Sodium Bicarbonate + Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 2 drug categories that Sodium Bicarbonate can interact with; the most serious is rated moderate. Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking methylxanthines.
Read the full interaction reportSodium Bicarbonate and Aspirin, Caffeine, Dihydrocodeine Bitartrate
These two interact in 2 distinct ways. Each one is explained separately below.
Why Are There 2 Interactions?
Sodium Bicarbonate interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 2 of those categories, so it can interact with Sodium Bicarbonate in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
METHYLXANTHINES
1 of 2Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls under METHYLXANTHINES — the group Sodium Bicarbonate interacts with.
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.
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.
Here's the link to know about: the caffeine in Synalgos DC is a methylxanthine, and like its cousin theophylline, it can nudge potassium levels a little lower by pushing potassium into your cells. Sodium bicarbonate (baking soda) can also lower potassium when used in big amounts. Put them together and, in theory, your potassium could dip more than expected.
I want to be straight with you, though: this is a theoretical concern based on how these things work, not strong real-world data. It really only becomes a worry if you're using a lot of baking soda, think tablespoons a day or close to a box a week, not the occasional pinch for heartburn. Low potassium can cause muscle weakness, cramps, or an irregular heartbeat. If you use bicarbonate often or have heart or kidney issues, check in with your pharmacist or doctor first.
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- 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
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- 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..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
- 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
- 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
ASPIRIN
2 of 2In humans, oral or intravenous administration of sodium bicarbonate increases salicylate elimination. Although the exact mechanism of this effect is not clear, some researchers hypothesize that sodium bicarbonate increases urinary pH, which increases salicylate ionization and subsequent excretion by the kidneys. In patients with urine pH of about 5.5, renal clearance of salicylate is approximately 55 mL/min. When urine pH is increased with oral sodium bicarbonate to about 7.5, renal clearance of salicylate increases to approximately 100 mL/min. Similarly, urine alkalinization with sodium bicarbonate increases the mean total body clearance of salicylate by approximately 60% compared with urine acidification.
Interaction 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..
Here's the deal with this combo (Synalgos DC). The part that interacts is the aspirin. When you take sodium bicarbonate (baking soda), it makes your urine more alkaline, and that actually helps your kidneys flush aspirin out faster. Studies in people back this up, so it's a real effect, not just theory. The practical result is that you may get less pain relief from the aspirin portion of this medicine.
The caffeine and dihydrocodeine pieces aren't really affected here. If you only use baking soda once in a while for heartburn, it's usually no big deal, but regularly taking it alongside this pain reliever could blunt how well it works. If you find you need consistent antacid help, check with your pharmacist about an option that won't interfere.
- Proudfoot AT, Krenzelok EP, Brent J, Vale JA. Does urine alkalinization increase salicylate elimination? If so, why? Toxicol Rev 2003;22(3):129-36. PubMed
- Neavyn MJ, Boyer EW, Bird SB, Babu KM. Sodium acetate as a replacement for sodium bicarbonate in medical toxicology: a review. J Med Toxicol 2013;9(3):250-4. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Sodium Bicarbonate Also Interacts With Other Medications
Sodium Bicarbonate has 256 moderate known drug interactions in our database — the Aspirin, Caffeine, Dihydrocodeine Bitartrate one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sodium Bicarbonate
We haven’t checked that one against Sodium Bicarbonate yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sodium Bicarbonate. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Caffeine, Dihydrocodeine Bitartrate
This page covers Sodium Bicarbonate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Dihydrocodeine Bitartrate page lists 398 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 Danshen (major).
By severity: 17 major · 334 moderate · 47 minor.
Open the Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction page
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 Aspirin, Caffeine, Dihydrocodeine Bitartrate 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:
Where Sodium Bicarbonate and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
#361 of 1,452 supplements looked up here in the last 7 days
#1,522 of 2,830 medications looked up here in the last 7 days
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.
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.
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.
No drugs match “”.
256 interactions
- Theophylline ›
- Salbutamol Sulfate ›
- Aspirin ›
- Hydrocortisone ›
- Hydrochlorothiazide ›
- Prednisone ›
- Dexamethasone ›
- Dyphylline ›
- Prednisolone ›
- Triamcinolone ›
- Amphotericin B ›
- Budesonide ›
- Fluticasone ›
- Pseudoephedrine ›
- Albuterol ›
- Terbutaline ›
- Tobramycin ›
- Trichlormethiazide ›
- Bendroflumethiazide ›
- Betamethasone ›
- Caffeine (otc Drug) ›
- Metolazone ›
- Neomycin ›
- Phenolphthalein ›
- Sodium Phenylbutyrate ›
- Amikacin ›
- Beclomethasone ›
- Beclomethasone Dipropionate ›
- Bisacodyl ›
- Caffeine (prescription Drug) ›
- Chlorpropamide ›
- Chlorthalidone ›
- Clobetasol ›
- Cortisone Acetate ›
- Cyclothiazide ›
- Didanosine ›
- Ephedrine Sulfate ›
- Indapamide ›
- Metaproterenol ›
- Methyclothiazide ›
- Methylprednisolone ›
- Oxtriphylline ›
- Retapamulin ›
- Sennosides (otc Drug) ›
- Sodium Phosphate (otc Drug) ›
- Torsemide ›
- Triamcinolone Acetonide ›
- Acetylsalicylic Acid ›
- Albuterol Sulfate ›
- Aminophylline ›
- Arformoterol ›
- Armodafinil ›
- Beclometasone Dipropionate ›
- Benzthiazide ›
- Betamethasone Dipropionate ›
- Betamethasone Valerate ›
- Bumetanide ›
- Casanthranol ›
- Castor Oil (otc Drug) ›
- Cefpodoxime Proxetil ›
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.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Warfarin ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Metoprolol ›
- Ivermectin ›
- Rivaroxaban ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Tadalafil ›
- Clopidogrel ›
- Atorvastatin ›
- Docusate ›
- Valacyclovir ›
- Abemaciclib ›
- Hydroxyurea ›
- Methamphetamine ›
- Ibuprofen ›
- Sumatriptan ›
- Semaglutide ›
- Warfarin Sodium ›
- Tirzepatide ›
- Propranolol ›
- Bupropion ›
- Lisdexamfetamine ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Acyclovir ›
- Bendamustine ›
- Amitriptyline ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Fluoxetine ›
- Acetaminophen, Codeine ›
- Amphetamine ›
- Gabapentin ›
- Pregabalin ›
- Dextroamphetamine ›
- Azithromycin ›
- Isotretinoin ›
- Clonazepam ›
- Omeprazole ›
- Methylene Blue ›
- Quetiapine ›
- Amlodipine Besylate ›
- Duloxetine ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Naproxen ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
Showing the 60 most looked-up of 2,573 medications checked with no known interaction — see the full Sodium Bicarbonate list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Aspirin, Caffeine, Dihydrocodeine Bitartrate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Dihydrocodeine Bitartrate as a medicine that can lower these. This is not an interaction with Sodium Bicarbonate — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Aspirin, Caffeine, Dihydrocodeine Bitartrate nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Sodium Bicarbonate and Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions
Can you take Sodium Bicarbonate with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Why are there 2 interactions listed for Sodium Bicarbonate and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
How serious is the Sodium Bicarbonate and Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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