Drug & supplement interaction

Sodium Bicarbonate + Albuterol

Albuterol brand names: Proventil, Volmax, Ventolin (U.S.), ProAir HFA.

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

Sodium Bicarbonate has a moderate interaction with Albuterol. Theoretically, sodium bicarbonate may increase the risk for hypokalemia in patients taking beta-adrenergic agonists.

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

Sodium Bicarbonate and Albuterol

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

Moderate

BETA-ADRENERGIC AGONISTS

Why this applies to Albuterol

Albuterol falls under BETA-ADRENERGIC AGONISTS — the group Sodium Bicarbonate interacts with.

Theoretically, sodium bicarbonate may increase the risk for hypokalemia in patients taking beta-adrenergic agonists.
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 adverse effect of intravenous sodium bicarbonate is hypokalemia. Oral, parenteral, or inhaled beta-adrenergic agonists can reduce serum potassium levels, especially during acute use of high doses.
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 gist for your inhaler: albuterol can nudge potassium out of your bloodstream, especially when you're using higher doses during a flare-up. Sodium bicarbonate, in large amounts, can do the same thing. So in theory, combining a lot of baking soda with your albuterol could push your potassium lower than either would alone. Low potassium (hypokalemia) can show up as muscle cramps, weakness, or a fluttery or irregular heartbeat.

The good news: this is a theoretical concern based on how the two work, not strong real-world data. It mainly matters if you're swallowing big, ongoing scoops of baking soda, not the occasional pinch for heartburn. Still, if you use albuterol often, check with your pharmacist or doctor before taking regular sodium bicarbonate.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
  2. Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
  3. Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
  4. Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
  5. Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
  6. Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
  7. Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
  8. Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
  9. Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
  10. Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
  11. Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
  12. 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
  13. Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
  14. 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
  15. 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 Albuterol 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. Albuterol)
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.

From our Q&A

Questions About Sodium Bicarbonate or Albuterol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sodium Bicarbonate or Albuterol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Albuterol

This page covers Sodium Bicarbonate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Albuterol page lists 32 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Black Tea (moderate), Caffeine (moderate), Cocoa (moderate) and Coffee (moderate).

By severity: 1 major · 22 moderate · 9 minor.

From our pharmacist’s overview on the Albuterol page

“Albuterol is a rescue drug; when an asthma attack hits, a Ventolin or ProAir inhaler has to work, which is why this list deserves a careful read rather than a skim. Of the 32 ingredients on file, activated charcoal alone is rated major, since it can soak up the drug and blunt its effect no matter how the albuterol was taken.”

Reviewed by 2 · Jul 18, 2026

Open the Albuterol 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 Albuterol 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 Albuterol 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%

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

29 days ago today
Medication Albuterol
Steady interest

#1,924 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
Medication

About Albuterol

What Is Albuterol Used For?

Brand names: Proventil, Volmax, Ventolin (U.S.), ProAir HFA

Albuterol is used to treat or prevent bronchospasm — sudden tightening of the airways — in adults and children with reversible obstructive airway disease, such as asthma. Most inhaled formulations (HFA inhalers, dry-powder inhalers, and nebulizer solutions) are approved for patients 4 years and older, though some nebulizer solutions are approved for children as young as 2, and the oral syrup covers adults and children 2 and older. Albuterol tablets are approved for adults and children 6 and older.

Albuterol inhaled products are also used to prevent exercise-induced bronchospasm in patients 4 years and older. The inhaled aerosol solution (0.5%) is approved specifically for relief of bronchospasm and acute attacks in patients 12 and older. Not every formulation covers every use — follow the instructions for the specific product you have been prescribed.

See full Albuterol drug information
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 Albuterol, 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 Albuterol supplement interactions › Every supplement checked against Albuterol, ranked by severity Albuterol drug information › The full plain-English guide to this medication 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 Albuterol Together: Common Questions

Can you take Sodium Bicarbonate with Albuterol?
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 Albuterol 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 Albuterol 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.