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mrsD · 02-05-2007, 03:26 PM

Quote:

Originally Posted by Wing42

I'd appreciate any details on the effects and risks of daily Alka Seltzer. There was a reference in another thread about MrsD's posting on Alka Seltzer. I can't find such a posting with the search engine, but vaguely remember it from the BrainTalk forum. Unfortunately, all the details are gone from my memory. I hope daily aspirin helps memory.

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Each Alka Seltzer tablet contains 325 mg. of aspirin.

Is it safe to take 650 mg. of aspirin every day? Three times a week?

How high is the risk of GI track bleeding with Alka Seltzer?

If bleeding occurs as a result of daily aspirin intake, is it more likely to be mild and transitory, or massive and continuing?

Is GI bleeding from aspirin dose dependent? Is GI bleeding dependent on duration of usage?

I've been taking 80 mg. of aspirin daily for blood lipid control and for prostate health and cancer protection (see http://search.lef.org/cgi-src-bin/Ms...S%20aspirin%20 and page 2 of http://www.lef.org/magazine/mag2007/...rostate_01.htm ).

Is it correct to assume that one should not take the 80 mg. of aspirin on days one takes two Alka Seltzers, and visa versa?

Hello, David... Did you not see the other thread? If you have serious concerns about the aspirin, you can try AlkaSeltzer Gold. (no aspirin in it).
The other alkaline buffer available is TriSalts
http://www.bio-tech-pharm.com/products/trisalts.html (the powder is stonger).

Aspirin in solution like AlkaSeltzer is absorbed very quickly from the stomach..it does not linger around to cause bleeds, like tablets do.

Aspirin taken systemically does reduce platelet activity to some extent. So systemically it would be additive with other drugs that thin the blood or affect platelets: SSRI antidepressants, Plavix, Pletal, warfarin,
Here is a fuller list of drug interactions, pro and con:

Quote:

DRUG INTERACTIONS

Anticoagulants: See WARNINGS section.
Hypoglycemic Agents: See WARNINGS section.
Uricosuric Agents: Aspirin may decrease the effects of probenecid, sulfinpyrazone, and phenylbutazone.
Spironolactone: See PRECAUTIONS section.
Alcohol: Has a synergistic effect with aspirin in causing gastrointestinal bleeding.
Corticosteroids: Concomitant administration with aspirin may increase the risk of gastrointestinal ulceration and may reduce serum salicylate levels.
Pyrazolone Derivatives (phenylbutazone, oxyphenbutazone, and possibly dipyrone): Concomitant administration with aspirin may increase the risk of gastrointestinal ulceration.
Nonsteroidal Antiinflammatory Agents: Aspirin is contraindicated in patients who are hypersensitive to nonsteroidal antiinflammatory agents.
Urinary Alkalinizers: Decrease aspirin effectiveness by increasing the rate of salicylate renal excretion.
Phenobarbital: Decreases aspirin effectiveness by enzyme induction.
Phenytoin: Serum phenytoin levels may be increased by aspirin.
Propranolol: May decrease aspirin's antiinflammatory action by competing for the same receptors. Antacids: Enteric Coated Aspirin should not be given concurrently with antacids, since an increase in the pH of the stomach may effect the enteric coating of the tablets.

from http://www.rxlist.com/cgi/generic/asa_ad.htm

The thread to which I am referring was on OBT chronic pain...
http://brain.hastypastry.net/forums/...ead.php?t=8553
and
http://brain.hastypastry.net/forums/...ead.php?t=8265

AlkaSeltzer will also block histamine reactions, from foods.
On both of those threads is a link to pain.org about acidic reactions at the
tissue level at nerve endings.

If you have some issue with the aspirin, you can ask your doctor. Aspirin prophylaxsis for CAD is either 81mg /day or 325mg/day depending on the doctor. Combined with other medications, is the most important thing to
consider. However, aspirin remains a treatment for many inflammatory conditions today, and even is basic to RA treatments, still today.

Aspirin affects lipid peroxidases, but does not control lipid levels to the best of my knowledge. These are different things.

