Alka-Seltzer

Alka-Seltzer is a combination medicine.

Aspirin helps to inactivate the COX enzyme, disrupting the binding of prostacyclins to PG and thromboxane, and with it the production of ATP. It also exhibits anti-inflammatory, analgesic and antipyretic effects and slows down platelet aggregation. [ 1 ]

Sodium bicarbonate neutralizes the action of free gastric hydrochloric acid, reducing the likelihood of developing the ulcerogenic effect of aspirin. Its antipyretic and analgesic effects develop quite quickly - because the drug is absorbed at a high speed.

Indications Alka-seltzer

It is used in case of such violations:

• arthritis of rheumatoid origin, rheumatism, as well as myocarditis of infectious-allergic origin;
• a feverish condition that develops during pathologies of an infectious and inflammatory nature;
• pain of various origins: toothaches or headaches (also caused by alcohol withdrawal), myalgia, migraine, algomenorrhea, neuralgia and arthralgia;
• prevention of the development of thromboembolism or thrombosis;
• secondary prevention of myocardial infarction development.

Release form

The medicinal element is released in soluble tablets - 10, 20 or 40 pieces per pack.

Pharmacokinetics

When taken orally, aspirin is fully and rapidly absorbed in the gastrointestinal tract. During and after absorption, aspirin is transformed into its main metabolic component, which has medicinal activity – salicylic acid. Intraplasmic Cmax of aspirin is observed after 10-20 minutes; for salicylic acid, this value is 0.3-2 hours.

Aspirin with salicylic acid are substantially synthesized with intraplasmic protein, distributing at high speed within the body. Salicylic acid crosses the placenta and is excreted with breast milk.

Excretion of phenolic acid with its metabolic elements is realized mainly through the kidneys. Among the breakdown products of the substance are salicylacyl and salicylphenol glucuronide, salicyluric and gentisic uric acids, as well as gentisic acid.

The rate of excretion of phenolic acid depends on the size of the portion, because its metabolic processes are limited by the properties of liver enzymes. Because of this, the half-life varies in the range of 2-3 hours in the case of small doses and increases to almost 15 hours in the case of large doses.

Sodium bicarbonate and citric acid are not absorbed.

Dosing and administration

The medicine is taken orally. For an adult, a single dose is 1-2 tablets (a maximum of 8 tablets can be taken per day). A child should take 0.5-1.5 tablets per single dose (no more than 4 tablets per day).

Application for children

For individuals under 14 years of age with diseases that cause hyperthermia, the medication is prescribed only if there is no effect from the use of other drugs.

Use Alka-seltzer during pregnancy

It should be taken into account that the introduction of large doses of salicylates in the first trimester has been associated in many epidemiological studies with a high probability of anomalies (for example, heart defects or cleft palate). But with standard doses, this risk is probably quite low - because in tests conducted on approximately 3,200 women, no increase in the incidence of anomalies was found.

In the 3rd trimester, the use of salicylates may cause prolongation of pregnancy and weakening of contractions during labor. An increased tendency to bleeding has been noted in the woman and fetus. In case of Alka-Seltzer use shortly before labor, intracranial bleeding may develop in newborn babies (especially premature babies).

In case of using standard doses of the drug, it is usually not necessary to stop breastfeeding for the duration of therapy. If constant use of large doses of the drug is required, a decision must be made to discontinue breastfeeding.

Contraindications

It is prohibited to prescribe sodium salicylate and Alka-Seltzer if the patient has ulcers or bleeding in the gastrointestinal tract.

Do not use if you have a history of ulcers, venous congestion (due to weakened gastric mucosa) or portal hypertension, or if you have a blood clotting disorder.

Long-term use of salicylates can lead to anemia, which requires regular blood tests and monitoring for blood in the stool.

Due to the risk of allergic reactions, the drug (and other salicylates) should be used with extreme caution in people with severe intolerance to penicillins and other allergenic medications.

Severe intolerance to Alka-Seltzer can lead to the development of "aspirin" asthma (special desensitizing procedures can prevent its development or treat an existing disorder).

In people with allergic pathologies, including bronchial asthma, hay fever and allergic rhinitis, epidermal itching, urticaria, nasal polyps and swelling of the mucous membranes, or in combination with respiratory tract infections (chronic), and in addition, in people with intolerance to antirheumatic and analgesic substances, "aspirin" asthma may be observed.

Without medical supervision, the medication is used only in standard doses and for only a few days.

Side effects Alka-seltzer

The introduction of the drug can provoke profuse sweating, hearing loss and tinnitus, as well as Quincke's edema, epidermal and other allergy symptoms.

It is necessary to take into account that prolonged use of the drug without medical supervision can lead to bleeding inside the stomach and dyspeptic disorders; in addition, damage to the mucous membrane of the entire gastrointestinal tract can occur.

To reduce the ulcerogenic effect and prevent bleeding inside the stomach, the medication should be taken only after meals; the tablets should be crushed well and washed down with a large amount of liquid (milk is recommended). However, there is also information that bleeding occurs when taking the medicine after meals. To reduce the irritating effect on the stomach, alkaline mineral waters or a solution of sodium bicarbonate can be taken after the medication.

Because of the effect on platelet aggregation and the existing anticoagulant effect, blood tests should be performed periodically during therapy. People with bleeding disorders (especially hemophilia) may experience bleeding. To detect ulcerogenic activity at an early stage, feces should be checked periodically for the presence of blood.

Overdose

Mild poisoning leads to the development of vomiting, pain in the epigastric region, nausea, and in addition (especially in the elderly and children) headaches, tinnitus and dizziness, as well as hearing and vision impairment.

Severe intoxication causes drowsiness, tremors, incoherence, suffocation, collapse, and confusion, as well as dyspnea, hyperthermia, respiratory alkalosis, dehydration, coma, metabolic acidosis, carbohydrate metabolism disorder, and urinary alkalinity.

The lethal dose of the drug for an adult is over 10 g; for a child – more than 3 g.

In case of overdose, taking into account the acid-base and salt balance indicators, sodium bicarbonate, sodium lactate or citrate liquids are administered.

Interactions with other drugs

Combining the drug with anticoagulants increases the risk of bleeding.

The combination of the drug with NSAIDs leads to a potentiation of the negative impact and the main effect of the latter.

When using Alka-Seltzer, an increase in the negative effects of methotrexate is noted.

Administration of the drug together with orally administered hypoglycemic agents (sulfonylurea derivatives) causes potentiation of antidiabetic activity.

The combination of the drug and GCS increases the likelihood of the patient developing gastrointestinal bleeding.

Aspirin reduces the therapeutic effect of furosemide, spironolactone, antihypertensive drugs and anti-gout agents that help excrete uric acid.

[ 2 ], [ 3 ]

Storage conditions

Alka-Seltzer should be stored in a place where small children cannot reach it. Temperature indicators should not exceed 25°C.

Shelf life

Alka-Seltzer can be used within 36 months from the date of sale of the medicinal product.

Analogues

The analogs of the drug are Acelizin, Aspirin with Alka-prim, Asprovit, Askofen with Antigripocaps, and in addition to this, Aspicod and Acecardin with Aspeter, Onofrol and Citropak. Also on the list are Polokard, Kopatsil, Citramon with Migralgin, Farmadol and Upsarin.