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Zegerid Side Effects

Please note - some side effects for Zegerid may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Zegerid - for the Consumer

Zegerid

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Zegerid:

Diarrhea; gas; headache; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Zegerid:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bone pain; chest pain; dark urine; fast, slow, or irregular heartbeat; fever, chills, or sore throat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; severe stomach pain or cramps; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual or sudden weight increase; unusual tiredness; vision changes; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Zegerid OTC

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Zegerid OTC:

Diarrhea; gas; headache; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Zegerid OTC:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bone pain; chest pain; dark urine; fast, slow, or irregular heartbeat; fever, chills, or sore throat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; severe stomach pain or cramps; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual or sudden weight increase; unusual tiredness; vision changes; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Zegerid Powder Packets

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Zegerid Powder Packets:

Diarrhea; gas; headache; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Zegerid Powder Packets:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bone pain; chest pain; dark urine; fast, slow, or irregular heartbeat; fever, chills, or sore throat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; severe stomach pain or cramps; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual or sudden weight increase; unusual tiredness; vision changes; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

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Zegerid Side Effects - for the Professional

Zegerid

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

In the U.S. clinical trial population of 465 patients, the adverse reactions summarized in Table 2 were reported to occur in 1% or more of patients on therapy with omeprazole. Numbers in parentheses indicate percentages of the adverse reactions considered by investigators as possibly, probably or definitely related to the drug.

Table 2: Adverse Reactions Occurring In 1% or More of Patients on Omeprazole Therapy
Omeprazole
(n = 465)
Placebo
(n = 64)
Ranitidine
(n = 195)
Headache 6.9 (2.4) 6.3 7.7 (2.6)
Diarrhea 3.0 (1.9) 3.1 (1.6) 2.1 (0.5)
Abdominal Pain 2.4 (0.4) 3.1 2.1
Nausea 2.2 (0.9) 3.1 4.1 (0.5)
URI 1.9 1.6 2.6
Dizziness 1.5 (0.6) 0.0 2.6 (1.0)
Vomiting 1.5 (0.4) 4.7 1.5 (0.5)
Rash 1.5 (1.1) 0.0 0.0
Constipation 1.1 (0.9) 0.0 0.0
Cough 1.1 0.0 1.5
Asthenia 1.1 (0.2) 1.6 (1.6) 1.5 (1.0)
Back Pain 1.1 0.0 0.5

Table 3 summarizes the adverse reactions that occurred in 1% or more of omeprazole-treated patients from international double-blind, and open-label clinical trials in which 2,631 patients and subjects received omeprazole.

Table 3: Incidence of Adverse Reactions ≥ 1% Causal Relationship not Assessed
Omeprazole
(n = 2631)
Placebo
(n = 120)
Body as a Whole, site unspecified
     Abdominal pain 5.2 3.3
     Asthenia 1.3 0.8
Digestive System
     Constipation 1.5 0.8
     Diarrhea 3.7 2.5
     Flatulence 2.7 5.8
     Nausea 4.0 6.7
     Vomiting 3.2 10.0
     Acid regurgitation 1.9 3.3
Nervous System/Psychiatric
     Headache 2.9 2.5

A controlled clinical trial was conducted in 359 critically ill patients, comparing Zegerid 40 mg/1680 mg suspension once daily to I.V. cimetidine 1200 mg/day for up to 14 days. The incidence and total number of AEs experienced by ≥ 3% of patients in either group are presented in Table 4 by body system and preferred term.

Table 4: Number (%) of Critically Ill Patients with Frequently Occurring (≥ 3%) Adverse Events by Body System and Preferred Term

* Clinically significant upper gastrointestinal bleeding was considered a serious adverse event but it is not included in this table.

NOS = Not otherwise specified.

Zegerid®
(N=178)
Cimetidine
(N=181)
MedDRA
Body System
     Preferred Term
All AEs
n (%)
All AEs
n (%)
BLOOD AND LYMPHATIC SYSTEM DISORDERS
     Anemia NOS 14 (7.9) 14 (7.7)
     Anemia NOS Aggravated 4 (2.2) 7 (3.9)
     Thrombocytopenia 18 (10.1) 11 (6.1)
CARDIAC DISORDERS
     Atrial Fibrillation 11 (6.2) 7 (3.9)
     Bradycardia NOS 7 (3.9) 5 (2.8)
     Supraventricular Tachycardia 6 (3.4) 2 (1.1)
     Tachycardia NOS 6 (3.4) 6 (3.3)
     Ventricular Tachycardia 8 (4.5) 6 (3.3)
GASTROINTESTINAL DISORDERS *
     Constipation 8 (4.5) 8 (4.4)
     Diarrhea NOS 7 (3.9) 15 (8.3)
     Gastric Hypomotility 3 (1.7) 6 (3.3)
GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS
     Hyperpyrexia 8 (4.5) 3 (1.7)
     Edema NOS 5 (2.8) 11 (6.1)
     Pyrexia 36 (20.2) 29 (16.0)
INFECTIONS AND INFESTATIONS
     Candidal Infection NOS 3 (1.7) 7 (3.9)
     Oral Candidiasis 7 (3.9) 1 (0.6)
     Sepsis NOS 9 (5.1) 9 (5.0)
     Urinary Tract Infection NOS 4 (2.2) 6 (3.3)
INVESTIGATIONS
     Liver Function Tests NOS Abnormal 3 (1.7) 6 (3.3)
METABOLISM AND NUTRITION DISORDERS
     Fluid Overload 9 (5.1) 14 (7.7)
     Hyperglycaemia NOS 19 (10.7) 21 (11.6)
     Hyperkalaemia 4 (2.2) 6 (3.3)
     Hypernatraemia 3 (1.7) 9 (5.0)
     Hypocalcaemia 11 (6.2) 10 (5.5)
     Hypoglycaemia NOS 6 (3.4) 8 (4.4)
     Hypokalaemia 22 (12.4) 24 (13.3)
     Hypomagnesaemia 18 (10.1) 18 (9.9)
     Hyponatraemia 7 (3.9) 5 (2.8)
     Hypophosphataemia 11 (6.2) 7 (3.9)
PSYCHIATRIC DISORDERS
     Agitation 6 (3.4) 16 (8.8)
RESPIRATORY, THORACIC AND MEDIASTINAL DISORDERS
     Acute Respiratory Distress Syndrome 6 (3.4) 7 (3.9)
     Nosocomial Pneumonia 20 (11.2) 17 (9.4)
     Pneumothorax NOS 1 (0.6) 8 (4.4)
     Respiratory Failure 3 (1.7) 6 (3.3)
SKIN AND SUBCUTANEOUS TISSUE DISORDERS
     Decubitus Ulcer 6 (3.4) 5 (2.8)
     Rash NOS 10 (5.6) 11 (6.1)
VASCULAR DISORDERS
     Hypertension NOS 14 (7.9) 6 (3.3)
     Hypotension NOS 17 (9.6) 12 (6.6)

