People’s Pharmacy: Don’t blow your stomach out with baking soda

Q. Although it says right on the package of baking soda that you can use it for heartburn, if you choose to use it, you must follow the directions exactly.

My husband had chronic indigestion due to an ulcer. He insisted this could be treated with baking soda, but he was not careful.

He drank much more baking soda in water than you’re supposed to, and he didn’t dissolve it first. Eventually, it made him throw up, so he took more to counteract that.

When he landed in the hospital, his potassium level was 1.9, the lowest the emergency room doctors had ever seen. His electrolytes are still messed up. That’s why, if you want to use baking soda, I think Alka Seltzer is safer because the dose is regulated.

A. Taking large doses of sodium bicarbonate (baking soda) can be dangerous, as your husband discovered. This is especially true if the baking soda is not fully dissolved before it is swallowed.

In addition to the scary drop in potassium (hypokalemia), there is the risk of a ruptured stomach. When excess bicarbonate interacts with stomach acid, it creates a lot of gas (carbon dioxide). In some cases, people who have taken a large dose on a full stomach have blown a hole in their stomachs (Annals of Internal Medicine, November 1984).

For more information on using baking soda safely and many other strategies to manage indigestion, you may wish to consult our “eGuide to Overcoming Digestive Disorders.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I’ve made it my practice to check my prescriptions at the pharmacy counter before I pay. Because you’ve recommended this, you may want to know my requests are always met with disdain, regardless of the pharmacy chain or location.

The feeling I am left with is that my request has no merit and only serves to slow down the transaction. Is this precaution so unusual?

A. Your request to double-check your prescription before leaving the pharmacy counter is neither unusual nor inappropriate. In fact, we encourage everyone to do this.

Most people count their money before leaving an ATM machine or a bank window. They should be as careful with their medicine as they are with their money.

Q. After reading your article on itching and Zyrtec, I threw away this antihistamine. I’d had unexplained itching for several years, and your article allowed me to finally connect my itching with the cause, stopping the medication.

After discontinuing Zyrtec cold turkey, I lived through a lot of itching. It’s been more than a month now and the itching has subsided almost entirely.

A. We have heard from hundreds of readers who have experienced challenging itching when they stop cetirizine (Zyrtec) or levocetirizine (Xyzal). This reaction has been described in some detail in the journal Therapeutic Advances in Drug Safety (July 5, 2019).

The authors, affiliated with the Food and Drug Administration, describe 146 cases of unbearable itching after cetirizine discontinuation. They conclude, “Patients and prescribers should have knowledge of this adverse event, given the widespread use and availability of cetirizine, and potential impact on patient quality of life.” We wish that the label on nonprescription packaging made this risk clear.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”