- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: citric acid/sodium bicarbonate
Brand and Other Names: Alka-Seltzer Heartburn Relief
Drug Class: Antacids, Combos
What is citric acid/sodium bicarbonate, and what is it used for?
Citric acid/sodium bicarbonate is a combination antacid tablet medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion.
Both citric acid and sodium bicarbonate react with the hydrochloric acid in the stomach and neutralize it, increasing the pH level and alkalinity of the stomach. Citric acid/sodium bicarbonate is available over the counter (OTC) as effervescent tablets that can be dissolved in water and swallowed.
Citric acid reacts with hydrochloric acid in the stomach to form sodium citrate which neutralizes the acid. Sodium and bicarbonate separate in the stomach and bicarbonate reacts with hydrogen ions to form water and carbon dioxide, thus also neutralizing the hydrochloric acid. Both citric acid and sodium bicarbonate can neutralize the acid that is already present in the stomach but has no effects on the acid-producing capacity of the stomach.
- Do not use citric acid/sodium bicarbonate in patients with hypersensitivity to any of the components in the formulation.
- Use with caution if you are on a sodium-restricted diet.
- Citric acid/sodium bicarbonate tablet contains phenylalanine, an amino acid. Use with caution if you have phenylketonuria, a disorder with inability to breakdown phenylalanine.
- Citric acid/sodium bicarbonate alters the pH in the stomach which may affect the absorption of other drugs if taken concurrently.
What are the side effects of citric acid/sodium bicarbonate?
Side effects of citric acid/sodium bicarbonate include:
- Gas (flatulence)
- Abdominal bloating
- Fluid retention
- Excessive alkalinity of body fluids (alkalosis)
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of citric acid/sodium bicarbonate?
Citric Acid/Sodium Bicarbonate
1000 mg/1940 mg
- Dissolve 2 tablets in water and drink effervescent solution every 4 hours as needed
- Not to exceed 8 tablets/24 hours
- Dissolve 2 tablets in water and drink the effervescent solution every 4 hours as needed
- Adults over 60 years: Not to exceed 4 tablets/24 hours
Children below 12 years
- Safety and efficacy not established
Children 12 years and above
- Dissolve 2 tablets in water and drink effervescent solution every 4 hours as needed
- Not to exceed 8 tablets/24 hours
- Fully dissolve tablets in 4 oz of water before drinking
- Citric acid/sodium bicarbonate overdose can increase the pH and alkalinity of body fluids and lead to alkalosis. Overdose may be treated with acidifying agents and symptomatic and supportive care.
- Kids With Autism Face Higher Odds of Vision Issues, But Many Don't Get Screened
- Mental Health Woes Double Women's Odds for Cervical Cancer
- Million-Person Study Finds Genes Common to Many Addiction Disorders
- Too Much Social Media Could Raise Risk for Eating Disorders
- Weaker Bones, Weakening Brain? Study Makes the Connection
- More Health News »
What drugs interact with citric acid/sodium bicarbonate?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Citric acid/sodium bicarbonate has no listed severe interactions with other drugs.
- Serious interactions of citric acid/sodium bicarbonate include:
- baloxavir marboxil
- Moderate interactions of citric acid/sodium bicarbonate include:
- Citric acid/sodium bicarbonate has no listed mild interactions with other drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Citric acid/sodium bicarbonate should be used during pregnancy only if potential benefits outweigh possible risks to the fetus.
- It is not known if citric acid/sodium bicarbonate is present in breast milk. Consult with your physician before use, if you are breastfeeding.
- Never take any OTC drugs including citric acid/sodium bicarbonate without first checking with your healthcare provider, if you are pregnant or breastfeeding.
What else should I know about citric acid/sodium bicarbonate?
- Take citric acid/sodium bicarbonate exactly as prescribed, or as per label directions if self-medication with OTC drug.
- Discontinue use and seek medical help if you find no relief for heartburn after using maximum dosage of citric acid/sodium bicarbonate for 2 weeks.
- Store safely out of reach of children.
- In case of overdose, seek medical help or contact Poison Control.
Citric acid/sodium bicarbonate is a combination antacid medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion. Use with caution if you are on a sodium-restricted diet. Side effects of citric acid/sodium bicarbonate include gas (flatulence), abdominal bloating, nausea, vomiting, diarrhea, fluid retention, and excessive alkalinity of body fluids (alkalosis). Consult your doctor if pregnant or breastfeeding.
Multimedia: Slideshows, Images & Quizzes
Acid Reflux (Heartburn, GERD): Symptoms & Remedies
Heartburn is a symptom of acid reflux that causes chest pain when stomach acid backs up into the esophagus. Heartburn symptoms...
