aspirin / citric acid / sodium bicarbonate
Alka-Seltzer is a medication used to treat symptoms of heartburn, such as upset stomach and headache. While there are multiple products under this brand, this page focuses on the combination medication containing 3 active ingredients: citric acid, sodium bicarbonate, and aspirin. It comes as tablets that are dissolved in water. You drink the mixture by mouth, typically every 4-6 hours as needed.
What is Alka-Seltzer?
What is Alka-Seltzer used for?
- Heartburn, indigestion, and sour stomach with headache, body aches, or pain
- Upset stomach and headache from having too much food or drink
- Headache, body aches, and pain alone
How Alka-Seltzer works
Alka-Seltzer is a combination of three medications:
- Citric acid and sodium bicarbonate are antacids that work to relieve indigestion and upset stomach by neutralizing the acid in your stomach.
- Aspirin is a non-steroidal inflammatory drug (NSAID) that stops the production of certain proteins in your body that cause pain and inflammation.
Drug facts
Side effects of Alka-Seltzer
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
See Risks and Warnings
Alka-Seltzer serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: trouble breathing, blisters, hives, swelling of your tongue or lips
Pros and cons of Alka-Seltzer
Pros
- Combination of three medications in a single pill
- Easy to take for people who have trouble swallowing pills
- Available over the counter
Cons
- Might not be safe for children 12 years old and younger
- Might need to take multiple times per day
- Might not be safe for people with certain health conditions (e.g. kidney problems, heart problems, high bleeding risk)
Pharmacist tips for Alka-Seltzer
- Double check your medication label to make sure you have the right Alka-Seltzer product because there are several medications with similar brand names. They can contain different active ingredients with different directions.
- It's best to dissolve Alka-Seltzer tablets in 4 ounces (half a cup) of room temperature water. Cold water will make the tablets dissolve slower and warm water can cause a lot of foaming.
- Alka-Seltzer is only meant to give temporary relief of heartburn symptoms. Let your provider know if your symptoms worsen or last more than 10 days. They can check with you to see if you need a longer-lasting heartburn medication.
- Because Alka-Seltzer contains aspirin, there's a chance this medication can raise your risk for stomach bleeds. Get medical help right away if you feel faint, vomit blood, have bloody or black stools, or have stomach pain that doesn't get better. These might be symptoms of stomach bleeds.
- Tell your provider if you notice a ringing in the ears or loss of hearing after starting Alka-Seltzer. These are possible side effects of aspirin, one of the ingredients in Alka-Seltzer. If so, your provider will ask you to stop taking Alka-Seltzer. The ringing sound should go away and your hearing should return after you stop taking this medication.
- Tell your provider or pharmacist about all the medications you're taking, especially if you're taking other NSAIDs, warfarin (Coumadin), or other blood thinners. Taking these with Alka-Seltzer can raise your risk of bleeding. Your provider will likely ask you to avoid these combinations, unless they think the benefits are greater than the risks of harm.
- Alka-Seltzer contains 567 mg of sodium. Depending on what other health conditions you have, your provider might ask you to follow a low-sodium diet while taking this medication. If you have heart problems (e.g., heart failure) or kidney problems, ask your provider if Alka-Seltzer is right for you.
Common questions about Alka-Seltzer
Alka-Seltzer should start to work within a few seconds once it reaches the stomach to relieve heartburn symptoms.
Alka-Seltzer isn't recommended during pregnancy because it contains aspirin. Taking NSAIDs, like aspirin, after 20 weeks of pregnancy can cause rare, but serious kidney and heart problems in unborn babies. If you're pregnant, talk to your provider about the symptoms you're having. They can point you to which treatment options are safe for you and your baby, such as calcium carbonate for heartburn.
Talk with your provider if you're considering taking Alka-Seltzer while breastfeeding. This medication contains aspirin, which can get into breastmilk. While children should avoid aspirin because of the risk for Reye's syndrome, there haven't been any known reports of harm in infants breastfed by mothers who were taking aspirin. To be safe, your provider might talk with you about other treatment options for your symptoms.
There are multiple products under the brand name Alka-Seltzer. Different products can contain different ingredients and directions. Before you start, make sure to read the label of your product for specific directions. For Alka-Seltzer (citric acid / sodium bicarbonate / aspirin), it's typical to take 2 tablets per dose. You can take a dose every 4 to 6 hours, depending on whether you're taking the extra-strength product or the regular-strength product (see dosing section for details). The maximum number of tablets also differs depending on age and which Alka-Seltzer product you're taking.
