Carbonation and drug interactions?

[Ritalin]

Hola Doctor Steve,

This doesn't rank up there with some of the more pressing questions you've answered, but it was being batted around here at home last night and I can't find an answer by googling it.

Does it make any difference if you take a pill with carbonated water - as opposed to regular tap water.

I'll hang up and listen for your answer.

[Dr Steve]

Hola Doctor Steve,

This doesn't rank up there with some of the more pressing questions you've answered, but it was being batted around here at home last night and I can't find an answer by googling it.

Does it make any difference if you take a pill with carbonated water - as opposed to regular tap water.

I'll hang up and listen for your answer.

<click!>

Carbonation is simply the result of dissolving carbon dioxide (CO2) in water. The CO2 is in equilibrium with H2CO3 which is also called "Carbonic Acid". Carbonic acid can, in theory, change the absorption or elimination of some medications. The only medication I could find concrete evidence on, however (and I'll keep looking), was for nicotine gum:

Drinking coffee and carbonated beverages blocks absorption of nicotine from nicotine polacrilex gum
J. E. Henningfield, A. Radzius, T. M. Cooper and R. R. Clayton
National Institute on Drug Abuse, Addiction Research Center, Baltimore, Md 21224.

Patients failing to obtain benefit from nicotine polacrilex gum in their efforts to quit smoking may be inadvertently blocking nicotine absorption. Effective nicotine absorption depends on the mildly alkaline saliva that is produced when buffering agents in the polacrilex are released along with nicotine as the polacrilex is chewed. We found that intermittent mouth rinsing with coffee or cola, but not distilled water, substantially reduced salivary pH and nicotine absorption. Because many commonly consumed substances were also found to be highly acidic, we recommend that patients do not ingest any substance during or immediately before nicotine polacrilex use.

In general, however, I would suspect this effect to be minimal for most medications.

I'll keep looking and see if I find something interesting out there.


your friend,


Steve

[HBox]

This is a somewhat related question: Is it true that soda, and caffeine in particular, can hinder the absorption of calcium?

[TooLowBrow]

This is a somewhat related question: Is it true that soda, and caffeine in particular, can hinder the absorption of calcium?

drop a tooth into a cup of coke

[RoseBlood]

I've wondered about this myself but never asked anyone. I'm curious what else Dr. Steve might find (if anything). On a related note; I have a naive question: Does the temperature of your drink effect the absorption of any vitamins, supplements or medications you may be taking it with, like hot coffee or tea?

[Dr Steve]

This is a somewhat related question: Is it true that soda, and caffeine in particular, can hinder the absorption of calcium?

Very interesting question!

http://www.ars.usda.gov/research/publications/publications.htm?SEQ_NO_115=193170
shows that a carbonated dairy beverage INCREASED the absorption of calcium

Carbonated drinks, however have been blamed for increased fracture risks, especially in women (which is where this idea comes from). However, in a study from the american journal of clinical nutrition (http://www.ajcn.org/cgi/content/full/74/3/343):

Conclusions: The excess calciuria associated with consumption of carbonated beverages is confined to caffeinated beverages. Acidulant type has no acute effect. Because the caffeine effect is known to be compensated for by reduced calciuria later in the day, we conclude that the net effect of carbonated beverage constituents on calcium economy is negligible. The skeletal effects of carbonated beverage consumption are likely due primarily to milk displacement.

what the hell "milk displacement" is, however, is something I'll have to research a little further.

It turns out that colas are bad for bones, but it's probably due to caffeine and PHOSPHORUS in the drinks, rather than the carbonation itself:
http://www.ajcn.org/cgi/content/abstract/84/4/936

Conclusions: Intake of cola, but not of other carbonated soft drinks, is associated with low BMD in women. Additional research is needed to confirm these findings.

crap, gotta go pick up my kid at school...more later if I can find anything interesting!

[Thebazile78]

Conclusions: The excess calciuria associated with consumption of carbonated beverages is confined to caffeinated beverages. Acidulant type has no acute effect. Because the caffeine effect is known to be compensated for by reduced calciuria later in the day, we conclude that the net effect of carbonated beverage constituents on calcium economy is negligible. The skeletal effects of carbonated beverage consumption are likely due primarily to milk displacement.

what the hell "milk displacement" is, however, is something I'll have to research a little further.....

"Milk displacement" is a fancy way to say that people are drinking soda rather than milk.

So...of COURSE there's a correlation between carbonated beverages and brittle bones. They're just ignoring the other habits.

[Dr Steve]

"Milk displacement" is a fancy way to say that people are drinking soda rather than milk.

So...of COURSE there's a correlation between carbonated beverages and brittle bones. They're just ignoring the other habits.

ha ha! thank you; caught up in the web of jargon myself this time. arrrghhhh, why can't they just say "people don't drink as much milk as they used to?"

[Don Stugots]

cause doctors like to use fancy words.

[FUNKMAN]

there is a country where all they eat is pasta, it's called carbo nation...