Omeprazole and Sodium Bicarbonate (Oral)

Omeprazole and sodium bicarbonate is a combination medicine that is used to treat conditions that cause a build-up of acid in the stomach, such as gastric ulcers, erosive esophagitis, and gastroesophageal reflux disease (GERD).

Overview

Some of these conditions can cause the excess acid in the stomach to flow back up the esophagus, causing heartburn.

Your gastric system produces acid using special enzymes along the walls of your stomach. Omeprazole works by blocking the action of these enzymes, therefore reducing the amount of acid that your stomach produces. However, one problem is that omeprazole itself is very sensitive to acid and can easily be destroyed in acidic environments. Sodium bicarbonate is used to lower the PH of your stomach, allowing the omeprazole to get to work in reducing acid production.

This medicine is also used to treat stomach infection by the H. pylori bacteria, alongside antibiotics such as amoxicillin or clarithromycin. In such cases, the omeprazole and sodium bicarbonate does not fight the infections itself, but helps treat the ulcers that such infections can cause.

Omeprazole and sodium bicarbonate is not suitable for immediate relief for acute symptoms of heartburn. It may take several days before the drug takes effect and the symptoms are improved.

This medication should be used with caution by people with certain existing medical conditions, including bone problems, liver problems, and gastrointestinal problems. Many medications and supplements interact with omeprazole and sodium bicarbonate in ways that can be dangerous - make sure that your doctor is aware of all medications, vitamins, and herbal supplements that you are presently taking.

Omeprazole and sodium bicarbonate is more commonly known under the brand name Zegerid.

Conditions Treated

  • Duodenal ulcers
  • Erosive esophagitis
  • Gastric ulcers
  • Gastroesophageal reflux disease (GERD)
  • H. pylori bacterial infection
  • Upper gastrointestinal tract bleeding

Type Of Medicine

  • Omeprazole: proton pump inhibitor (PPI)
  • Sodium bicarbonate: antacid

Side Effects

As well as the intended effect of reducing the amount of acid in the stomach, this medication may cause undesired side effects that can be unpleasant or harmful.

Contact your doctor immediately if you experience any of the side effects listed below:

  • Black, tarry, or bloody stools
  • Bleeding or painful gums
  • Blood in the urine
  • Changes to urine output - more or less than usual
  • Chills
  • Coughing
  • Cramps
  • Diarrhea, especially if it is watery, bloody or does not go away
  • Disorientation or confusion
  • Dizziness, faintness or lightheadedness
  • Drowsiness
  • Fever
  • Headache
  • Nausea, sickness, or vomiting
  • Nervousness or anxiety
  • Numbness
  • Pain in the chest
  • Pain in the muscles or joints
  • Pain in the stomach
  • Pale skin
  • Problems with your vision
  • Reduced appetite
  • Ringing or pounding in the ears
  • Shallow breathing
  • Slower than usual heartbeat
  • Small red spots on the skin
  • Sneezing fits
  • Sweating
  • Tingling sensations, especially around the lips, feet or hands
  • Thirst or a dry mouth

Some side effects may occur that are less serious, although they may be unpleasant to experience. Some of these simply disappear after a short period of time as your body adapts to the presence of the medication. However, you should consult your doctor if you experience any of the side effects listed below. They may be able to prescribe you another medication that will remove or reduce the side effect, or they may want to change the dosage of your medication.

  • Agitation
  • Difficulty sleeping, nightmares or strange dreams
  • Dry skin
  • Excess gas
  • Hair loss, or thinner hair
  • Increased appetite
  • Flushing
  • Fruity odor on the breath
  • Lack of emotion / not caring
  • Lowered temperature, cold sweats or cool skin
  • Reduced mood or depression
  • Sensitivity to sunlight / getting sunburn more easily than usual
  • Swelling of the breast or chest area, in women or men

Medications can affect people in unexpected ways and therefore it is not possible to provide a complete list of the potential side effects that you might experience while taking omeprazole and sodium bicarbonate. While you are taking the medication, pay attention to your body and to how you are feeling. If you notice anything out of the ordinary, consult your doctor, especially if you find it worrying or bothersome. In many cases side effects disappear on their own, but you may be given another medication to manage them.

Allergic reaction

Serious allergic reactions to this medication are rare, but they have been reported. Inform your doctor about any allergies that you have, especially if you are allergic to omeprazole, sodium bicarbonate, or any non-active ingredients that are typically added to medications, such as filler materials.

