Aspirin/citric acid/sodium bicarbonate (By mouth)

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody or black, tarry stools.
• Bloody vomit or vomit that looks like coffee grounds.
• Fever, chills, lightheadedness, fainting.
• Dark urine, yellowing of your skin or the whites of your eyes.
• Pain that lasts longer than 10 days.
• Pale skin, unusual bleeding, bruising, or weakness.
• Redness or swelling.
• Severe stomach pain.
• Ringing in your ears that will not stop.
• Worsening pain or new symptoms.

If you notice these less serious side effects, talk with your doctor:

• Mild stomach pain, nausea, heartburn.
• Slight ringing in your ears, problems with hearing.
• Trouble sleeping.

How to Use This Medicine

Fizzy Tablet, Tablet

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• If you are using this medicine without a prescription, follow the instructions on the medicine label.
• If you are using the effervescent tablet form of this medicine, dissolve the tablets fully in 4 ounces of water. Drink all of this mixture right away.
• It is best to take this medicine with food or milk.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Brand Name(s)

Alka-Seltzer Extra Strength, Pain Relief, Quality Choice Effervescent Pain Relief, Alka-Seltzer, Medi-Seltzer

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to aspirin, citric acid, or sodium bicarbonate. You should not use this medicine during the last 3 months of pregnancy. This medicine should not be given to children or teenagers with fever, chickenpox, or symptoms of the flu or viral infection. Aspirin can cause a serious disease called Reye's syndrome in children or teenagers. You should not use this medicine if you have an active stomach ulcer or any kind of bleeding problem.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many other medicines that should not be taken together with an antacid, such as sodium bicarbonate. Tell your doctor about all other medicines you are using.
• Make sure your doctor knows if you are also using a blood thinner such as warfarin (Coumadin®).
• Make sure that none of the other medicines you are using also contain aspirin.
• Aspirin can cause stomach bleeding. Drinking alcohol can make this worse. If you have 3 or more drinks of alcohol every day, ask your doctor if you should use this medicine. One drink of alcohol is the same as 4 ounces of wine, 12 ounces of beer, or 1 ounce of hard liquor (gin, whiskey, and others).

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breast feeding. Tell your doctor if you have arthritis, asthma, diabetes, gout, or a bleeding disorder such as hemophilia. Make sure your doctor knows if you have a stomach disorder such as an ulcer, heartburn that last or come back frequently, or GERD (reflux disease).
• Tell your doctor if your symptoms get worse or last longer than 10 days.

Introduction

Aspirin (AS-pir-in), Citric Acid (SIT-rik AS-id), Sodium Bicarbonate (SOE-dee-um bye-KAR-bo-nate)

Treats heartburn, acid indigestion, and sour stomach with headache, minor pain, or body aches. Also treats the symptoms of a hangover caused by drinking alcohol.