Can You Take Alka-Seltzer After Taking Nitroglycerin?

In our latest question and answer, our pharmacist discusses the safety of combining nitroglycerin and Alka-Seltzer.

Question

Can I take an Alka-Seltzer after taking a nitrogen pill?

Asked by Jeff On Jan 19, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jan 20, 2023
Last updated Jan 20, 2023

Key points

  • Some Alka-Seltzer products contain aspirin, which could increase nitroglycerin levels and increase the risk of side effects.
  • Most studies report this interaction as relatively minor as it appears only large doses of aspirin may have this effect and not every study has found the same results.

Answer

Thanks so much for reaching out! Your question isn't entirely clear in regard to what 'nitrogen pill' you are referring to, but I'm going to assume you are talking about nitroglycerin. If this is incorrect, please write back and let us know.

Regarding nitroglycerin, which is used to relieve chest pain, it does interact with some Alka-Seltzer products. 

It is important to note here that Alka-Seltzer is a brand name, and there are several different products that use the name. I'm not sure which Alka-Seltzer product you are referring to, but there is an interaction specifically with Alka-Seltzer products that contain aspirin. Here is one example of an Alka-Seltzer product that contains aspirin:

Alka Seltzer With Aspirin


Interaction Details

The interaction here is that aspirin (which is contained in some Alka-Seltzer products) may increase the concentrations of nitroglycerin, potentially increasing the risk of side effects, such as hypotension (i.e., low blood pressure) and increased heart rate. One study concluded the following:

We conclude that pretreatment with 1 g of aspirin increases NTG [nitroglycerin] plasma levels and therefore significantly enhances the pharmacodynamic effects of NTG.

J Cardiovasc Pharmacol . 1983 Sep-Oct;5(5):874-7.

Now, it is important to note a few things.

For one, most studies show that only high doses of aspirin (over 1 gram) are likely to cause an interaction. Alka Seltzer tablets in the product I pictured above contain only 325mg (per tablet). Additionally, not all studies have found that aspirin significantly affects nitroglycerin concentrations.

Lastly, in your question, you wanted to know about taking Alka-Seltzer after nitroglycerin, and that appears to be safe. Documented interactions have occurred when aspirin is given before nitroglycerin.

So, overall, this interaction is thought to be a relatively minor one and probably not very likely to be of significance for most people. Nevertheless, I would be cautious of using both together.

Final Words

I hope you found this helpful!

Remember that the interaction is between Alka-Seltzer products that contain aspirin. Other Alka-Seltzer products that don't aren't known to interact with nitroglycerin.

References

  • The effect of aspirin on the hemodynamic response to nitroglycerin, PubMed
  • Influence of aspirin on the hemodynamic effects of sublingual nitroglycerin, PubMed
  • Pharmacological interaction between nitroglycerin and aspirin after acute and chronic aspirin treatment of healthy subjects, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

Recent Questions