Aspirin, Sodium Bicarbonate, and Citric Acid (Systemic)

Brand Names : Alka-Seltzer Effervescent Pain Reliever and Antacid, Flavored Alka-Seltzer Effervescent Pain Reliever and Antacid, acetylsalicylic acid, ASA

Precautions While Using This Medicine

If you will be taking this medicine for a long time (more than 5 days in a row for children or 10 days in a row for adults), your doctor should check your progress at regular visits.

Check with your doctor if your pain and/or upset stomach last for more than 10 days for adults or 5 days for children or if they get worse, if new symptoms occur, or if the painful area is red or swollen. These could be signs of a serious condition that needs medical treatment.

The sodium bicarbonate in this combination medicine can keep other medicines from working properly if the 2 medicines are taken too close together. Always take this medicine :

• At least 6 hours before or 2 hours after taking ciprofloxacin (e.g., Cipro) or lomefloxacin (e.g., Maxaquin) .
• At least 8 hours before or 2 hours after taking enoxacin (e.g., Penetrex) .
• At least 2 hours after taking itraconazole (e.g., Sporanox) .
• At least 3 hours before or after taking ketoconazole (e.g., Nizoral) .
• At least 2 hours before or after taking norfloxacin (e.g., Noroxin) or ofloxacin (e.g., Floxin) .
• At least 3 or 4 hours before or after taking a tetracycline antibiotic by mouth .
• At least 1 or 2 hours before or after taking any other medicine by mouth .

If you are also taking a laxative that contains cellulose, take this combination medicine at least 2 hours before or after you take the laxative. Taking the medicines too close together may lessen the effects of aspirin.

Check the labels of all nonprescription (over-the-counter [OTC]) and prescription medicines you now take . If any contain aspirin or other salicylates, including bismuth subsalicylate (e.g., Pepto-Bismol), magnesium salicylate (e.g., Nuprin Backache Caplets), or salsalate (e.g., Disalcid); if any contain salicylic acid (present in some shampoos or medicines for your skin); or if any contain sodium, check with your health care professional . Taking other salicylate-containing or other sodium-containing products together with this medicine may cause an overdose.

Do not take aspirin for 5 days before any surgery, including dental surgery, unless otherwise directed by your medical doctor or dentist. Taking aspirin during this time may cause bleeding problems.

For patients taking this medicine to lessen the chance of a heart attack, stroke, or other problems caused by blood clots:

• Take only the amount of aspirin ordered by your doctor . If you need a medicine to relieve pain, a fever, or arthritis, your doctor may not want you to take extra aspirin. It is a good idea to discuss this with your doctor, so that you will know ahead of time what medicine to take.
• Do not stop taking this medicine for any reason without first checking with the doctor who directed you to take it .

Taking certain other medicines together with a salicylate may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your doctor directs you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take any of the following medicines together with a salicylate for more than a few days, unless your doctor has directed you to do so and is following your progress :

• Acetaminophen (e.g., Tylenol)
• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Etodolac (e.g., Lodine)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen, oral (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Ketorolac (e.g., Toradol)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Nabumetone (e.g., Relafen)
• Naproxen (e.g., Naprosyn)
• Oxaprozin (e.g., Daypro)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Tenoxicam (e.g., Mobiflex)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)

If you will be taking more than an occasional 1 or 2 doses of this medicine:

• Do not drink alcoholic beverages . Drinking alcoholic beverages while you are taking aspirin, especially if you take aspirin regularly or in large amounts, may increase the chance of stomach problems.
• Do not drink a lot of milk or eat a lot of milk products . To do so may increase the chance of side effects.
• To prevent side effects caused by too much sodium in the body, you may need to limit the amount of sodium in the foods you eat. Some foods that contain large amounts of sodium are canned soup, canned vegetables, pickles, ketchup, green and ripe (black) olives, relish, frankfurters and other sausage-type meats, soy sauce, and carbonated beverages. If you have any questions about this, check with your health care professional.

Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by the aspirin in this combination medicine.

For diabetic patients :

• Aspirin can cause false urine glucose (sugar) test results if you regularly take 8 or more 324-mg, or 4 or more 500-mg (extra-strength), tablets a day. Smaller amounts or occasional use of aspirin usually will not affect the test results. However, check with your health care professional if you notice any change in your urine glucose test results. This is especially important if your diabetes is not well-controlled.

If you think that you or anyone else may have taken an overdose, get emergency help at once . Taking an overdose of aspirin may cause unconsciousness or death, especially in young children. Signs of overdose include convulsions (seizures), hearing loss, confusion, ringing or buzzing in the ears, severe drowsiness or tiredness, severe excitement or nervousness, and fast or deep breathing.