Drug & supplement interaction

Sodium Bicarbonate + Acetaminophen, Caffeine, Codeine

Acetaminophen, Caffeine, Codeine brand names: Gesic C8, Gesic C15, Lenoltec 2, Gesic C30, Lenoltec 3, and others.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Sodium Bicarbonate has a moderate interaction with Acetaminophen, Caffeine, Codeine. Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking methylxanthines.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sodium Bicarbonate and Acetaminophen, Caffeine, Codeine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

METHYLXANTHINES

Why this applies to Acetaminophen, Caffeine, Codeine

Acetaminophen, Caffeine, Codeine falls under METHYLXANTHINES — the group Sodium Bicarbonate interacts with.

Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking methylxanthines.
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia. Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia. Theophylline and related drugs can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the connection for this combo pill. The piece that interacts is the caffeine, which belongs to a drug family (methylxanthines) that can nudge your blood potassium a bit lower. On its own that's rarely a big deal. But large amounts of baking soda can also lower potassium, so in theory, stacking the two could drop your level a little more than either one alone.

To be clear, this is a theoretical concern based on how these things work, not something seen with normal use. It mainly becomes a worry with heavy baking soda intake (think tablespoons daily). An occasional teaspoon for heartburn alongside this medicine is unlikely to matter. If you notice muscle cramps, weakness, or an odd heartbeat, or you use baking soda often, check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
  3. Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
  4. Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
  5. Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
  6. Proudfoot, A. T., Krenzelok, E. P., and Vale, J. A. Position Paper on urine alkalinization. J Toxicol Clin Toxicol 2004;42(1):1-26. PubMed
  7. Fitzgibbons, L. J. and Snoey, E. R. Severe metabolic alkalosis due to baking soda ingestion: case reports of two patients with unsuspected antacid overdose. J Emerg Med 1999;17(1):57-61. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Sodium Bicarbonate Also Interacts With Other Medications

Sodium Bicarbonate has 256 moderate known drug interactions in our database — the Acetaminophen, Caffeine, Codeine one above is one of them. If you take anything else, check it against the full list below.

Moderate 256 No known interaction 2,574 (incl. Acetaminophen, Caffeine, Codeine)
Taking anything else?

Check Another of Your Medications Against Sodium Bicarbonate

Covers the 2,830 medications we’ve checked against Sodium Bicarbonate. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Caffeine, Codeine

This page covers Sodium Bicarbonate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Codeine page lists 303 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Ephedra (major).

By severity: 15 major · 244 moderate · 44 minor.

Open the Acetaminophen, Caffeine, Codeine interaction page

One more smart check

Taking Sodium Bicarbonate as Part of a Dietary Supplement Product? Check It for Interactions

We hold 176 real supplement products containing Sodium Bicarbonate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sodium Bicarbonate. Your product may carry other ingredients that interact with Acetaminophen, Caffeine, Codeine too, on top of Sodium Bicarbonate — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sodium Bicarbonate and Acetaminophen, Caffeine, Codeine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Sodium Bicarbonate
Top 25%

#343 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Caffeine, Codeine
Top 5%

#82 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Sodium Bicarbonate

What is Sodium Bicarbonate?

  • Heartburn and indigestion (antacid)
  • Athletic performance (exercise buffer)
  • Urine alkalinization
  • Soothing skin irritation or itching (topical baths)
  • Mouth rinse and oral care

Sodium bicarbonate (baking soda) is a simple compound most often used as a fast-acting antacid and, in sports, as a buffer that may help with short, high-intensity exercise. It is generally safe in small, occasional doses, but it is high in sodium and can cause serious problems if overused, so people with heart, kidney, or blood pressure issues should be careful and check with a pharmacist or doctor.

Read the full Sodium Bicarbonate monograph & all interactions
Keep checking

Other Drugs & Sodium Bicarbonate

Browse every other medication we’ve checked against Sodium Bicarbonate — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
256Moderate
0Minor
2,573No known interaction
256 Moderate 2,573 No interaction
Moderate

256 interactions

Showing 60 of 256 moderate interactions — see all 256 on the Sodium Bicarbonate page.

No interaction 2,573 drugs checked — show the list

We also checked Sodium Bicarbonate against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,573 medications checked with no known interaction — see the full Sodium Bicarbonate list.

See the full Sodium Bicarbonate interactions page
See every supplement checked against Acetaminophen, Caffeine, Codeine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Sodium Bicarbonate monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Caffeine, Codeine supplement interactions › Every supplement checked against Acetaminophen, Caffeine, Codeine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Sodium Bicarbonate and Acetaminophen, Caffeine, Codeine Together: Common Questions

Can you take Sodium Bicarbonate with Acetaminophen, Caffeine, Codeine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Sodium Bicarbonate and Acetaminophen, Caffeine, Codeine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Acetaminophen, Caffeine, Codeine and Sodium Bicarbonate?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.