Drug & supplement interaction

Sodium Bicarbonate + Mesalamine

Mesalamine brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, and others.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Sodium Bicarbonate and Mesalamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Mesalamine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Sodium Bicarbonate and Mesalamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Mesalamine and Sodium Bicarbonate in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Sodium Bicarbonate safety at a glance

Sodium Bicarbonate overall Use caution Generally safe in small, occasional amounts but high in sodium and risky if overused or used long-term.
Pregnancy Possibly Unsafe When used orally or intravenously during pregnancy. There is concern that sodium bicarbonate may increase the risk of metabolic alkalosis or fluid retention whe... Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally or intravenously during pregnancy. There is concern that sodium bicarbonate may increase the risk of metabolic alkalosis or fluid retention whe... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Mesalamine and Sodium Bicarbonate? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Mesalamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Mesalamine is filed under a single classification — oral drugs. Sodium Bicarbonate has documented interactions with 14 drug classes — the most serious being aminoglycoside antibiotics (moderate), amphotericin-b (abelcet, others) (moderate) and aspirin (moderate) — and none of Mesalamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Sodium Bicarbonate Does Interact With Other Medications

Sodium Bicarbonate has 257 moderate known drug interactions in our database — Mesalamine isn’t one of them. If you take anything else, check it against the full list below.

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.

What to actually watch for

No Interaction Found — But Data Suggests Sodium Bicarbonate and Mesalamine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Bloating or gas / Stomach pain / Diarrhea / Vomiting Additional detail

    Sodium Bicarbonate

    “Orally, sodium bicarbonate is generally well tolerated when used in over-the-counter antacid products. However, it is possibly unsafe when used in excessive amounts. Intravenously, sodium bicarbonate is generally well tolerated when used appropriately with proper medical supervision.”

    Sodium Bicarbonate · Natural Medicines adverse-effect record, reported in diarrhea.

    “Orally, sodium bicarbonate may cause mild adverse effects including gastrointestinal disturbance such as bloating, nausea, vomiting, and abdominal pain. The severity of these effects appears to increase with dose.”

    Sodium Bicarbonate · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 25706. Carr, A. J., Hopkins, W. G., and Gore, C. J. Effects of acute alkalosis and acidosis on performance: a meta-analysis. Sports Med 2011;41(10):801-814. PubMed
    2. 106250. Grgic J, Pedisic Z, Saunders B, et al. International society of sports nutrition position stand: sodium bicarbonate and exercise performance. J Int Soc Sports Nutr 2021;18(1):61. PubMed
    3. 104850. Gurton WH, Gough LA, Sparks SA, Faghy MA, Reed KE. Sodium bicarbonate ingestion improves time-to-exhaustion cycling performance and alters estimated energy system contribution: A dose-response investigation. Front Nutr. 2020 Sep 8;7:154. PubMed
    4. 29962. Thomas SH, Stone CK. Acute toxicity from baking soda ingestion. Am J Emerg Med 1994;12(1):57-9. PubMed
    5. 104853. Hilton NP, Leach NK, Craig MM, Sparks SA, McNaughton LR. Enteric-coated sodium bicarbonate attenuates gastrointestinal side-effects. Int J Sport Nutr Exerc Metab. 2019 Nov 21:1-7. PubMed
    6. 25735. Barna, P. Sodium bicarbonate: burst stomachs and high sodium. J Clin Gastroenterol 1986;8(6):697-698.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • Headache Additional detail

    Sodium Bicarbonate

    “Orally, concomitant use of excessive sodium bicarbonate (intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with at least two cases of hypercalcemia-induced metabolic alkalosis, characterized by dizziness, headache, and loss of consciousness with shivering. Rare symptoms include drowsiness, lethargy, seizures, and coma.”

    Sodium Bicarbonate · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 25733. 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
    2. 106255. Hughes A, Brown A, Valento M. Hemorrhagic encephalopathy from acute baking soda ingestion. West J Emerg Med. 2016;17(5):619-22. PubMed
    3. 13309. Food and Drug Administration. A Catalog of FDA Approved Drug Products. Available at: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/ (Accessed 28 June 2005).

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

Reported for Sodium Bicarbonate but not commonly for Mesalamine: stomach upset, fainting, low potassium and drowsiness.

