omeprazole and sodium bicarbonate (Oral route)

oh-MEP-ra-zole, SOE-dee-um bye-KAR-bo-nate

Commonly used brand name(s)

In the U.S.

  • Zegerid

Available Dosage Forms:

  • Packet
  • Capsule

Therapeutic Class: Gastric Acid Secretion Inhibitor

Pharmacologic Class: Proton Pump Inhibitor

Uses For omeprazole and sodium bicarbonate

Omeprazole and sodium bicarbonate combination is used to treat certain conditions where there is too much acid in the stomach. It is used to treat gastric and duodenal ulcers, erosive esophagitis, and gastroesophageal reflux disease (GERD). GERD is a condition where the acid in the stomach washes back up into the esophagus. Sometimes omeprazole and sodium bicarbonate is used in combination with antibiotics (e.g., amoxicillin, clarithromycin) to treat ulcers associated with infection caused by the H. pylori bacteria (germ).

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

Omeprazole and sodium bicarbonate combination is used to prevent upper gastrointestinal tract bleeding in seriously ill patients.

Omeprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid produced by the stomach.

Sodium bicarbonate, also known as baking soda, is an antacid. It works by neutralizing the excess acid in the stomach.

omeprazole and sodium bicarbonate is available only with your doctor's prescription.

Before Using omeprazole and sodium bicarbonate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For omeprazole and sodium bicarbonate, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to omeprazole and sodium bicarbonate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of omeprazole and sodium bicarbonate combination in children. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of omeprazole and sodium bicarbonate combination in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking omeprazole and sodium bicarbonate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using omeprazole and sodium bicarbonate with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rilpivirine

Using omeprazole and sodium bicarbonate with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Bendamustine
  • Bosutinib
  • Citalopram
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Dabrafenib
  • Dasatinib
  • Delavirdine
  • Elvitegravir
  • Erlotinib
  • Eslicarbazepine Acetate
  • Indinavir
  • Ketoconazole
  • Methotrexate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Nilotinib
  • Pazopanib
  • Ponatinib
  • Saquinavir
  • Tacrolimus
  • Topotecan
  • Vismodegib

Using omeprazole and sodium bicarbonate with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Armodafinil
  • Carbamazepine
  • Cholic Acid
  • Cilostazol
  • Cranberry
  • Dasatinib
  • Digoxin
  • Disulfiram
  • Fluconazole
  • Ginkgo Biloba
  • Iron
  • Raltegravir
  • St John's Wort
  • Tipranavir
  • Triazolam
  • Voriconazole
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of omeprazole and sodium bicarbonate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bartter's syndrome (rare kidney problem) or
  • Diarrhea or
  • Hypokalemia (low potassium in the blood) or
  • Hypomagnesemia (low magnesium in the blood), history of or
  • Osteoporosis (bone problem) or
  • Respiratory alkalosis (low levels of carbon dioxide in the blood) or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Liver disease—You may need a dose adjustment. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of omeprazole and sodium bicarbonate

Take omeprazole and sodium bicarbonate only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Do not stop taking omeprazole and sodium bicarbonate if your doctor told you to take it for a specific amount of time, even if you feel better.

omeprazole and sodium bicarbonate comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions.

omeprazole and sodium bicarbonate contains sodium (salt). Talk to your doctor before using omeprazole and sodium bicarbonate if you are on a low-sodium (low-salt) diet or if you have or are at risk for congestive heart failure.

Tell your doctor if you are taking calcium supplements on a regular basis.

Both 20 and 40 milligrams oral suspension packets or capsules contain the same amount of sodium bicarbonate. Do not substitute two 20 milligrams (mg) oral suspension packets or capsules with one 40 mg oral suspension packets or capsules. Talk to your doctor if you have any questions.

Take omeprazole and sodium bicarbonate on an empty stomach at least 1 hour before a meal. For patients receiving continuous feeding through a tube, feeding should be temporarily stopped about 3 hours before and 1 hour after administration of Zegerid® powder for oral suspension.

Swallow the capsules whole with water. Do not take it with other liquids. Do not break, crush, or chew it. Do not open the capsule and sprinkle the contents into food.

To use the powder for oral suspension:

  • Empty packet of powder into a small cup containing 1 to 2 tablespoons of water.
  • Do not use other liquids or foods.
  • Stir well and drink immediately.
  • Refill cup with water and drink.

If you are using the powder for oral suspension with a nasogastric or orogastric tube:

  • Mix the packet of powder with approximately 20 mL of water.
  • Stir well and draw up into appropriately sized syringe.
  • Give the medicine through the nasogastric or orogastric tube into the stomach right away.
  • Refill the syringe with an equal amount of water.
  • Shake and flush any remaining contents from the nasogastric or orogastric tube into the stomach.

Dosing

The dose of omeprazole and sodium bicarbonate will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of omeprazole and sodium bicarbonate. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or powder for suspension):
    • To treat duodenal ulcers, erosive esophagitis, and GERD:
      • Adults—20 milligrams (mg) once a day at least 1 hour before a meal. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • To treat gastric ulcers:
      • Adults—40 milligrams (mg) once a day at least 1 hour before a meal. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (powder for suspension):
    • To prevent upper gastrointestinal tract bleeding in seriously ill patients:
      • Adults—The first day: 40 milligrams (mg) for the first dose; then after 6 to 8 hours, a second 40 mg dose. After the first day: 40 mg once a day for up to 14 days.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of omeprazole and sodium bicarbonate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using omeprazole and sodium bicarbonate

It is important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and other laboratory tests may be needed to check for unwanted effects. If your condition does not improve, or if it becomes worse, check with your doctor.

