Skip to main content

Drug Interactions between Alka-Seltzer Original and Diamox

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Major

acetaZOLAMIDE aspirin

Applies to: Diamox (acetazolamide) and Alka-Seltzer Original (aspirin/citric acid/sodium bicarbonate)

GENERALLY AVOID: The combination of large doses of salicylates and oral carbonic anhydrase inhibitors (CAI) may rarely result in severe metabolic acidosis and/or salicylate toxicity. The mechanism is unknown but may involve salicylate-induced displacement of CAIs from plasma protein-binding sites and reduced renal clearance, or CAI-induced plasma pH changes resulting in increased amounts of unionised salicylates entering the CNS. Coma and death have been reported. Although this has not been reported with ocular CAIs, the clinician should consider the possibility of an interaction with these agents, also.

MANAGEMENT: In general, concomitant use of antirheumatic doses of salicylates and oral CAIs is not recommended. If coadministration is necessary, careful monitoring of the patient's mental status and acid base balance is strongly recommended. Patients should be advised to promptly notify their physicians if they experience symptoms such as lethargy, tinnitus, confusion, nausea, vomiting, or hyperventilation.

References

  1. Sweeney KR, Chapron DJ, Kramer PA "Effect of salicylate on serum protein binding and red blood cell uptake of acetazolamide in vitro." J Pharm Sci 77 (1988): 751-6
  2. Favre L, Vallotton MB "Relationship of renal prostaglandins to three diuretics." Prostaglandins Leukot Med 14 (1984): 313-9
  3. Cowan RA, Hartnell GG, Lowdell CP, Baird IM, Leak AM "Metabolic acidosis induced by carbonic anhydrase inhibitors and salicylates in patients with normal renal function." Br Med J (Clin Res Ed) 289 (1984): 347-8
  4. Sweeney KR, Chapron DJ, Brandt JL, Gomolin IH, Feig PU, Kramer PA "Toxic interaction between acetazolamide and salicylate: case reports and a pharmacokinetic explanation." Clin Pharmacol Ther 40 (1986): 518-24
  5. Anderson CJ, Kaufman PL, Sturm RJ "Toxicity of combined therapy with carbonic anhydrase inhibitors and aspirin." Am J Ophthalmol 86 (1978): 516-9
  6. Sweeney KR, Chapron DJ, Antal EJ, Kramer PA "Differential effects of flurbiprofen and aspirin on acetazolamide disposition in humans." Br J Clin Pharmacol 27 (1989): 866-9
  7. Rousseau P, Fuentevilla-Clifton A "Acetazolamide and salicylate interaction in the elderly: a case report." J Am Geriatr Soc 41 (1993): 868-9
  8. "Product Information. Diamox (acetazolamide)." Lederle Laboratories PROD (2001):
  9. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc PROD (2001):
  10. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Co., Inc PROD (2001):
  11. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  12. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  13. Cerner Multum, Inc. "Australian Product Information." O 0
View all 13 references

Switch to consumer interaction data

Moderate

aspirin sodium bicarbonate

Applies to: Alka-Seltzer Original (aspirin/citric acid/sodium bicarbonate) and Alka-Seltzer Original (aspirin/citric acid/sodium bicarbonate)

MONITOR: Agents that cause urinary alkalinization can reduce serum salicylate concentrations in patients receiving anti-inflammatory dosages of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to increased urinary pH, resulting in increased renal salicylate clearance especially above urine pH of 7. This interaction is sometimes exploited in the treatment of salicylate toxicity.

MANAGEMENT: Patients treated chronically with urinary alkalinizers and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References

  1. Berg KJ "Acute acetylsalicylic acid poisoning: treatment with forced alkaline diuresis and diuretics." Eur J Clin Pharmacol 12 (1977): 111-6
  2. Prescott LF, Balali-Mood M, Critchley JA, Johnstone AF, Proudfoot AT "Diuresis or urinary alkalinisation for salicylate poisoning?" Br Med J (Clin Res Ed) 285 (1982): 1383-6
  3. Balali-Mood M, Prescott LF "Failure of alkaline diuresis to enhance diflunisal elimination." Br J Clin Pharmacol 10 (1980): 163-5
  4. Berg KJ "Acute effects of acetylsalicylic acid in patients with chronic renal insufficiency." Eur J Clin Pharmacol 11 (1977): 111-6
  5. Brouwers JRBJ, Desmet PAGM "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet 27 (1994): 462-85
View all 5 references

Switch to consumer interaction data

Drug and food interactions

Moderate

aspirin food

Applies to: Alka-Seltzer Original (aspirin/citric acid/sodium bicarbonate)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

Switch to consumer interaction data

Minor

aspirin food

Applies to: Alka-Seltzer Original (aspirin/citric acid/sodium bicarbonate)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 71-6

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.