citric acid/sodium bicarbonate overdose can increase the pH and alkalinity of body fluids and lead to alkalosis. Overdose may be treated with acidifying agents and symptomatic and supportive care.
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What drugs interact with citric acid/sodium bicarbonate?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Citric acid/sodium bicarbonate has no listed severe interactions with other drugs.
- Serious interactions of citric acid/sodium bicarbonate include:
- atazanavir
- baloxavir marboxil
- infigratinib
- pazopanib
- ponatinib
- sotorasib
- Moderate interactions of citric acid/sodium bicarbonate include:
- budesonide
- dabrafenib
- ledipasvir/sofosbuvir
- nilotinib
- omadacycline
- pexidartinib
- riociguat
- sarecycline
- sofosbuvir/velpatasvir
- Citric acid/sodium bicarbonate has no listed mild interactions with other drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Citric acid/sodium bicarbonate should be used during pregnancy only if potential benefits outweigh possible risks to the fetus.
- It is not known if citric acid/sodium bicarbonate is present in breast milk. Consult with your physician before use, if you are breastfeeding.
- Never take any OTC drugs including citric acid/sodium bicarbonate without first checking with your healthcare provider, if you are pregnant or breastfeeding.
What else should I know about citric acid/sodium bicarbonate?
- Take citric acid/sodium bicarbonate exactly as prescribed, or as per label directions if self-medication with OTC drug.
- Discontinue use and seek medical help if you find no relief for heartburn after using maximum dosage of citric acid/sodium bicarbonate for 2 weeks.
- Store safely out of reach of children.
- In case of overdose, seek medical help or contact Poison Control.
Summary
Citric acid/sodium bicarbonate is a combination antacid medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion. Use with caution if you are on a sodium-restricted diet. Side effects of citric acid/sodium bicarbonate include gas (flatulence), abdominal bloating, nausea, vomiting, diarrhea, fluid retention, and excessive alkalinity of body fluids (alkalosis). Consult your doctor if pregnant or breastfeeding.
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Treatment & Diagnosis
- GERD Acid reflux during pregnancy?
- GERD: Relief from GERD?
- Why is acid reflux GERD worse at night time?
- GERD Symptoms After Exercise?
- GERD How long can you take Prilosec safely?
- GERD: Any substitute for Propulsid in treating GERD
- Heartburn or Heart Attack? Emergency In Flight
- Heartburn: Is Heartburn Inherited?
- Are Tums or Rolaids Good for Heartburn?
- Can You Overdose on Antacids?
Medications & Supplements
- calcium carbonate antacid - oral, Dicarbosil, Rolaids, Titralac,
- sodium citrate
- aluminum hydroxide, magnesium hydroxide, simethicone antacids
- Types of Medication for GERD (Heartburn)
- citric acid/sodium citrate
- lansoprazole (Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24)
- sodium citrate/dextrose/fructose
- citric acid/potassium-sodium citrates - oral, Cytra-3, Polycitra
Prevention & Wellness
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https://reference.medscape.com/drug/alka-seltzer-heartburn-relief-citric-acid-sodium-bicarbonate-999794
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dc1641f8-54c2-0d86-e053-2995a90a1dce
https://www.webmd.com/drugs/2/drug-103237/sodium-bicarbonate-citric-acid-oral/details/list-sideeffects