Advice from FDA: Warning: Aspirin-Containing Antacid Medicines Can Cause Bleeding

Antacids are over-the-counter (OTC) medicines used to treat upset stomach or heartburn. Some antacids contain aspirin, which can increase the risk of serious stomach irritation that can cause bleeding. The US Food and Drug Administration (FDA) recently updated a warning about this increased risk since they continue to receive reports of new cases of serious bleeding from aspirin-containing antacid products. Some of these cases have even required blood transfusions. So, how do you know which antacid to choose?

It is important to read the Drug Facts label on medicines. This label lists all the ingredients in the medicine, including aspirin if it is present. For example, a common antacid brand, Alka-Seltzer Original Flavor, contains aspirin. You can use this product to treat pain such as a headache, backache, body aches, and muscle pain, but not heartburn or an upset stomach. On the other hand, Alka-Seltzer Heartburn Relief Extra Strength contains citric acid and sodium bicarbonate, not aspirin. This product is suitable for treating heartburn, acid indigestion, and upset stomach and does not increase the risk of stomach bleeding. Similarly, if you choose to purchase a generic or store-brand product, be sure to read the Drug Facts label for the specific ingredients and which symptoms the product will treat.

One other thing to note, some people are at greater risk for bleeding when they take aspirin-containing products. Risk factors include the following:

• Being 60 years or older
• Having a history of stomach ulcers or bleeding problems
• Taking medicines that thin the blood (or reduce the bloods ability to clot)
• Taking steroids (e.g., prednisone) for another condition
• Taking other non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen) or medicines containing NSAIDs (e.g., multi-ingredient cough and cold formulations)
• Drinking three or more alcoholic drinks on most days

Here’s what you can do: Talk to your doctor or pharmacist about which OTC antacid products would be best for you, especially if you take prescription medicines that contain aspirin. Read the Drug Facts labels on all OTC products. If you take an aspirin-containing antacid, talk to your healthcare professional immediately if you have any of the following signs of stomach or intestinal bleeding:

• Feeling faint
• Vomiting blood
• Passing black or bloody stools
• Having stomach pain

Advice from FDA is a feature brought to you by FDA. You can find this information and more on FDA’s Consumer Health Information website at: www.ismp.org/ext/1039. This website features the latest updates on medicines and products regulated by FDA. Sign up for a free email subscription at: www.ismp.org/ext/262.

Published December 11, 2022