If you notice any symptoms of an allergic reaction, contact your doctor immediately. Such allergic reactions include:

  • Rashes, hives or redness in any area of the skin
  • Itching sensations on the skin
  • Swelling particularly when located in the face, tongue, or throat
  • Extreme dizziness, drowsiness, or fatigue
  • Any breathing problems, including, shortness of breath, wheezing
  • Overdose
  • It can be potentially very harmful to take greater doses than you have been prescribed. Symptoms of an overdose of omeprazole and sodium bicarbonate include:
  • Blurred vision
  • Confusion
  • Drowsiness
  • Dry mouth
  • Feelings of warmth
  • Flushed skin
  • Headaches
  • Increased or excessive sweating
  • Redness in the face, arms, neck or upper-chest area
  • Seizures
  • Tachycardia (fast heartbeat)
  • Vomiting
  • If you notice any of the above symptoms, seek emergency medical attention immediately.
  • Vitamin B12 absorption

This medication may interfere with your body's ability to absorb vitamin B12. If you are taking this medication for a long period of time - typically for around three years - your doctor may want to prescribe vitamin B12 supplementation. Discuss any concerns you have regarding vitamin B12 deficiency with your doctor.

Fractures and sprains

Omeprazole and sodium bicarbonate may increase your likelihood of experiencing a sprain or a fracture, particularly in the hips, wrists, or spine. This is more likely to occur if you take the medication for a long period of time, if you have been prescribed high doses of the medication, or if you are over 50 years of age.

Hypomagnesemia

This medication increases the risk of hypomagnesemia in some people, which means you have low levels of magnesium in the blood stream. There are several factors which make this more likely to occur:

  • You are taking omeprazole and sodium bicarbonate for longer than a year
  • You are also taking digoxin (Lanoxin)
  • You are also taking diuretics
  • Contact your doctor immediately if you experience any symptoms of hypomagnesemia, which include:
  • Changes to the heart rate, including a racing pulse or irregular heart beat
  • Convulsions
  • Muscle spasms
  • Seizures
  • Tremors or shaking
  • Unusual tiredness, fatigue or weakness
  • Acute interstitial nephritis

In rare cases this medication can cause a condition called acute interstitial nephritis. Contact your doctor immediately if you notice any of the following symptoms:

  • Fever
  • Pain in the joints
  • Rash on the skin
  • Swelling in the body, especially the feet or the ankles
  • Unusual or rapid weight gain

Dosage

You will be prescribed a dose of omeprazole and sodium bicarbonate that is appropriate for your demographics, age, bodyweight, and the type and severity of the symptoms that you are experiencing. You should always take your medication exactly as prescribed by your doctor - do not take larger or more frequent doses than you have been prescribed.

However, for reference, here are some common doses that are prescribed:

For duodenal ulcers, erosive esophagitis, and GERD:

Adults - 20 mg once per day, 1 hour before food.

Children - Your doctor will determine an appropriate dose.

For gastric ulcers:

Adults - 40 mg once a day at least 1 hour before a meal. Your doctor may adjust your dose if needed.

Children - Your doctor will determine an appropriate dose.

For upper gastrointestinal tract bleeding in seriously ill patients:

Adults - On the first day of treatment, two doses of 40 mg spaced 6 to 8 hours apart from each other. From the second to the 14th day, 40 mg once a day.

Children - Your doctor will determine an appropriate dose.

People of Asian descent or who have Asian relatives may be more sensitive to the medication and may be prescribed a lower dose, particularly when the medication has been prescribed to maintain healing of erosive esophagitis. This includes countries such as the Philippines, China, Japan, Korea and Taiwan.

Note that the products containing 20mg or 40mg of omeprazole both contain the same amount of sodium bicarbonate. So if you are prescribed to take 40 mg of omeprazole, you cannot take two doses of 20 mg, because then you would be taking double the usual amount of sodium bicarbonate. Talk to your doctor if you have any questions about your dosing.

Take the medication on an empty stomach, at least one hour before food. Take capsules whole and swallow them with water - do not use any other liquid other than water to consume the capsules. Do not crush the capsules, or mix the medication with food.

If you have been given the powdered form of omeprazole and sodium bicarbonate, you should mix one packet with 20 ml of water. Stir well until it has completely dissolved into the water. Then draw the solution into your syringe and send it through the nasogastric or orogastric tube immediately.

If you forget to take one of your scheduled doses of omeprazole and sodium bicarbonate, take it as soon as you remember. However, if it will soon be time for you to take the next dose, simply skip the missed dose and continue your normal schedule. Do not take a double dose to make up for a missed one - taking larger doses of this medication than you have been prescribed to take can be harmful.