Effects for Mesalamine come from the ADVERSE REACTIONS section of its FDA label; effects for Sodium Bicarbonate come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Sodium Bicarbonate in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally or intravenously during pregnancy. There is concern that sodium bicarbonate may increase the risk of metabolic alkalosis or fluid retention when used orally during pregnancy. There is insufficient reliable information available about the safety of oral or intravenous sodium bicarbonate when used in medicinal amounts during lactation.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Mesalamine Products Have a Food Rule — Sodium Bicarbonate Should Not Break It

At least one FDA label for a product containing Mesalamine says to take it with food. If you take Sodium Bicarbonate on an empty stomach out of habit, keep them separate — and take Mesalamine with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Mesalamine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

( 2 ) Administer mesalamine delayed-release tablets with food.

From the Dosage and Administration section of the FDA label we read for Mesalamine — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Sodium Bicarbonate or Mesalamine

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 Mesalamine, 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 Mesalamine

This page covers Sodium Bicarbonate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mesalamine page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Mesalamine page

“Activated charcoal is the one entry here I would treat as a genuine problem for anyone taking mesalamine (Asacol, Lialda, Pentasa, and others). It is the lone major-rated interaction among the 17 on file, because charcoal soaks up drugs in the gut and can pull mesalamine out of the picture before it does its job.”

Reviewed by 2 · Jul 18, 2026

Open the Mesalamine 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. Even though Sodium Bicarbonate itself has no known interaction with Mesalamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sodium Bicarbonate and Mesalamine 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 half

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

29 days ago today
Medication Mesalamine
Top 25%

#453 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Sodium Bicarbonate reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Sodium Bicarbonate and Mesalamine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Not applicable (a manufactured chemical compound, NaHCO3) · Powder (baking soda), tablets, effervescent powders, oral solution, and intravenous solution (medical use)

An interaction check asks whether these two react with each other — it does not ask whether Sodium Bicarbonate is a good idea for someone in your situation. Here is what our Sodium Bicarbonate record says about it on its own.

Sodium Bicarbonate: dosing

There is no single "correct" dose for supplement use, and the right amount depends on why it is being used. Over-the-counter antacid products list specific directions on the label, and you should follow those exactly rather than guessing with kitchen baking soda.For antacid use, it is meant for occasional, short-term relief — not daily use. For exercise or medical purposes, doses are higher and should only be used under the guidance of a healthcare professional, because the risk of side effects rises with the dose.

From our Sodium Bicarbonate monograph — the full record covers uses, side effects and every documented interaction.

Read the full Sodium Bicarbonate monograph & all interactions
Medication

About Mesalamine

What Is Mesalamine Used For?

Brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, Delzicol

Mesalamine is used to treat mildly to moderately active ulcerative colitis — a condition where the lining of the large intestine becomes inflamed and ulcerated. Depending on the product and formulation, it can be used to bring the disease under control (induction of remission) and/or to keep it from coming back (maintenance of remission).

Different products target different parts of the lower digestive tract. Oral forms (tablets and capsules) treat the colon more broadly. Rectal forms — including enemas (ROWASA, sfROWASA, mesalamine rectal suspension) — are used for distal ulcerative colitis, proctosigmoiditis, or proctitis (inflammation limited to the lower end of the colon or rectum). Rectal suppositories (CANASA, mesalamine rectal suppositories) are specifically for ulcerative proctitis (inflammation of the rectum only).

See full Mesalamine 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
257Moderate
0Minor
2,572No known interaction
Moderate

257 interactions

Showing 60 of 257 moderate interactions — see all 257 on the Sodium Bicarbonate page.

No interaction 2,572 drugs checked — show the list
Evidence & sources

Sodium Bicarbonate References

The 49 references that drive our Sodium Bicarbonate monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
  3. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  4. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  5. Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
  6. Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
  7. 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
  8. 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
  9. 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..
  10. Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
  11. 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
  12. Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
  13. Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
  14. Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
  15. 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..

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Sodium Bicarbonate and Mesalamine Together: Common Questions

Is it safe to take Sodium Bicarbonate with Mesalamine?
We do not list a known interaction between Sodium Bicarbonate and Mesalamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Sodium Bicarbonate and Mesalamine have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Sodium Bicarbonate and Mesalamine at the same time of day?
At least one FDA label for a product containing Mesalamine says to take it with food. If you take Sodium Bicarbonate on an empty stomach out of habit, keep them separate and take Mesalamine with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Mesalamine products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Sodium Bicarbonate and Mesalamine combination checked?
Interactions in our licensed database are recorded against drug classes. Mesalamine is filed under 1 classification, and Sodium Bicarbonate has documented interactions with 14 drug classes — none of Mesalamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Sodium Bicarbonate interact with any other medications?
Yes. Sodium Bicarbonate has 257 documented drug interactions in our database — Mesalamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Mesalamine interact with any supplements?
Yes. Mesalamine has documented interactions with 17 supplements in our database — Sodium Bicarbonate is not one of them. The Mesalamine interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Mesalamine 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.