Omeprazole Sodium Bicarbonate: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Omeprazole/sodium bicarbonate is a combination medication used to manage conditions caused by excess stomach acid, such as gastroesophageal reflux disease (GERD), peptic ulcers, and heartburn. Omeprazole, a proton pump inhibitor (PPI), works by reducing the production of stomach acid, while sodium bicarbonate, an antacid, helps neutralize existing acid. This medication is available in different strengths and forms. Always consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Zegerid (Omeprazole/sodium bicarbonate)

The generic name refers to the active ingredients in the medication. In this case, the generic name is listed in parentheses.

Pharmacologic Category

Proton Pump Inhibitors (PPIs)

Antacids

Omeprazole Sodium Bicarbonate Dosage

Omeprazole/sodium bicarbonate is used to treat various conditions, and the dosage may differ depending on the specific condition. Always consult your healthcare provider before making any changes to your dose. You can also consult one of our providers through telemedicine for further guidance.

1. Gastroesophageal Reflux Disease (GERD): 20 mg/1100 mg or 40 mg/1100 mg once daily for 4-8 weeks.
2. Peptic Ulcer Disease: 40 mg/1100 mg once daily for 4-8 weeks.
3. Zollinger-Ellison Syndrome: 60 mg/1100 mg once daily, with adjustments based on response.
4. Erosive Esophagitis: 20 mg/1100 mg or 40 mg/1100 mg once daily for 4-8 weeks.
5. Heartburn: 20 mg/1100 mg once daily for up to 14 days.
6. Dyspepsia: 20 mg/1100 mg once daily for 4-8 weeks.
7. Gastritis: 20 mg/1100 mg once daily for 4-8 weeks.
8. Barrett’s Esophagus: 40 mg/1100 mg once daily, with long-term treatment potentially required.
9. Helicobacter pylori Eradication: 40 mg/1100 mg twice daily for 10-14 days, in combination with antibiotics.
10. Stomach Ulcers: 40 mg/1100 mg once daily for 4-8 weeks.

Dosage Forms and Strengths

Omeprazole/sodium bicarbonate is available in the following forms:

1. Capsules: 20 mg/1100 mg, 40 mg/1100 mg
2. Powder for Oral Suspension: 20 mg/1680 mg, 40 mg/1680 mg

Administration Instructions

Take Omeprazole/sodium bicarbonate on an empty stomach, at least one hour before a meal. Swallow the capsules whole; do not crush or chew them. If using the powder form, mix it with water and drink immediately. Do not substitute other liquids. Always follow your healthcare provider’s instructions for proper use. If you miss a dose, take it as soon as you remember, but skip it if it’s almost time for your next dose. Never take two doses at once.

Omeprazole Sodium Bicarbonate Side Effects

Like all medications, Omeprazole/sodium bicarbonate may cause side effects. Most are mild, but some can be more serious. If you experience severe symptoms, contact your healthcare provider immediately.

1. Common (1-10%): Headache, nausea, diarrhea, stomach pain, gas.
2. Less Common (0.1-1%): Dizziness, dry mouth, constipation, rash.
3. Rare (<0.1%): Severe allergic reactions, kidney problems, low magnesium levels, bone fractures (with long-term use).

Contraindications

A contraindication is a specific condition where a medication should not be used because it may be harmful. If you have any of the following conditions, avoid taking Omeprazole/sodium bicarbonate unless advised otherwise by your healthcare provider.

1. Allergy to Omeprazole or Sodium Bicarbonate: If you have had an allergic reaction to either ingredient, taking this medication could cause serious allergic reactions, including rash, swelling, or difficulty breathing.
2. Metabolic Alkalosis: This condition involves an excess of bicarbonate in the body, leading to an imbalance in blood pH levels. Sodium bicarbonate in this medication could worsen this condition.
3. Severe Hypocalcemia: Low calcium levels can be aggravated by sodium bicarbonate, potentially causing muscle spasms, cramps, or more serious complications like heart issues.
4. Hypokalemia: Low potassium levels can be worsened by sodium bicarbonate, leading to muscle weakness, cramps, or abnormal heart rhythms.
5. Severe Liver Disease: Omeprazole is processed by the liver. If you have severe liver disease, your body may not process the medication effectively, leading to a buildup of the drug.
6. Kidney Disease: Sodium bicarbonate can affect kidney function, especially in people with pre-existing kidney problems, potentially leading to fluid retention or worsening kidney function.