Interactions

Some medications and other products can interact with omeprazole and sodium bicarbonate in ways that produce adverse side effects. Before you take omeprazole and sodium bicarbonate, you should discuss with your doctor any other medication, vitamins, herbal products or food supplements that you are presently taking. Your doctor can then assess the benefits and risk of taking this medication, and make an informed decision on whether it is safe for you to take.

Rilpivirine

If you are taking rilpivirine, your doctor will probably advise you not to take omeprazole and sodium bicarbonate.

Major interactions

The medications on the list below are generally not recommended to be taken at the same time as omeprazole and sodium bicarbonate due to the undesired side effects that can result. However, in some cases the potential benefits will outweigh the potential costs. Inform your doctor if you are taking any of the following medications:

  • Abacavir (Triumeq)
  • Acalabrutinib (Calquence)
  • Atazanavir (Evotaz, Reyataz)
  • Cilostazol (Pletal)
  • Citalopram (Celexa)
  • Clopidogrel (Plavix)
  • Cobicistat (Evotaz)
  • Dasatinib (Sprycel)
  • Dolutegravir (Juluca, Tivicay, Triumeq)
  • Emtricitabine (AccessPak)
  • Erlotinib (Tarceva)
  • Lamivudine (Triumeq)
  • Methotrexate (Folex PFS, Methotrexate LPF Sodium, Otrexup, Rasuvo, Rheumatrex Dose Pack, Trexall, Xatmep)
  • Nelfinavir (AccessPak, Viracept)
  • Neratinib
  • Pazopanib (Votrient)
  • Rilpivirine (Edurant, Juluca)
  • Sofosbuvir (Epclusa, Vosevi)
  • Tenofovir (AccessPak)
  • Velpatasvir (Epclusa, Vosevi)
  • Voxilaprevir (Vosevi)

Other interactions

Some drugs may increase the risk that you will experience unpleasant side effects when taken with omeprazole and sodium bicarbonate, but in many cases these are less serious, or can be managed with other medications. These include the following drugs and products:

Allergy medications, including over-the-counter products for hayfever

  • Armodafinil
  • Aspirin
  • Calcium supplements
  • Carbamazepine
  • Cyclobenzaprine
  • Dasatinib
  • Digoxin
  • Disulfiram
  • Fluconazole
  • Ginkgo Biloba (herbal supplement)
  • Iron supplements
  • Levothyroxine
  • Loratadine
  • Raltegravir
  • St John's Wort (herbal supplement)
  • Tipranavir
  • Triazolam
  • Vitamin B12
  • Vitamin D
  • Warfarin
  • Zoloft

These lists are not exhaustive and there may be other medications that interact with omeprazole and sodium bicarbonate. Ensure your doctor is aware of any medications you are taking before you are prescribed this product.

If you are taking a medication that interacts with omeprazole and sodium bicarbonate, you may still be able to take it, but your doctor may want to adjust the dose of one or both medications, or they may prescribe another medication to help manage or reduce the risk of side effects. They also may wish to see you more often to ensure that side effects are not occurring.

Cranberry

Tell your doctor if you are taking cranberry supplements or if you regularly drink cranberry juice.

Warnings

Sometimes the symptoms of a heart attack may be confused for heartburn. If you feel any of the symptoms below, seek emergency medical attention immediately:

  • A general feeling of unwell
  • Feelings of nausea or vomiting
  • Pain or a feeling of heaviness in the chest
  • Pain that spreads into the arm or the shoulder

Contact your doctor if you have concerns about this, or if you feel you need more advice on recognising the symptoms of a heart attack.

Omeprazole and sodium bicarbonate is generally a safe drug to take when used under the supervision of a doctor. However, this medication can make the symptoms of certain other medical conditions worse, and should therefore be used with caution by certain individuals. Always discuss any of your present medical conditions with your doctor before you begin your course of treatment with omeprazole and sodium bicarbonate. The following conditions are of particular concern:

  • Bartter's syndrome (a rare kidney problem)
  • Bone problems, including fractured or broken bones

Cutaneous or systemic lupus erythematosus (symptoms may worsen - see your doctor if you notice any joint pain, skin rashes, or increased sensitivity to sunlight particularly in areas where the rash is present)

  • Diarrhea
  • Epilepsy
  • Gastrointestinal problems
  • Heart problems
  • Hypocalcemia (low calcium levels)
  • Hypokalemia (low potassium levels)
  • Hypomagnesemia (low magnesium levels)
  • Liver disease or any other problem with your liver
  • Osteoporosis (weakening of the bones)
  • Respiratory alkalosis (low levels of carbon dioxide in the blood)
  • Seizures

You should also inform your doctor if you have a history of the above problems, even if you do not suffer from them now. You may still be able to take omeprazole and sodium bicarbonate, but your doctor may wish to see you more frequently for check-ups, or they may want to give you a different dose of omeprazole and sodium bicarbonate than they otherwise would.

