omeprazole and sodium bicarbonate

Generic Name: omeprazole and sodium bicarbonate (oh ME pray zol and SO dee um by KAR bon ate)
Brand Name: Zegerid, Zegerid OTC

What is omeprazole and sodium bicarbonate?

Omeprazole is a proton pump inhibitor that decreases the amount of acid your stomach produces. Sodium bicarbonate is an antacid that raises the pH in your stomach to keep the omeprazole from breaking down in stomach acid.

Omeprazole and sodium bicarbonate is a combination medicine used to treat heartburn and other symptoms of gastroesophageal reflux disease (GERD). This medicine is also used to treat ulcers and other conditions involving excessive stomach acid production.

Omeprazole and sodium bicarbonate is not for immediate relief of heartburn symptoms.

Omeprazole and sodium bicarbonate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about omeprazole and sodium bicarbonate?

Omeprazole and sodium bicarbonate is a combination medicine used to treat heartburn and other symptoms of gastroesophageal reflux disease (GERD). This medicine is also used to treat ulcers and other conditions involving excessive stomach acid production. Symptom relief does not mean that serious stomach problems (like cancer) do not exist. Talk to your doctor if old stomach symptoms return or new symptoms appear.

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

This medication contains sodium bicarbonate, a form of salt. If you are on a low-salt or low-sodium diet, you may not be able to use omeprazole and sodium bicarbonate. Talk with your doctor.

This medication can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking omeprazole and sodium bicarbonate and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

What should I discuss with my health care provider before taking omeprazole and sodium bicarbonate?

Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

You should not take this medication if you are allergic to omeprazole or sodium bicarbonate.

This medicine contains sodium bicarbonate, a form of salt. Each capsule contains the equivalent of 300 mg of sodium. Each packet of powder contains the equivalent of 460 mg of sodium. If you are on a low-salt or low-sodium diet, you may not be able to use omeprazole and sodium bicarbonate. Talk with your doctor.

To make sure this medicine is safe for you, tell your doctor if you have:

  • kidney or liver disease;

  • heart disease;

  • metabolic or respiratory alkalosis (usually after prolonged illness); or

  • low levels of calcium, magnesium, or potassium levels in your blood.

Some people taking omeprazole may have an increased risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people taking omeprazole long term or at high doses, and in people who are age 50 and older. Omeprazole may not be the actual cause of increased fracture risk. Before you take this medication, tell your doctor if you have a bone disorder.

Some conditions are treated with a combination of antibiotics with omeprazole and sodium bicarbonate. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

FDA pregnancy category C. It is not known whether omeprazole and sodium bicarbonate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Omeprazole and sodium bicarbonate can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take omeprazole and sodium bicarbonate?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine on an empty stomach, at least 1 hour before eating a meal. If this medicine is given to a person who is fed through a nasogastric (NG) tube, the feeding should be stopped at least 3 hours before giving the medicine. Do not restart nasogastric feeding for at least 1 hour after giving omeprazole and sodium bicarbonate.

Take the omeprazole and sodium bicarbonate capsule with a full glass of water. Do not use any other type of liquid or food.

Do not open the capsule or empty the medicine powder from it. Swallow the capsule whole.

To use the powder form, open a packet and pour all of the powder into a small cup with 1 or 2 tablespoons of water. Do not use any other type of liquid. Stir the mixture and drink it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

The 20-mg and the 40-mg forms of this medicine contain the same strength of sodium bicarbonate. Do not use two 20-mg capsules to equal one 40-mg capsule. Do not use two 20-mg powder packets to equal one 40-mg powder packet. If you do not use the exact capsule or powder packet your doctor has prescribed, you may receive too much sodium bicarbonate.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking omeprazole and sodium bicarbonate?

This medication can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking omeprazole and sodium bicarbonate and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid taking this medicine with milk if you use omeprazole and sodium bicarbonate long-term.

Omeprazole and sodium bicarbonate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • stiffness or loss of movement in any part of your body;

  • diarrhea that is watery or bloody;

  • fast or slow heartbeats;

  • seizure (convulsions); or

  • low magnesium (dizziness, confusion, fast or uneven heart rate, jerking muscle movements, jittery feeling, muscle cramps, muscle weakness or limp feeling, cough or choking feeling).

Common side effects may include:

  • headache;

  • nausea, stomach pain, gas; or

  • mild diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Omeprazole and sodium bicarbonate dosing information

Usual Adult Dose for Duodenal Ulcer:

Short-term treatment of active duodenal ulcer: 20 mg orally once daily for 4 weeks.

Usual Adult Dose for Gastric Ulcer:

Benign gastric ulcer: 40 mg orally once daily for 4 to 8 weeks.

