Acetaminophen, Sodium Bicarbonate, and Citric Acid (Systemic)

Brand Names : Bromo-Seltzer

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For acetaminophen, sodium bicarbonate, and citric acid combination, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to acetaminophen or aspirin, or to sodium bicarbonate. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - Make certain your health care professional knows if you are on a low-sodium, low-sugar, or any other special diet. This medicine contains a large amount of sodium (more than 750 mg for each 325 mg of acetaminophen).

Pregnancy - Although studies on birth defects have not been done in humans, the ingredients in this combination medicine have not been reported to cause birth defects in humans. However, you should avoid this medicine if you tend to retain (keep) body water because the sodium in it can cause the body to hold water. This can result in swelling and weight gain.

Breast-feeding - Acetaminophen passes into the breast milk in small amounts. However, acetaminophen, sodium bicarbonate, and citric acid have not been reported to cause problems in nursing babies.

Children - Acetaminophen has been tested in children and has not been shown to cause different side effects or problems than it does in adults. However, sodium bicarbonate should not be given to young children (under 6 years of age) unless ordered by their doctor. Small children with stomach problems usually cannot describe their symptoms very well. They should be checked by a doctor, because they may have a condition that needs other treatment.

Older adults - Acetaminophen has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, the large amount of sodium in this combination medicine can be harmful to some elderly people. Therefore, it is best that older people not use this medicine for more than 5 days in a row, unless otherwise directed by their doctor.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this combination medicine, it is especially important that your health care professional know if you are taking any of the following:

• Alcohol - The chance of liver damage may be increased

• Ciprofloxacin (e.g., Cipro) or
• Enoxacin (e.g., Penetrex) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Lomefloxacin (e.g., Maxaquin) or
• Methenamine (e.g., Mandelamine) or
• Norfloxacin (e.g., Noroxin) or
• Ofloxacin (e.g., Floxin) or
• Tetracyclines (medicine for infection), taken by mouth - Sodium bicarbonate can keep these medicines from working properly

• Mecamylamine (e.g., Inversine) - Sodium bicarbonate can increase the risk of unwanted effects by causing mecamylamine to stay in your body longer than usual

Other medical problems - The presence of other medical problems may affect the use of acetaminophen, sodium bicarbonate, and citric acid combination. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse or
• Hepatitis or other liver disease - The chance of serious side effects, including liver damage, may be increased

• Appendicitis (symptoms of, such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting) - Sodium bicarbonate can make your condition worse; also, people who may have appendicitis need medical attention and should not try to treat themselves

• Edema (swelling of face, fingers, feet, or lower legs caused by too much water in the body) or
• Heart disease or
• High blood pressure or
• Toxemia of pregnancy - The sodium in this combination medicine can make these conditions worse

• Kidney disease - The chance of serious side effects may be increased