If one already has erosions in the stomach (AlkaSeltzer would not reach the small intestine in appreciable amounts like tablets would) then bleeding could occur. To intact mucosa? Not much risk. People who have constant GI issues like GERD, typically have poor mucosal lining, due to long term EFA depletion, or infections with H.pylori. These patients would do better with TriSalts or AlkaSeltzer Gold.

Here is an article about tablet form of aspirin in the 81mg-325mg dose range:
http://gastroenterology.jwatch.org/c...ull/2003/128/1

Here is an old paper illustrating the difference between acidic solutions, and basic ones:
http://www.springerlink.com/content/v844n8771p26g082/

Quote:

J. N. Hunt1, 2 Contact Information and Margaret A. Fisher1
(1) Department of Physiology, Guy's Hospital Medical School, London, England
(2) Present address: Department of Physiology, Baylor College of Medicine, 77030 Houston, Texas

Received: 24 May 1979 Revised: 17 September 1979 Accepted: 25 September 1979
Abstract In 7 subjects, 100-ml successive portions of buffered acid (pH between 3.5 and 2.9) solutions of aspirin (1 g/liter) were instilled into the stomach and recovered after 10 min. Blood in the recoveries was estimated chemically. After there had been three successive increases in the rate of blood loss into the gastric lumen, typically rising from about 0.1 to 1 ml/day after about 80 min, buffered neutral solution of aspirin was instilled and recovered after 10 min. This was followed by a fall in the rate of blood loss into the gastric lumen which occurred despite a rise in the concentration of salicylate in the plasma from a mean of 55 mg/liter to 74 mg/liter. Under these conditions, salicylate in the plasma and acetylsalicylate in the gastric contents did not prevent gastric mucosal bleeding from falling to control levels within 50 min.

and this from Rxlist.com

Quote:

Gastrointestinal reactions: Doses of 1,000 mg per day of aspirin caused gastrointestinal symptoms and bleeding that, in some cases, were clinically significant. In the largest postinfarction study (the Aspirin Myocardial Infarction Study (AMIS) with 4,500 people), the percentage of incidences of gastrointestinal symptoms for the aspirin (1,000 mg of a standard, solid-tablet formulation) and placebo-treated subjects, respectively, were stomach pain (14.5%, 4.4%), heartburn (11.9%, 4.8%), nausea and/or vomiting (7.6%, 2.1%), hospitalization for GI disorder (4.9%, 3.5%). In the A.I. and other trials, aspirin-treated patients had increased rates of gross gastrointestinal bleeding. Symptoms and signs of gastrointestinal irritation were not significantly increased in subjects treated for unstable angina with buffered aspirin in solution.

http://www.rxlist.com/cgi/generic/asa_ad.htm

AlkaSeltzer is just not like taking aspirin TABLETS in any form. It does not stay in the stomach long enough to irritate it.

Here is another paper...
http://jada.ada.org/cgi/content/abstract/93/1/111

I will add that some researchers do not trust enteric coating at all. It breaks down in the intestine, and a bleed can occur there, just as easily as in the stomach if the concentrated tablet does not dilute out quickly.

When you take any aspirin product, or NSAID (Feldene and Indocin are the worst, but any can do it)...a bleed can occur where there is an erosion, inflammation of the GI mucosa due to any reason. Most the GI bleeding from NSAIDs (and some of the aspirin) is due to SYSTEMIC suppression of platelets, that the drugs cause. This has a time factor... and does not occur at the
very beginning of therapies.

You can get a bleed from that 81mg tablet of aspirin as well, enteric coated or not.

So if you are concerned then, I'd go for the AlkaSeltzer Gold or TriSalts to get the acidic buffering benefit. I like the aspirin because I have pain anyway.
And even with my GI issues and hiatal hernia I have never had a bleed or incident. I also let the bubbles go flat before drinking...to minimize reflux or burping.

This is some detail... and I hope it answers your questions. Any further, just post them here. Remember there are NO guarantees with ANY drug therapy on the planet.