Drug & supplement interaction

Sodium Bicarbonate + Prednisone

Prednisone brand names: Deltasone, Cortan, Orasone, Prednisone, Prednicen-M, and others.

Moderate Interaction
The bottom line Moderate

Sodium Bicarbonate has a moderate interaction with Prednisone. Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking corticosteroids.

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

Sodium Bicarbonate and Prednisone

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

Moderate

CORTICOSTEROIDS

Why this applies to Prednisone

Prednisone falls under CORTICOSTEROIDS — the group Sodium Bicarbonate interacts with.

Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking corticosteroids.
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 intravenous complication of sodium bicarbonate is hypokalemia. Some glucocorticoids (corticosteroids) can also cause hypokalemia by causing sodium retention, resulting in compensatory renal potassium excretion. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.
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 with prednisone and baking soda: both can nudge your potassium down. Prednisone can make your body hold onto sodium and dump potassium, and large amounts of sodium bicarbonate can do something similar. Stack them together in big doses and you could lower your potassium more than either would alone, which might show up as muscle cramps, weakness, or an irregular heartbeat.

I want to keep this in perspective, though. This is a theoretical concern based on how these work, not strong proof. An occasional teaspoon of baking soda for heartburn alongside prednisone is unlikely to be a problem. The real risk comes from heavy use, think tablespoons daily or close to a box a week. If you're on prednisone long-term or have heart or kidney issues, check with your pharmacist before using baking soda regularly.

References
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. 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
  3. 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 Prednisone one above is 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.

From our Q&A

Questions About Sodium Bicarbonate or Prednisone

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 Prednisone, 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 Prednisone

This page covers Sodium Bicarbonate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Prednisone page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lily-of-the-valley (major), St. John's Wort (major) and Acacia Rigidula (moderate).

By severity: 4 major · 168 moderate · 36 minor.

From our pharmacist’s overview on the Prednisone page

“Prednisone (Deltasone) suppresses the immune system to control inflammation, and that mechanism shapes most of what can go wrong on this 208-ingredient list, which I read as one to approach carefully rather than casually. Four entries rate major.”

Reviewed by 2 · Jul 18, 2026

Open the Prednisone 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 Prednisone 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 Prednisone 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%

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

29 days ago today
Medication Prednisone
Top 1%

#22 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 Prednisone

What Is Prednisone Used For?

Brand names: Deltasone, Cortan, Orasone, Prednisone, Prednicen-M, Meticorten, Sterapred, Rayos

Prednisone treats a broad range of conditions where the body's immune system is overactive or inflammation needs to be controlled. It works across many organ systems, from the lungs and skin to the joints and blood.

Doctors prescribe it for conditions like asthma, severe allergies, Crohn's disease, multiple sclerosis flares, certain cancers, and to prevent organ rejection after transplant, among many others.

See full Prednisone 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
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
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

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Pharmacist Counseling Corner

Taking Sodium Bicarbonate and Prednisone Together: Common Questions

Can you take Sodium Bicarbonate with Prednisone?
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 Prednisone 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 Prednisone 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.