Omeprazole and sodium bicarbonate contains a source of salt - typically 300 mg per capsule and 460 mg per packet of powdered medication. If you have been advised by your doctor to maintain a low-salt diet, or if you have any conditions for which high salt intake is not advisable (such as Bartter's syndrome, a rare kidney problem), you should discuss this with your doctor. You may not be able to use the medication, or your doctor may wish to monitor you closely while you are taking it.

Some people experience drowsiness while they are taking this medication. You should not drive or operate machinery until you are sure that it is safe for you to do so.

It is important that you complete your full course of treatment with this medication. Do not stop taking the medication unless you have been instructed to do so by your doctor.

Pregnancy

Adequate studies in humans have not yet been conducted that would determine whether this medication is safe to take by pregnant women, although animal studies have shown some harmful effects to offspring when pregnant females were given the drug.

If you are pregnant, or plan to be pregnant while you are taking this medication, discuss this with your doctor who will have the most up-to-date information and can advise you on the best course of action. If you become pregnant during a course of treatment with omeprazole and sodium bicarbonate, consult your doctor immediately.

Breastfeeding

This medication can enter breast milk and therefore pass to the infant. As this medication is harmful if consumed by infants, you should not breastfeed while you are taking this medication.

Children

No adequate studies have been conducted that can establish the safety and efficacy of the medication in children under the age of 18. Your doctor will advise you on whether this medication is safe for your children to take, and whether any adjustments to the usual dose are necessary.

Elderly Individuals

Several studies have been conducted to test the impact of omeprazole and sodium bicarbonate when used in people over the age of 65. The studies concluded that this medication is generally as effective and safe in this age group as with younger adults. However, high sensitivity to the medication is seen in some individuals. If you are over the age of 65 your doctor may want to see you more frequently for check ups, to ensure that the medication is working properly and is not causing any side effects.

Storage

If this medication is not stored correctly it may become less potent, or it may become dangerous for you to consume. Follow the guidelines set out below when you are storing this medication.

Avoid heat - Excess heat can damage the medication. Store the capsules and powdered form of this medication at room temperature. Keep the medication away from sources of heat such as radiators, heaters, or the stove. Do not store the medication in the glove compartment of your car, and keep it away from direct sunlight.

Avoid cold - Do not store this medication in the refrigerator, nor in the freezer.

Avoid moisture - Store the medication in a dry place. Do not store the medication in the bathroom because the moisture and heat produced by the shower can damage them. If you received the capsules in a bottle containing cotton wool, remove this as it can transfer moisture into the bottle.

Keep away from children - This medication may be harmful if consumed by children, particularly if consumed in large amounts. Keep your omeprazole and sodium bicarbonate in a location that is out of the sight and reach of children. You should also store the medication in a child-safe container.

If you follow these guidelines the medication will be safe to use, but you should still inspect the medication for signs of damage before you consume it. Signs of damage include changes to the usual coloration, capsules feeling soft or sticking together, or the powder sticking in clumps. If you see these signs, do not take the medication.

Also, check the expiration date of the medication and ensure it is still within its shelf-life. If it has passed the expiry date, do not take the medication.

Summary

Omeprazole and sodium bicarbonate is a prescription-only medicine that is used to treat conditions that cause acid to build up in the stomach, or that cause acid to flow upwards into the esophagus. Such conditions include gastric ulcers, erosive esophagitis, and gastroesophageal reflux disease (GERD).

People with certain medical conditions may be at greater risk of experiencing unpleasant side effects as a result of taking omeprazole and sodium bicarbonate. These include gastrointestinal problems, bone problems such as osteoporosis, liver problems and kidney problems. Such people may be prescribed a lower dose of this medication than usual, or they may be monitored more closely by their doctor.

This medication is known to trigger side effects in some individuals. Over the short-term, these are usually harmless, and disappear with time. However, people using this medication in high doses, or for long periods of time, may experience side effects including weakness in the bones or joints, vitamin B12 deficiency, and low levels of magnesium in the blood.

This medication is potentially harmful to infants and can pass into the breastmilk, so women are advised not to breastfeed while taking this medication.

Some other medications can interact with omeprazole and sodium bicarbonate in ways that trigger undesired or harmful side effects. Make sure your doctor is aware of all medications, supplements and vitamins that you are taking before you are prescribed this medication.