Usual Adult Dose for Gastroesophageal Reflux Disease:

Symptomatic GERD without esophageal erosions: 20 mg orally once daily for up to 4 weeks.

Usual Adult Dose for Erosive Esophagitis:

Endoscopically diagnosed erosive esophagitis: 20 mg orally once daily for 4 to 8 weeks.

Maintenance of healing of erosive esophagitis: 20 mg orally once daily.

Usual Adult Dose for Gastrointestinal Hemorrhage:

Reduction of risk of upper gastrointestinal bleeding in critically ill patients (40 mg oral suspension only): 40 mg orally followed by 40 mg six to eight hours later, and 40 mg daily thereafter for 14 days.

Usual Pediatric Dose for Duodenal Ulcer:

Omeprazole-sodium bicarbonate has not received FDA approval for use in children despite an approved dosage for omeprazole in children and considering that omeprazole has been used safely in children as an extemporaneous formulation with sodium bicarbonate. Although not FDA approved, the following dosage is recommended for GERD, ulcers, and esophagitis:

5 kg to less than 10 kg: 5 mg once daily

10 kg to less than or equal to 20 kg: 10 mg once daily

greater than or equal to 20 kg: 20 mg once daily

Alternate dosing: 1 mg/kg/day once or twice daily; range of effective doses in the literature: 0.2 to 3.5 mg/kg/day. Higher doses may be necessary for children between 1 to 6 years of age due to increased metabolic clearance. To maintain gastric pH greater than 5 in critically ill children, administration every 6 to 8 hours may be necessary (1.5 to 2 mg/kg/day).

Usual Pediatric Dose for Gastric Ulcer:

Omeprazole-sodium bicarbonate has not received FDA approval for use in children despite an approved dosage for omeprazole in children and considering that omeprazole has been used safely in children as an extemporaneous formulation with sodium bicarbonate. Although not FDA approved, the following dosage is recommended for GERD, ulcers, and esophagitis:

5 kg to less than 10 kg: 5 mg once daily

10 kg to less than or equal to 20 kg: 10 mg once daily

greater than or equal to 20 kg: 20 mg once daily

Alternate dosing: 1 mg/kg/day once or twice daily; range of effective doses in the literature: 0.2 to 3.5 mg/kg/day. Higher doses may be necessary for children between 1 to 6 years of age due to increased metabolic clearance. To maintain gastric pH greater than 5 in critically ill children, administration every 6 to 8 hours may be necessary (1.5 to 2 mg/kg/day).

Usual Pediatric Dose for Gastroesophageal Reflux Disease:

Omeprazole-sodium bicarbonate has not received FDA approval for use in children despite an approved dosage for omeprazole in children and considering that omeprazole has been used safely in children as an extemporaneous formulation with sodium bicarbonate. Although not FDA approved, the following dosage is recommended for GERD, ulcers, and esophagitis:

5 kg to less than 10 kg: 5 mg once daily

10 kg to less than or equal to 20 kg: 10 mg once daily

greater than or equal to 20 kg: 20 mg once daily

Alternate dosing: 1 mg/kg/day once or twice daily; range of effective doses in the literature: 0.2 to 3.5 mg/kg/day. Higher doses may be necessary for children between 1 to 6 years of age due to increased metabolic clearance. To maintain gastric pH greater than 5 in critically ill children, administration every 6 to 8 hours may be necessary (1.5 to 2 mg/kg/day).

What other drugs will affect omeprazole and sodium bicarbonate?

Omeprazole and sodium bicarbonate can change the way your body absorbs or eliminates certain other drugs. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with omeprazole and sodium bicarbonate, especially:

  • bosentan;

  • citalopram;

  • clopidogrel;

  • cyclosporine;

  • diazepam (Valium) or similar sedatives;

  • digoxin, digitalis;

  • disulfiram, Antabuse;

  • methotrexate;

  • rifabutin, rifampin, rifapentine;

  • sodium polystyrene sulfonate;

  • St. John's wort;

  • tacrolimus;

  • an antibiotic--ampicillin, clarithromycin, nafcillin, rifampin;

  • an antifungal medicine--ketoconazole, voriconazole;

  • a blood thinner such as warfarin, Coumadin;

  • calcium supplements or iron supplements (including ferrous fumarate, ferrous gluconate, ferrous sulfonate);

  • a diuretic or "water pill";

  • HIV medicine--atazanavir, efavirenz, nelfinavir, nevirapine, rilpivirine, ritonavir, saquinavir; or

  • seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone.

This list is not complete and other drugs may interact with omeprazole and sodium bicarbonate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about omeprazole and sodium bicarbonate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.03. Revision Date: 2013-02-14, 12:03:26 PM.

Hide
(web2)