Tell your doctor if you have Asian relatives, such as Filipino, Chinese, Japanese, Korean, or Taiwanese. You may need a lower dose of omeprazole and sodium bicarbonate to treat erosive esophagitis.

omeprazole and sodium bicarbonate is sometimes given together with other medicines to treat ulcers. Be sure you understand about the risks and proper use of any other medicine your doctor gives you together with omeprazole and sodium bicarbonate combination.

Atrophic gastritis (inflammation in the stomach) may occur, especially if you take omeprazole and sodium bicarbonate for a long time. Talk with your doctor if you have concerns about this.

omeprazole and sodium bicarbonate may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you receive high doses of omeprazole and sodium bicarbonate or use it for one year or more.

omeprazole and sodium bicarbonate may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking omeprazole and sodium bicarbonate for more than one year, or if you are taking omeprazole and sodium bicarbonate together with digoxin (Lanoxin®) or certain diuretics or "water pills". Stop using omeprazole and sodium bicarbonate and check with your doctor right away if you have convulsions (seizures); fast, racing, or uneven heartbeat; muscle spasms (tetany); tremors; or unusual tiredness or weakness.

Check with your doctor right away if you have watery stool that does not go away, stomach pain, and fever while taking omeprazole and sodium bicarbonate.

Do not stop taking omeprazole and sodium bicarbonate without first checking with your doctor, or unless told to do so by your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

omeprazole and sodium bicarbonate Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • confusion
  • convulsions
  • cough
  • decreased urine
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • fainting
  • fast or irregular heartbeat
  • fever or chills
  • headache
  • increased thirst
  • lightheadedness
  • loss of appetite
  • mood or mental changes
  • muscle pain or cramps
  • muscle spasms (tetany) or twitching
  • nausea or vomiting
  • nervousness
  • numbness or tingling in the hands, feet, or lips
  • pale skin
  • pinpoint red spots on the skin
  • pounding in the ears
  • rapid, shallow breathing
  • seizures
  • shortness of breath
  • slow heartbeat
  • sneezing
  • sore throat
  • sweating
  • tightness in the chest
  • trembling
  • troubled breathing
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • wheezing
Less common
  • Abdominal or stomach cramps or pain
  • bladder pain
  • blue lips, fingernails, or skin
  • bone pain
  • chest discomfort
  • cloudy urine
  • coma
  • decreased urine output
  • difficult or troubled breathing
  • difficult, burning, or painful urination
  • fast, pounding, or irregular heartbeat or pulse
  • frequent urge to urinate
  • headache
  • high blood pressure
  • irregular, fast or slow, or shallow breathing
  • irritability
  • lower back or side pain
  • muscle cramps in the hands, arms, feet, legs, or face
  • restlessness
  • swelling
  • swelling of the face, feet, lower legs, ankles, or hands
  • weakness or heaviness of the legs
Rare
  • Severe pain in the chest
  • sudden onset of severe breathing difficulty
Incidence not known
  • Arm, back, or jaw pain
  • blistering, peeling, or loosening of the skin
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • chest tightness or heaviness
  • constipation
  • cough or hoarseness
  • dark-colored urine
  • diarrhea
  • difficulty with swallowing
  • fever with or without chills
  • general body swelling
  • general feeling of tiredness or weakness
  • greatly decreased frequency of urination or amount of urine
  • high fever
  • hives
  • indigestion
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • noisy breathing
  • nosebleeds
  • pain with swallowing
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid weight gain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • skin rash
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain, continuing
  • sweating
  • swollen glands
  • unexplained bleeding or bruising
  • unusual weight gain or loss
  • weight gain
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Feeling of warmth
  • increased sweating
  • redness of the face, neck, arms, and occasionally, upper chest

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Agitation
  • anxiety
  • cold sweats
  • cool, pale skin
  • depression
  • excess air or gas in the stomach or intestines
  • flushed, dry skin
  • fruit-like breath odor
  • full feeling
  • increased hunger
  • increased thirst
  • increased urination
  • lack or loss of strength
  • nightmares
  • passing gas
  • shakiness
  • slurred speech
  • white patches in the mouth or throat or on the tongue
  • white patches with diaper rash
Incidence not known
  • Abnormal dreams
  • attack, assault, or force
  • bad, unusual, or unpleasant (after) taste
  • blindness
  • blue-yellow color blindness
  • change in taste
  • continuing ringing or buzzing or other unexplained noise in the ears
  • decreased vision
  • double vision
  • dry eyes or skin
  • eye pain
  • feeling of constant movement of self or surroundings
  • general feeling of discomfort or illness
  • hair loss or thinning of the hair
  • hearing loss
  • hives or welts
  • increased sensitivity of the skin to sunlight
  • itching, redness, tearing, or other sign of eye irritation not present before use of omeprazole and sodium bicarbonate or becoming worse during use
  • lack of feeling or emotion
  • pain in the testes
  • pinpoint red or purple spots on the skin
  • redness or other discoloration of the skin
  • seeing, hearing, or feeling things that are not there
  • sensation of spinning
  • severe sunburn
  • sleepiness or unusual drowsiness
  • sleeplessness
  • sugar in the urine
  • swelling of the breasts or breast soreness in both females and males
  • swelling or inflammation of the mouth
  • trouble sleeping
  • unable to sleep
  • uncaring

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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