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Zegerid OTC Side Effects

Generic Name: omeprazole / sodium bicarbonate

Note: This page contains side effects data for the generic drug omeprazole / sodium bicarbonate. It is possible that some of the dosage forms included below may not apply to the brand name Zegerid OTC.

In Summary

More frequent side effects include: congenital anomalies and abdominal pain. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to omeprazole / sodium bicarbonate: oral capsule, oral packet

As well as its needed effects, omeprazole / sodium bicarbonate may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking omeprazole / sodium bicarbonate, check with your doctor immediately:

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
  • 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
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
  • 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
  • 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 or skin rash
  • 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
  • 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

If any of the following symptoms of overdose occur while taking omeprazole / sodium bicarbonate, get emergency help immediately:

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

Minor Side Effects

Some omeprazole / sodium bicarbonate side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned 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 this medicine 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
  • sugar in the urine
  • swelling of the breasts or breast soreness in both females and males
  • swelling or inflammation of the mouth
  • trouble sleeping
  • uncaring

For Healthcare Professionals

Applies to omeprazole / sodium bicarbonate: oral capsule, oral powder for reconstitution


Very common (10% or more): Pyrexia (Up to 20.2%)
Common (1% to 10%): Hyperpyrexia, candida infection not otherwise specified (NOS), sepsis NOS

Common (1% to 10%): Asthenia
Postmarketing reports: Fever, pain, fatigue, malaise, tinnitus[Ref]


Very common (10% or more): Hypokalemia (Up to 12.4%), hyperglycemia not otherwise specified (NOS) (Up to 10.7%), hypomagnesemia (Up to 10.1%)
Common (1% to 10%): Fluid overload, hyperkalemia, hypernatremia, hypocalcemia, hyponatremia, hypoglycemia NOS, hypophosphatemia

Postmarketing reports: Anorexia, hyponatremia, hypoglycemia, hypomagnesemia, weight gain

Sodium Bicarbonate:
Postmarketing reports: Metabolic acidosis, tetany[Ref]


Very common (10% or more): Nosocomial pneumonia (Up to 11.2%)
Common (1% to 10%): Acute respiratory distress syndrome, respiratory failure
Uncommon (0.1% to 1%): Pneumothorax not otherwise specified (NOS)

Common (1% to 10%): Upper respiratory infection, cough
Postmarketing reports: Bronchospasm, epistaxis, pharyngeal pain[Ref]


Very common (10% or more): Thrombocytopenia (Up to 10.1%)
Common (1% to 10%): Anemia not otherwise specified (NOS), anemia NOS aggravated

Postmarketing reports: Pancytopenia, agranulocytosis/fatal agranulocytosis, thrombocytopenia, neutropenia, leukopenia, anemia, leukocytosis, hemolytic anemia[Ref]


Common (1% to 10%): Atrial fibrillation, bradycardia not otherwise specified (NOS), supraventricular tachycardia, tachycardia NOS, ventricular tachycardia, edema NOS, hypertension NOS, hypotension NOS

Postmarketing reports: Chest pain/angina, tachycardia, bradycardia, palpitation, elevated blood pressure, peripheral edema[Ref]


Common (1% to 10%): Constipation, diarrhea not otherwise specified (NOS), gastric hypomobility, oral candidiasis
Frequency not reported: Upper gastrointestinal bleeding

Common (1% to 10%): Diarrhea, abdominal pain, nausea, vomiting, constipation, flatulence, acid regurgitation
Postmarketing reports: Pancreatitis/fatal pancreatitis, irritable colon, fecal discoloration, esophageal candidiasis, mucosal atrophy of the tongue, dry mouth, stomatitis, abdominal swelling, gastric fundic gland polyps, Clostridium difficile associated diarrhea[Ref]

Benign gastric fundic gland polyps occurred rarely and appeared to be reversible when omeprazole was discontinued.[Ref]


Common (1% to 10%): Decubitus ulcer, rash not otherwise specified (NOS)

Common (1% to 10%): Rash
Postmarketing reports: Urticaria, severe generalized skin reactions, toxic epidermal necrolysis (TEN)/fatal TEN, Steven-Johnson syndrome, erythema multiforme/severe erythema multiforme, purpura and/or petechia with/without rechallenge, skin inflammation, urticaria, pruritus, photosensitivity, alopecia, dry skin, hyperhidrosis[Ref]


Common (1% to 10%): Abnormal liver function tests not otherwise specified (NOS)

Postmarketing reports: Mild to marked elevation of liver function tests (ALT, AST, gamma-glutamyl transpeptidase, alkaline phosphatase), overt liver disease, hepatocellular/cholestatic/mixed hepatitis, liver necrosis/fatal liver necrosis, hepatic failure/fatal hepatic failure[Ref]


Common (1% to 10%): Agitation

Postmarketing reports: Psychiatric disturbances, depression, agitation, aggression, hallucinations, confusion, insomnia, nervousness, apathy, anxiety, abnormal dreams[Ref]


Common (1% to 10%): Urinary tract infection not otherwise specified (NOS)

Postmarketing reports: Urinary tract infection, microscopic pyuria, urinary frequency, proteinuria, hematuria, testicular pain[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness
Postmarketing reports: Hepatic encephalopathy, tremors, somnolence, vertigo, paresthesia, hemifacial dysesthesia, taste perversion

Sodium Bicarbonate:
Postmarketing reports: Seizures[Ref]


Common (1% to 10%): Back pain
Postmarketing reports: Muscle cramps, myalgia, muscle weakness, joint pain, bone fracture, leg pain[Ref]


Postmarketing reports: Blurred vision, ocular irritation, dry eye syndrome, optic atrophy, anterior ischemic optic neuropathy, optic neuritis, double vision[Ref]


Postmarketing reports: Hypersensitivity reactions, anaphylaxis, anaphylactic shock, angioedema[Ref]


Postmarketing reports: Interstitial nephritis with/without positive rechallenge, elevated serum creatinine, glycosuria[Ref]


Gastroduodenal carcinoids have been reported in patients with Zollinger-Ellison syndrome on long-term therapy. This condition may be a manifestation of the underlying condition, which is known to cause tumors.[Ref]

Postmarketing reports: Gastroduodenal carcinoids[Ref]


Postmarketing reports: Gynecomastia[Ref]


1. "Product Information. Zegerid (omeprazole-sodium bicarbonate)." Santarus Inc, San Diego, CA.

It is possible that some side effects of Zegerid OTC may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.