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of omeprazole. Because these reactions are voluntarily reported from a population of uncertain size, it is not always possible to reliably estimate their actual frequency or establish a causal relationship to drug exposure.

Body as a Whole: Hypersensitivity reactions, including anaphylaxis, anaphylactic shock, angioedema, bronchospasm, interstitial nephritis, urticaria, fever, pain, fatigue, malaise.

Cardiovascular: Chest pain or angina, tachycardia, bradycardia, palpitation, elevated blood pressure, and peripheral edema.

Gastrointestinal: Pancreatitis (some fatal), anorexia, irritable colon, flatulence, fecal discoloration, esophageal candidiasis, mucosal atrophy of the tongue, dry mouth, stomatitis and abdominal swelling. During treatment with omeprazole, gastric fundic gland polyps have been noted rarely. These polyps are benign and appear to be reversible when treatment is discontinued. Gastroduodenal carcinoids have been reported in patients with Zollinger-Ellison syndrome on long-term treatment with omeprazole. This finding is believed to be a manifestation of the underlying condition, which is known to be associated with such tumors.

Hepatic: Mild and, rarely, marked elevations of liver function tests [ALT (SGPT), AST (SGOT), γ-glutamyl transpeptidase, alkaline phosphatase, and bilirubin (jaundice)]. In rare instances, overt liver disease has occurred, including hepatocellular, cholestatic, or mixed hepatitis, liver necrosis (some fatal), hepatic failure (some fatal), and hepatic encephalopathy.

Metabolism and Nutritional Disorders: Hyponatremia, hypoglycemia, hypomagnesemia, and weight gain.

Musculoskeletal: Muscle cramps, myalgia, muscle weakness, joint pain, bone fracture, and leg pain.

Nervous System/Psychiatric: Psychic disturbances including depression, agitation, aggression, hallucinations, confusion, insomnia, nervousness, tremors, apathy, somnolence, anxiety, dream abnormalities; vertigo; paresthesia; and hemifacial dysesthesia.

Respiratory: Epistaxis, pharyngeal pain.

Skin: Severe generalized skin reactions including toxic epidermal necrolysis (TEN; some fatal), Stevens-Johnson syndrome, and erythema multiforme (some severe); purpura and/or petechiae (some with rechallenge); skin inflammation, urticaria, angioedema, pruritus, photosensitivity, alopecia, dry skin, and hyperhidrosis.

Special Senses: Tinnitus, taste perversion.

Ocular: Blurred vision, ocular irritation, dry eye syndrome, optic atrophy, anterior ischemic optic neuropathy, optic neuritis and double vision.

Urogenital: Interstitial nephritis (some with positive rechallenge), urinary tract infection, microscopic pyuria, urinary frequency, elevated serum creatinine, proteinuria, hematuria, glycosuria, testicular pain, and gynecomastia.

Hematologic: Rare instances of pancytopenia, agranulocytosis (some fatal), thrombocytopenia, neutropenia, leukopenia, anemia, leucocytosis, and hemolytic anemia have been reported.

The incidence of clinical adverse experiences in patients greater than 65 years of age was similar to that in patients 65 years of age or less.

Additional adverse reactions that could be caused by sodium bicarbonate include metabolic alkalosis, seizures, and tetany.

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Side Effects by Body System - for Healthcare Professionals

Dermatologic

Dermatologic side effects have included rash.

Gastrointestinal

Gastrointestinal side effects have included diarrhea, nausea, constipation, abdominal pain, flatulence, acid regurgitation, and vomiting.

Nervous system

Nervous system side effects have included confusion, dizziness, hypoesthesia, insomnia, migraine aggravation, paresthesia, sleep disorder, somnolence, tremor, vertigo, and seizures.

Musculoskeletal

Musculoskeletal side effects have included asthenia and back pain. Postmarketing reports of increased risk of bone fracture have been reported.

Respiratory

Respiratory side effects have included cough and upper respiratory infection.

Metabolic

FDA warns that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year). Patients who develop hypomagnesemia may experience seizures, dizziness, abnormal or fast heart beat, or skipped heartbeat, jitteriness, jerking movements or tremors, muscle weakness, spasms of the hands and feet, cramps or muscle aches, and spasm of the voice box.

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