Drug · FAERS side-effect profile with label screen

Citric Acid and Aspirin and Bicarbonate side effects: what 329 FDA adverse event reports show

Anhydrous Citric Acid, Aspirin, And Sodium Bicarbonate · 9 reaction terms · 123 drug–reaction co-reports · data 2026-09-14

Drug class

Not stated in label

Label matched

Citric Acid (Soothe Chewable)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

329 reports · 76% serious · 29 with death outcome · 60% female

openFDA FAERS counts, all years, deduplication not applied

Used for

For the relief of Heartburn, acid indigestion, and upset stomach associated with these symptoms.

FDA label, Indications and Usage

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 7 strongest signals

Reporting / coding artifact 5No label text to screen 2

What the badges mean

Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
No label text to screen No validated FDA label was retrievable for this product, so the screen could not run. Disproportionality only.

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 2 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show: hide coding/lab/outcome terms hide indication terms unlabeled only hide PRR-only

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Gastric haemorrhage	9	49.4 25.9–94.1ROR 50.8 · χ² 380 / p 8e-85	45.0 EB05 25.3 · IC025 +2.7 3/3 methods agree	No label text to screen label has no adverse-reaction text	serious PRR 38.8	no trial data cached
Choking	14	45.8 27.4–76.5ROR 47.8 · χ² 570 / p 3e-126	43.3 EB05 27.4 · IC025 +3.3 3/3 methods agree	No label text to screen label has no adverse-reaction text	serious PRR 40.8	no trial data cached
Incorrect drug administration duration	17	37.9 23.8–60.2ROR 39.9 · χ² 575 / p 3e-127	36.5 EB05 24.1 · IC025 +3.4 3/3 methods agree	Reporting / coding artifact	serious PRR 71.3	no trial data cached
Therapeutic response unexpected	23	32.5 21.9–48.2ROR 34.8 · χ² 672 / p 2e-148	31.7 EB05 22.2 · IC025 +3.6 3/3 methods agree	Reporting / coding artifact	serious PRR 29.3 · 100% consumer	no trial data cached
Drug dependence	39	15.2 11.3–20.5ROR 17.1 · χ² 508 / p 7e-113	15.0 EB05 11.3 · IC025 +3.2 3/3 methods agree	Reporting / coding artifact	serious PRR 11.8 · 100% consumer	no trial data cached
Drug administration error	6	12.3 5.5–27.1ROR 12.5 · χ² 51 / p 4e-13	8.7 EB05 3.6 · IC025 +1.3 3/3 methods agree	Reporting / coding artifact	serious PRR 27.3	no trial data cached
Wrong technique in drug usage process	7	12.1 5.8–25.1ROR 12.3 · χ² 61 / p 4e-15	9.0 EB05 4.0 · IC025 +1.5 3/3 methods agree	Reporting / coding artifact	serious PRR 30.3	no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Drug dependence	39	15.2 11.3–20.5ROR 17.1 · χ² 508 / p 7e-113	15.0 EB05 11.3 · IC025 +3.2 3/3 methods agree	Reporting / coding artifact	serious PRR 11.8 · 100% consumer	no trial data cached
Therapeutic response unexpected	23	32.5 21.9–48.2ROR 34.8 · χ² 672 / p 2e-148	31.7 EB05 22.2 · IC025 +3.6 3/3 methods agree	Reporting / coding artifact	serious PRR 29.3 · 100% consumer	no trial data cached
Incorrect drug administration duration	17	37.9 23.8–60.2ROR 39.9 · χ² 575 / p 3e-127	36.5 EB05 24.1 · IC025 +3.4 3/3 methods agree	Reporting / coding artifact	serious PRR 71.3	no trial data cached
Choking	14	45.8 27.4–76.5ROR 47.8 · χ² 570 / p 3e-126	43.3 EB05 27.4 · IC025 +3.3 3/3 methods agree	No label text to screen label has no adverse-reaction text	serious PRR 40.8	no trial data cached
Gastric haemorrhage	9	49.4 25.9–94.1ROR 50.8 · χ² 380 / p 8e-85	45.0 EB05 25.3 · IC025 +2.7 3/3 methods agree	No label text to screen label has no adverse-reaction text	serious PRR 38.8	no trial data cached
Wrong technique in drug usage process	7	12.1 5.8–25.1ROR 12.3 · χ² 61 / p 4e-15	9.0 EB05 4.0 · IC025 +1.5 3/3 methods agree	Reporting / coding artifact	serious PRR 30.3	no trial data cached
Drug administration error	6	12.3 5.5–27.1ROR 12.5 · χ² 51 / p 4e-13	8.7 EB05 3.6 · IC025 +1.3 3/3 methods agree	Reporting / coding artifact	serious PRR 27.3	no trial data cached
Dependence	4	4.6 1.7–12.1ROR 4.6 · χ² 8 / p 0.002	3.3 EB05 1.4 · IC025 -0.1 PRR-only: not supported by EBGM or IC	No label text to screen label has no adverse-reaction text	serious PRR 3.5	no trial data cached
Product taste abnormal	4	18.9 7.1–50.1ROR 19.1 · χ² 51 / p 4e-13	12.9 EB05 3.6 · IC025 +0.9 3/3 methods agree	Reporting / coding artifact	serious n=3	no trial data cached

Unlabeled candidate signals

Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Zoledronic acid (bisphosphonates) ↔ Osteonecrosis of the jaw.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Citric Acid and Aspirin and Bicarbonate?

In FDA FAERS, the most frequently co-reported reaction terms for Citric Acid and Aspirin and Bicarbonate are choking, gastric haemorrhage, dependence. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Citric Acid and Aspirin and Bicarbonate have an FDA boxed warning?

No. The FDA label retrieved for Citric Acid and Aspirin and Bicarbonate has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Citric Acid and Aspirin and Bicarbonate causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

FDA label via openFDA (set ID 04a27a71-b7b2-12aa-e063-6294a90a312f, effective 20250115; matched on openfda.generic_name.exact:"CITRIC ACID")
Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA count= aggregation, field patient.drug.openfda.generic_name.exact, 9 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction
Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
Seriousness and sex counts from openFDA count=serious, patient.patientsex, seriousnessdeath

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.