Drug interactions
Aspirin / citric acid / sodium bicarbonate + Hydrocortisone
Severity: Moderate
Aspirin / citric acid / sodium bicarbonate and Hydrocortisone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Corticosteroids and aspirin together increase the risk of peptic ulcer and gastrointestinal bleeding. Buffering with bicarbonate and citric acid does not remove the systemic mucosal and antiplatelet effects of aspirin.
What this interaction means in plain words
Aspirin / citric acid / sodium bicarbonate and Hydrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive gastrointestinal mucosal injury from systemic prostaglandin inhibition and corticosteroid effects, with aspirin antiplatelet action.
What to do
Consider proton pump inhibitor gastroprotection in at-risk patients and monitor for GI bleeding. Use the lowest effective doses for the shortest time.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
Frequently asked questions
Can I take Aspirin / citric acid / sodium bicarbonate with Hydrocortisone?
MediHelp rates the interaction as moderate. Aspirin / citric acid / sodium bicarbonate and Hydrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Corticosteroids and aspirin together increase the risk of peptic ulcer and gastrointestinal bleeding. Buffering with bicarbonate and citric acid does not remove the systemic mucosal and antiplatelet effects of aspirin.
How serious is the interaction between Aspirin / citric acid / sodium bicarbonate and Hydrocortisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider proton pump inhibitor gastroprotection in at-risk patients and monitor for GI bleeding. Use the lowest effective doses for the shortest time.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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