It'll likely depend on what's causing the nausea. Alka-Seltzer isn't considered an antiemetic (nausea medication). But if you're having nausea from heartburn or an upset stomach after eating or drinking too much, then Alka-Seltzer might help. Keep in mind that Alka-Seltzer also has aspirin, which might cause nausea as a side effect. If your nausea doesn't improve with Alka-Seltzer, you should contact your provider to see if the nausea is caused by a more serious medical problem.
If you're having gas (belching) from heartburn or indigestion, it's possible that Alka-Seltzer might help. But if it's not working, talk with your provider.
Yes, each dissolvable tablet of Alka-Seltzer contains 325 mg of aspirin. You shouldn't give Alka-Seltzer to a child unless their provider specifically said it was safe to do so because of the risk of Reye's syndrome. Additionally, if you're at high risk for bleeding (e.g., age 60 or older, history of bleeding problems, taking blood thinners, taking other NSAIDs like ibuprofen (Advil), or drink 3 or more alcoholic drinks per day), you shouldn't use Alka-Seltzer without talking to your provider first.
Alka-Seltzer is a combination medication that contains 2 antacids: citric acid and sodium bicarbonate. They work to relieve symptoms of indigestion and upset stomach.
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Risks and warnings for Alka-Seltzer
Alka-Seltzer can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Stomach bleeding and ulcers
- Risk factors: History of stomach bleeding or ulcers | Taking other NSAIDs, blood thinners, or corticosteroids while also taking Alka-Seltzer | Drinking 3 or more alcoholic beverages per day | Age 60 years or older | Taking Alka-Seltzer for a long time | Taking more Alka-Seltzer than instructed
Alka-Seltzer contains aspirin, which can irritate your stomach. This irritation can feel like stomach pain or heartburn. It can also lead to serious stomach problems, including bleeding and ulcers in this area. If you have stomach pain that doesn't get better; vomit or cough up blood or bits that look like coffee grounds; or have bloody or black, tarry stools; stop taking Alka-Seltzer and get medical attention right away. These can be signs of stomach bleeding or a stomach ulcer that your provider can help manage and treat.
Reye's syndrome in children
- Risk factors: Children recovering from chickenpox or flu-like symptoms
Aspirin use in children is linked to a rare but serious condition called Reye's syndrome. It typically occurs when children who are recovering from flu-like symptoms or other viruses use aspirin. Early symptoms of Reye's syndrome include vomiting, headache, confusion, and distress, but it can lead to seizures and loss of consciousness. Don't give Alka-Seltzer to a child who has a fever due to the flu. Ask your child's provider for medication recommendations for children who are sick.
Allergic reactions
- Risk factors: NSAID allergy
Severe allergic reactions to Alka-Seltzer are possible, including anaphylaxis (closing of the throat). Call 911 if you experience hives, trouble breathing, or swelling of your lips or tongue. Let your provider know if you have an allergy to aspirin or other NSAIDs before you start taking Alka-Seltzer.
Alka-Seltzer dosage
Typical dosage for Alka-Seltzer
There are many different products under the brand name Alka-Seltzer. They can differ in active ingredients, strength, and direction. Refer to the manufacturer's label for directions that are specific to your product.
Some examples include:
-
Alka-Seltzer: Each dissolvable tablet contains 1,000 mg of citric acid, 325 mg of aspirin, and 1,916 mg of sodium bicarbonate.
- Ages under 12 years: Ask your child's provider.
- Ages 12 to 59 years: The typical dose is 2 tablets dissolved in 4 ounces of water, taken by mouth every 4 hours. The maximum dose is 8 tablets in 24 hours.
- Ages 60 years and older: The typical dose is 2 tablets dissolved in 4 ounces of water, taken by mouth every 4 hours. The maximum dose is 4 tablets in 24 hours.
-
Alka-Seltzer Extra Strength: Each dissolvable tablet contains 1,000 mg of citric acid, 500 mg of aspirin, and 1,985 mg of sodium bicarbonate.
- Ages under 12 years: Ask your child's provider.
- Ages 12 to 59 years: The typical dose is 2 tablets dissolved in 4 ounces of water, taken by mouth every 6 hours. The maximum dose is 7 tablets in 24 hours.
- Ages 60 years and older: The typical dose is 2 tablets dissolved in 4 ounces of water, taken by mouth every 6 hours. The maximum dose is 3 tablets in 24 hours.
Alka-Seltzer contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Alka-Seltzer will not be safe for you to take.
- Allergy to aspirin or another NSAID
- Children younger than 12 years old
