Which drug classification interacts with over-the-counter (otc) drugs such as aspirin and antacids?

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Antacids usually come in the following drug forms:

  • liquid
  • chewable gummy or tablet
  • tablet that you dissolve in water to drink

Popular antacid brands include:

  • Alka-Seltzer
  • Maalox
  • Mylanta
  • Rolaids
  • Tums

Antacids are typically safe for most people. However, people with certain medical conditions should talk with their doctors before taking certain antacids that contain aluminum hydroxide and magnesium carbonate.

For example, people with heart failure may have sodium restrictions to help decrease fluid buildup. However, antacids often contain a lot of sodium. These people should ask their doctor before using antacids.

People with kidney failure may develop a buildup of aluminum after using antacids. This can lead to aluminum toxicity. People with kidney failure also tend to have problems with electrolyte balance. All antacids contain electrolytes, which could make electrolyte balance problems worse.

Talk to your child’s doctor before giving your child antacids. Children don’t typically develop symptoms of excess stomach acid, so their symptoms could be related to another condition.

Side effects from antacids are rare. However, they can occur, even when you use them according to the directions.

Antacids can either cause constipation or have a laxative effect. Some people have had allergic reactions. Antacids might also increase the risk of developing sensitivities to certain foods.

Side effects from misuse

Many of the side effects of antacids come from not taking them as directed.

Many antacids — including Maalox, Mylanta, Rolaids and Tums — contain calcium. If you take too much or take them for longer than directed, you could get an overdose of calcium. Too much calcium can cause:

  • nausea
  • vomiting
  • mental status changes
  • kidney stones

Excess calcium can also lead to alkalosis. In this condition, your body doesn’t make enough acid to function properly.

If you feel like you need to use a lot of an antacid for relief, that might be a sign of another condition. If you’ve taken an antacid according to the directions and haven’t gotten relief, talk to your doctor.

Antacids can interfere with the function of other drugs. If you take other medications, check with your doctor or pharmacist before using antacids.

Some antacids, such as Alka-Seltzer, contain aspirin. The Food and Drug Administration issued a safety alert about this type of antacid in June 2016. This alert was issued because of reports of serious bleeding related to aspirin-containing antacids.

If you take another medication that increases your risk of bleeding, such as an anticoagulant or antiplatelet drug, you shouldn’t take these antacids.

Be sure to talk to your doctor before taking aspirin-containing antacids if you:

  • have a history of stomach ulcers or bleeding disorders
  • are older than 60 years old
  • drink three or more alcoholic drinks per day

Antacids can often relieve symptoms of excess stomach acid. However, sometimes these symptoms mean you have a more serious condition.

It’s important that you know how to recognize these conditions and how to respond to them. An upset stomach could actually be gastroesophageal reflux disease (GERD) or a peptic ulcer.

Antacids can only soothe, not cure, some of the symptoms of these conditions. If you have severe pain that doesn’t get better after using the recommended dosage of antacids for two weeks, call your doctor.

Some heart attack symptoms can also mimic stomach pains. You may be having a heart attack if you have severe chest pain that lasts longer than two minutes with any of the following symptoms:

  • lightheadedness
  • shortness of breath
  • pain that radiates to your arms, shoulders, or jaw
  • neck or back pain
  • vomiting or nausea

If you think you may be experiencing a heart attack, call 911 or your local emergency services.

If you have acid reflux or other symptoms caused by stomach acidity, get to know your OTC medications.

Antacids neutralize the acid that your stomach makes. This can make you more comfortable. On the other hand, H2 receptor blockers and PPIs can block your stomach from making too much acid. This can allow the damage in your stomach and esophagus to heal.

Ask your doctor which is better for you.

pronounced as (as' pir in) (oh me' pray zol)

The combination of aspirin and omeprazole is used to reduce the risk of stroke or heart attack in patients who have had or are at risk of these conditions and are also at risk of developing a stomach ulcer when taking aspirin. Aspirin is in a class of medications called antiplatelet agents. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke. Omeprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

The combination of aspirin and omeprazole comes as a delayed-release tablet (releases the medication in the intestine to prevent damage to the stomach) to take by mouth. It is usually taken once daily with liquid at least 60 minutes before a meal. Take the combination of aspirin and omeprazole at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take the combination of aspirin and omeprazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the delayed-release tablets whole; do not split, dissolve, chew, or crush them.

Continue to take aspirin and omeprazole even if you feel well. Do not stop taking aspirin and omeprazole without talking to your doctor. If you stop taking aspirin and omeprazole, there is a higher risk that you may have a heart attack or stroke.