Heartburn: Foods to Eat, Foods to Avoid
Learn the symptoms of heartburn and which foods cause heartburn or GERD. Discover home remedies and which foods may provide...
10 Fast Acting Ways to Relieve Heartburn
What do you need to know about heartburn remedies? Learn the foods that cause heartburn, quick home remedies, and the rules of...
GERD Quiz: Test Your Digestive Diseases IQ
Who is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about...
Picture of Gastroesophageal Reflux (GERD)
The stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by...
Related Disease Conditions
How To Cure GERD Fast and Permanently?
GERD can be managed with a combination of lifestyle modifications and medications, such as the following home remedies and tips.
How Long Does GERD Take to Heal?
GERD is a medical condition in which acidic liquids in the stomach leak up into the esophagus. Minor cases of GERD can heal in less than a month while moderate cases can take 6 to 12 weeks of treatment.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
GERD (Acid Reflux, Heartburn)
Gastroesophageal reflux disease (GERD), also called acid reflux, can cause symptoms like heartburn, chest pain, regurgitation, and nausea. Learn about causes, diagnosis, treatment and prevention.
Gastroesophageal Reflux Disease (GERD)
Second Source article from The Cleveland Clinic
Indigestion (Dyspepsia, Upset Stomach Pain)
Indigestion (dyspepsia, upset stomach) can be caused by problems related to, or not related to the gastrointestinal tract. Signs and symptoms are upper abdominal pain, belching, nausea, vomiting, abdominal bloating, and abdominal distention. Treatment depends upon the cause.
What Should I Eat When I Have Heartburn?
Heartburn happens when your stomach acid comes up your throat. Foods you should eat if you have heartburn include oatmeal, sweet potatoes, ginger, melons, chicken broth, fennel, non-fat milk, herbs, olive oil and lean meat.
28 Tips to Get Rid of Heartburn at Night
What to know about nighttime heartburn relief. Learn foods to avoid, lifestyle changes, and medications for heartburn.
Beyond Food: What Triggers Heartburn and GERD?
Heartburn is the burning sensation in the chest due to backflow or reflux of the acidic stomach contents into the food pipe (esophagus). Heartburn is a major symptom of gastroesophageal reflux disease or GERD.
Ways to Relieve Acid Reflux (GERD, Heartburn)
Most people have experienced some sort of pain or discomfort following a large meal or a particular food that didn’t quite agree with their stomach. Acid reflux symptoms can happen without a specific underlying condition.
What Should I Eat for Dinner to Avoid Heartburn?
Acid reflux takes place when the acid from your stomach touches the esophagus, causing pain and irritation. Good foods to eat for dinner to avoid heartburn include leafy greens, non-citrus fruits, ginger, oatmeal, healthy fats, seafood and aloe vera juice.
Heart Attack vs. Heartburn
Heartburn is a symptom of another disease or medical problem and can be described as a feeling of burning in the chest accompanied by symptoms of nausea, vomiting, or a sour taste or food stuck in the back of the throat. Heart attack occurs when an artery in the heart is completely blocked by a blood clot, which causes that portion of heart muscle to die. Heart attack also has symptoms of chest pain, nausea, and vomiting, however, other warning signs and symptoms of a heart attack are unusual weakness or fatigue, and persistent and/or increased severity of symptoms over a few minutes. Heart attack is a life threatening emergency. If you think you or someone you are with is having a heart attack, call 911 immediately for urgent medical treatment. It may save your life.
Is GERD Curable?
GERD happens when stomach acid, fluids, or food flow back up into your food pipe, also called the esophagus. There is no cure for GERD — it’s an ongoing digestive disorder — but it is treatable.
What Can Heartburn Be a Sign of?
Heartburn symptoms may indicate a bigger health concern. Learn more about heartburn, heartburn symptoms, heartburn related to other health conditions, how it's diagnosed, and your treatment options for heartburn.
Can Cashew Nuts Cause Heartburn?
Although not a major cause, nuts, such as cashews, can trigger heartburn in some individuals. Nuts, including cashews, are high in fats, which slow down the emptying stomach.
GERD: Is the Damage Reversible?
Gastroesophageal reflux disease or GERD is caused by the weakening of the lower esophageal sphincter (LES). LES is a group of muscles that act as a valve to prevent the acidic contents of the stomach from refluxing into the esophagus.