Drug to Drug Interactions

Omeprazole/sodium bicarbonate can interact with other medications, affecting how they work or increasing the risk of side effects. Inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements. Some known interactions include:

1. Clopidogrel (Plavix): Omeprazole may reduce the effectiveness of clopidogrel, a blood thinner used to prevent strokes and heart attacks.
2. Warfarin (Coumadin): Omeprazole can increase the effects of warfarin, raising the risk of bleeding.
3. Diazepam (Valium): Omeprazole can slow down the breakdown of diazepam, leading to increased sedation and drowsiness.
4. Ketoconazole (Nizoral): Omeprazole reduces stomach acid, which can decrease the absorption of ketoconazole, making it less effective.
5. Digoxin (Lanoxin): Omeprazole may increase the absorption of digoxin, potentially leading to toxicity and heart problems.
6. Iron Supplements: Omeprazole can reduce the absorption of iron, potentially leading to iron deficiency or making iron supplements less effective.

Omeprazole/Sodium Bicarbonate in Pregnancy

Is it safe to take Omeprazole/sodium bicarbonate during pregnancy?

Omeprazole is classified as a Category C drug by the FDA for use during pregnancy. This means that while there are no well-controlled studies in pregnant women, animal studies have shown potential risks to the fetus. Sodium bicarbonate, on the other hand, may cause fluid retention, which could pose challenges during pregnancy. It is crucial to consult your healthcare provider before taking Omeprazole/sodium bicarbonate if you are pregnant. Our telemedicine providers are available to help you weigh the potential risks and benefits based on your individual health needs.

Omeprazole/Sodium Bicarbonate While Breastfeeding

Is it safe to take Omeprazole/sodium bicarbonate while breastfeeding?

Omeprazole is excreted in breast milk in small amounts, but its effects on nursing infants have not been thoroughly studied. Sodium bicarbonate may also pass into breast milk. Given that the risks to a breastfeeding infant are not fully understood, it is essential to consult your healthcare provider before using this medication while breastfeeding. Our telemedicine team is here to discuss your options and help you make an informed decision.

Estimated Cost of Omeprazole/Sodium Bicarbonate

The estimated cost of a 30-day supply of Omeprazole/sodium bicarbonate without insurance typically ranges from $30 to $50, depending on the pharmacy and location. With a GoodRX coupon, you may be able to reduce the price to around $20 to $35. Prices can vary, so it’s a good idea to check for discounts and consult your pharmacy for the most accurate pricing.

Possible Alternatives to Omeprazole/Sodium Bicarbonate

If Omeprazole/sodium bicarbonate is not the right option for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these options.

Gastroesophageal Reflux Disease (GERD)

Alternatives include H2 blockers like famotidine (Pepcid) or lifestyle modifications, such as avoiding trigger foods (spicy, acidic, or fatty foods), eating smaller meals, and elevating the head of your bed while sleeping.

Peptic Ulcer Disease

H2 blockers or antibiotics (if the ulcer is caused by H. pylori) may be used. Lifestyle changes, such as reducing NSAID use and avoiding smoking or alcohol, can also be beneficial.

Zollinger-Ellison Syndrome

High-dose proton pump inhibitors (PPIs) like lansoprazole (Prevacid) or pantoprazole (Protonix) may be considered as alternatives. In severe cases, surgical options may also be explored.

Erosive Esophagitis

PPIs like esomeprazole (Nexium) may be recommended, along with lifestyle changes such as weight loss and dietary adjustments.

Heartburn

Over-the-counter antacids like calcium carbonate (Tums) or lifestyle changes, such as avoiding late-night meals and reducing caffeine intake, may provide relief.

Dyspepsia

Antacids or H2 blockers may be used, along with dietary changes like avoiding spicy or fatty foods to help manage symptoms.

Gastritis

H2 blockers or antibiotics (if caused by H. pylori) may be prescribed. Reducing alcohol intake and avoiding NSAIDs can also help alleviate symptoms.

Barrett’s Esophagus

High-dose PPIs or endoscopic treatments may be recommended. Lifestyle changes, such as quitting smoking and losing weight, can also help reduce symptoms and improve outcomes.

Helicobacter Pylori Eradication

A combination of antibiotics and PPIs is typically used to eradicate H. pylori. If antibiotic resistance is a concern, alternative antibiotic regimens may be considered.

Stomach Ulcers

H2 blockers or antibiotics (if caused by H. pylori) may be used. Reducing NSAID use and avoiding smoking or alcohol can also promote healing and prevent recurrence.

Recent Updates on Omeprazole/Sodium Bicarbonate Research

Recent studies have examined the long-term safety of proton pump inhibitors (PPIs) like Omeprazole, particularly their impact on kidney function and bone health. Some research suggests that prolonged use may increase the risk of chronic kidney disease and bone fractures, especially in older adults. However, these risks are generally considered low, and for most patients, the benefits of treatment outweigh the potential risks. Ongoing research is also exploring the role of PPIs in reducing the risk of esophageal cancer in patients with Barrett’s esophagus. As always, it’s important to discuss the risks and benefits of long-term PPI use with your healthcare provider. Our telemedicine providers are available to help you navigate these concerns and make informed decisions about your treatment.

James Kingsley

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