Do not take the combination of aspirin and omeprazole to treat sudden signs and symptoms of a heart attack or stroke.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking aspirin and omeprazole,

  • tell your doctor and pharmacist if you are allergic to aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, others) and indomethacin (Indocin), omeprazole, any other medications, or any of the ingredients in the combination of aspirin and omeprazole delayed-release tablets. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking rilpivirine (Edurant, in Complera, in Odefsey). Your doctor will probably tell you not to take aspirin and omeprazole if you are taking this medication.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); anticoagulants ('blood thinners') such as heparin and warfarin (Coumadin, Jantoven); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Epaned, Vasotec), fosinopril, lisinopril (Prinivil, Qbrelis, Zestril), perindopril (Aceon), quinapril (Accupril), and ramipril (Altace); antiretrovirals such as atazanavir (Reyataz, in Evotaz), nelfinavir (Viracept), or saquinavir (Invirase); beta blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, others), nadolol (Corgard, in Corzide), and propranolol (Inderal, Innopran); citalopram (Celexa); cilostazol; clopidogrel (Plavix); cyclosporine (Gengraf, Neoral, Sandimmune); dasatinib (Sprycel); oral medications for diabetes; diazepam (Diastat, Valium); digoxin (Lanoxin); disulfiram (Antabuse); diuretics ('water pills'); erlotinib (Tarceva); iron salts; itraconazole (Onmel, Sporanox); ketoconazole (Nizoral); methotrexate (Otrexup, Rasuvo, Trexall); mycophenolate (Cellcept); nilotinib (Tasigna); other nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve, Naprosyn); phenytoin (Dilantin, Phenytek); probenecid (Probalan); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); tacrolimus (Astagraf, Prograf); ticagrelor (Brilinta); valproic acid (Depakene); and voriconazole (Vfend). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John's Wort.
  • tell your doctor if you have or have ever had severe shortness of breath, chest tightness or pain, coughing or wheezing (asthma), rhinitis (frequent stuffed or runny nose), or nasal polyps (growths on the linings of the nose) after taking aspirin or other NSAIDs including ibuprofen (Advil, Motrin, others). Your doctor may tell you that you should not take aspirin and omeprazole if you have any of these conditions.
  • tell your doctor if you are of Asian descent or if you drink three or more alcoholic drinks every day. Also, tell your doctor if you have or have ever had a low level of magnesium in your blood, bleeding problems such as hemophilia, lupus, or liver or kidney disease.
  • you should know that aspirin should not be taken by children and teenagers who have chicken pox, flu, flu symptoms, or who have received the varicella virus (chicken pox) vaccine in the past six weeks because of the risk of Reye's Syndrome (a serious condition in which fat builds up on the brain, liver, and other body organs).
  • tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Aspirin or aspirin-containing medications may harm the fetus and cause problems with delivery if it is taken around 20 weeks or later during pregnancy. Do not take aspirin around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while taking aspirin, call your doctor.
  • you should know that this medication may decrease fertility in women. Talk to your doctor about the risks of taking aspirin and omeprazole.
  • if you are 70 years of age or older, do not take this medication for a longer period of time than recommended by your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking aspirin and omeprazole.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Aspirin and omeprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • heartburn
  • vomiting

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • unusual bruising or bleeding
  • bloody or black, tarry stools
  • bloody vomit
  • vomit that looks like coffee grounds
  • severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps
  • frequent nose bleeds
  • changes in urination, swelling of the hands and feet, rash, itching, or having breath that smells like ammonia
  • yellowing of the skin or eyes
  • dark urine
  • pain or discomfort in right upper stomach area
  • shortness of breath, lightheadedness, muscle weakness, pale skin, feeling tired, mood changes, or numbness
  • seizures, dizziness, muscle aches, or hand or feet spasms
  • rash, especially a rash on the cheeks or arms that gets worse in sunlight
  • increased or decreased urination, blood in urine, fatigue, nausea, loss of appetite, fever, rash, or joint pain

People who take proton pump inhibitors such as omeprazole may be more likely to fracture their wrists, hips, or spine than people who do not take one of these medications. The risk is highest in people who take high doses of one of these medications or take them for one year or longer.

Aspirin and omperazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Your medication may come with a desiccant packet (small packet that contains a substance that absorbs moisture to keep the medication dry) in the container. Leave the packet in the bottle, do not throw it away.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

  • ringing in the ears
  • fever
  • confusion
  • drowsiness
  • blurred vision
  • rapid heartbeat
  • nausea
  • vomiting
  • sweating
  • flushing
  • headache
  • dry mouth

Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests before and during your treatment, especially if you have severe diarrhea.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking aspirin and omperazole.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

  • Yosprala®

Last Revised - 01/15/2021

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