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include: Belching Nausea after eating A feeling of fullness during or after eating Abdominal bloating Upset stomach Belching Wheezing Reflux laryngitis A tightness in the throat Problems swallowing Indigestion In some people, vomiting Causes of acid reflux and heartburn include: Being obese Slouching (poor posture) Medications like calcium channel blockers, theophylline, nitrates, and antihistamines Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate Pregnancy Diabetes Increase in stomach acid Eating a heavy meal Eating before bed The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.REFERENCES:American College of Gastroenterology. "Acid Reflux." 2017.<http://patients.gi.org/topics/acid-reflux/> familydoctor.org. "Heartburn." Updated: Mar 2014.<https://familydoctor.org/condition/heartburn/> National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.<https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072436/>
GERD (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Common symptoms of GERD in children include colic, feeding problems, poor growth, frequent vomiting or coughing, heartburn, regurgitation, recurrent wheezing, pneumonia, choking, or gagging. Treatment may involve elevating the child's bed, keeping the child upright after eating, limiting foods that seem to make the reflux worse, encouraging your child to exercise, and serving several small meals a day.
Why Do I Keep Getting Heartburn Every Day?
While occasional heartburn is common, heartburn that occurs every day may be a sign of something more serious. Learn about what causes frequent heartburn and what may be triggering the discomfort.
Quick Relief For Heartburn
Heartburn refers to the burning sensation in the chest due to backflow or reflux of the acidic stomach contents into the food pipe (esophagus). If you are experiencing heartburn, you may ease the problem through various ways.
How Do You Prevent Heartburn When Exercising?
Exercise is an excellent way to lose weight, which is one of the causes of heartburn. However, some people may experience heartburn after exercise or during a workout. There are six tips that may help you ease exercise heartburn.
What Home Remedies Kill Heartburn?
Heartburn can cause an uncomfortable burning sensation in the chest. Here are 15 natural remedies to relieve heartburn and alleviate symptoms.
How Do You Stop Heartburn Instantly?
Heartburn happens when your esophagus becomes irritated due to stomach acid. You can stop heartburn instantly with over-the-counter medications like antacids.
What Are the Best Foods To Eat If You Have GERD?
What is GERD, and how can you manage it? Learn more about this condition and how making diet and lifestyle changes can play an important role in treatment.
When Should You Worry About Heartburn?
Heartburn is usually not a cause for concern. However, if the pain is persistent or frequent, it could be a sign of something more serious. Here are signs to look out for.
What Causes Gastroesophageal Reflux Disease (GERD)?
Gastroesophageal reflux disease (GERD) is a chronic disorder in which acid reflux occurs at least two times a week for several weeks. Acid reflux is a condition in which the acidic stomach contents leak back in the food pipe (esophagus) and cause heartburn.
What Gets Rid of Heartburn Fast?
Learn what causes heartburn and how to get rid of heartburn fast.
How Do You Know If You Have Heartburn When Pregnant?
Heartburn is a common issue that affects many pregnant people. Learn the signs of heartburn in pregnancy, what causes it, how doctors diagnose it, and what you can do to treat it.
How Do You Know When Heartburn Is Serious?
Heartburn may be serious if it occurs more than twice a week and persists despite dietary changes and the use of over-the-counter medications.
Treatment & Diagnosis
- GERD Gastroesophageal Reflux Disease FAQs
- Gonorrhea Treatment Recommendations Update
- GERD Surgery - No Good?
- GERD: Questions To Ask Your Doctor About GERD (Heartburn)
- GERD Surgery Doesn't Prevent Cancer
- Heartburn: Is Heartburn Inherited?
- Esophageal Cancer Linked to Heartburn
- IBS, GERD, Hepatitis C: Doctors Dialogue
- GERD: Types of antacids for GERD?
- GERD: Safe GERD medications for pregnancy?
- GERD Acid reflux during pregnancy?
- GERD: Relief from GERD?
- GERD Symptoms improve with weight loss?
- Why is acid reflux GERD worse at night time?
- GERD Symptoms After Exercise?
- Bad breath from GERD?
- GERD Best treatment for Barrett Esophagus?
- GERD How long can you take Prilosec safely?
- GERD: Any substitute for Propulsid in treating GERD
- GERD: Use of Propulsid GERD
- Heartburn Diagnosis
- Heartburn or Heart Attack? Emergency In Flight
- What Is the Relationship Between GERD and Scleroderma?
- Are Tums or Rolaids Good for Heartburn?
- What Are Foods to Avoid With GERD?
- Can You Overdose on Antacids?
- Heartburn: Carbonated Soda & Sleeping Pills Increase Nighttime Heartburn
Medications & Supplements
- calcium carbonate antacid - oral, Dicarbosil, Rolaids, Titralac,
- aluminum hydroxide, magnesium hydroxide, simethicone antacids
- citric acid/sodium citrate
- lansoprazole (Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24)
- sodium citrate
- Types of Medication for GERD (Heartburn)
- sodium citrate/dextrose/fructose
- citric acid/potassium-sodium citrates - oral, Cytra-3, Polycitra
Prevention & Wellness
Subscribe to MedicineNet's General Health Newsletter
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.