Omeprazole and Sodium Bicarbonate

Omeprazole and Sodium Bicarbonate Brand Names- OmePPi | Zegerid

What is Omeprazole and Sodium Bicarbonate

Omeprazole and sodium bicarbonate is an immediate-release product combining a proton pump inhibitor (PPI) and sodium bicarbonate buffer. Prescription products are used for gastroesophageal reflux disease (GERD), erosive esophagitis, and gastric or duodenal ulcers.

The powder for oral suspension is additionally approved for stress ulcer prophylaxis in critically ill patients.

Non-prescription products are used for the short-term (14 days or less) treatment of frequent heartburn; patients may repeat a 14-day course every 4 months.

Like other PPIs, omeprazole is unstable in the acidic environment of the stomach and conventional oral formulations are available as delayed-release products with enteric coatings; combining uncoated omeprazole powder with sodium bicarbonate allows for rapid delivery to the site of drug absorption, while decreasing gastric acid degradation following administration. Compared to conventional delayed-release omeprazole capsules, omeprazole; sodium bicarbonate has an earlier detectable antisecretory effect that lasts at least as long as delayed-release formulations.

The more rapid onset may be due, in part, to the immediate neutralizing capacity of sodium bicarbonate. Because of the sodium bicarbonate content, patients receive a substantial sodium load equivalent to 300 to 303 mg of sodium in the capsules and 460 mg in the suspension; an alternative PPI may be a more appropriate treatment option for patients on a sodium-restricted diet.

In critically ill patients, omeprazole; sodium bicarbonate reduced the incidence of clinically significant bleeding and overt bleeding, and had a lower incidence of inadequate pH control relative to parenteral cimetidine.

On the basis of available research, no clear advantage has been demonstrated for the use of one PPI over another in the treatment of GERD. Instead, a key to optimizing effectiveness is tailoring dosage and frequency of use. A one-time switch to a different PPI in a refractory patient may be useful.

Indications

1. duodenal ulcer
2. eosinophilic esophagitis
3. esophagitis
4. gastric ulcer
5. gastroesophageal reflux disease (GERD)
6. pyrosis (heartburn)
7. stress gastritis prophylaxis

Side Effects

1. abdominal pain
2. acute respiratory distress syndrome (ARDS)
3. agitation
4. agranulocytosis
5. alopecia
6. anaphylactoid reactions
7. anemia
8. angina
9. angioedema
10. anorexia
11. anxiety
12. arthralgia
13. asthenia
14. atrial fibrillation
15. back pain
16. blurred vision
17. bone fractures
18. bradycardia
19. bronchospasm
20. candidiasis
21. confusion
22. constipation
23. cough
24. depression
25. diarrhea
26. diplopia
27. dizziness
28. drowsiness
29. dysgeusia
30. edema
31. elevated hepatic enzymes
32. epistaxis
33. erythema multiforme
34. fatigue
35. fever
36. flatulence
37. fluid retention
38. gastric polyps
39. glycosuria
40. gynecomastia
41. hallucinations
42. headache
43. hematuria
44. hemolytic anemia
45. hepatic encephalopathy
46. hepatic necrosis
47. hepatitis
48. hyperbilirubinemia
49. hyperglycemia
50. hyperhidrosis
51. hyperkalemia
52. hypernatremia
53. hypertension
54. hypocalcemia
55. hypoglycemia
56. hypokalemia
57. hypomagnesemia
58. hyponatremia
59. hypotension
60. increased urinary frequency
61. infection
62. insomnia
63. interstitial nephritis
64. jaundice
65. leukocytosis
66. leukopenia
67. lupus-like symptoms
68. malaise
69. metabolic alkalosis
70. muscle cramps
71. myalgia
72. myasthenia
73. nausea
74. neutropenia
75. ocular irritation
76. optic atrophy
77. optic neuritis
78. palpitations
79. pancreatitis
80. pancytopenia
81. paresthesias
82. peripheral edema
83. pernicious anemia
84. petechiae
85. photosensitivity
86. pneumothorax
87. proteinuria
88. pruritus
89. pseudomembranous colitis
90. purpura
91. pyuria
92. rash
93. renal failure (unspecified)
94. seizures
95. sinus tachycardia
96. Stevens-Johnson syndrome
97. stomatitis
98. stool discoloration
99. supraventricular tachycardia (SVT)
100. testicular pain
101. tetany
102. thrombocytopenia
103. toxic epidermal necrolysis
104. tremor
105. urticaria
106. ventricular tachycardia
107. vertigo
108. vitamin B12 deficiency
109. vomiting
110. weight gain
111. xerophthalmia
112. xerosis
113. xerostomia

Monitoring Parameters

• LFTs
• serum magnesium

Contraindications

• acid/base imbalance
• Asian patients
• Bartter’s syndrome
• bone fractures
• breast-feeding
• children
• diarrhea
• edema
• gastric cancer
• geriatric
• heart failure
• hepatic disease
• hypernatremia
• hypertension
• hypocalcemia
• hypokalemia
• hypomagnesemia
• infants
• laboratory test interference
• long QT syndrome
• metabolic alkalosis
• neonates
• osteopenia
• osteoporosis
• poor metabolizers
• pregnancy
• proton pump inhibitors (PPIs) hypersensitivity
• pseudomembranous colitis
• rebound acid hypersecretion
• renal disease
• sodium restriction
• systemic lupus erythematosus (SLE)
• vitamin B12 deficiency

Interactions

• Acalabrutinib
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acrivastine; Pseudoephedrine
• Alendronate
• Alendronate; Cholecalciferol
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alprazolam
• Amiloride; Hydrochlorothiazide, HCTZ
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Atorvastatin
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amobarbital
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Amphetamines
• Ampicillin
• Ampicillin; Sulbactam
• Anticholinergics
• Apalutamide
• Aprepitant, Fosaprepitant
• Armodafinil
• Ascorbic Acid, Vitamin C
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol; Chlorthalidone
• Atorvastatin
• Atorvastatin; Ezetimibe
• Atropine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Edrophonium
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Avanafil
• Azilsartan; Chlorthalidone
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Bempedoic Acid; Ezetimibe
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benztropine
• Bisacodyl
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bisphosphonates
• Bosentan
• Bosutinib
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Budesonide
• Budesonide; Formoterol
• Bumetanide
• Butabarbital
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Candesartan; Hydrochlorothiazide, HCTZ
• Cannabidiol
• Capecitabine
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Pseudoephedrine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Pseudoephedrine
• Carisoprodol
• Cefditoren
• Cefpodoxime
• Ceftibuten
• Cefuroxime
• Cetirizine; Pseudoephedrine
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroquine
• Chlorothiazide
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Choline Salicylate; Magnesium Salicylate
• Chromium
• Cilostazol
• Ciprofloxacin
• Citalopram
• Clobazam
• Clomipramine
• Clonazepam
• Clopidogrel
• Clorazepate
• Clozapine
• Cobicistat
• Colchicine
• Colchicine; Probenecid
• Conivaptan
• Cyanocobalamin, Vitamin B12
• Cysteamine
• Dabrafenib
• Dacomitinib
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Delavirdine
• Desloratadine; Pseudoephedrine
• Dexamethasone
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmethylphenidate
• Dextroamphetamine
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Quinidine
• Diazepam
• Dicyclomine
• Diflunisal
• Digoxin
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diphenhydramine; Naproxen
• Dirithromycin
• Disulfiram
• Dolutegravir; Rilpivirine
• Donepezil; Memantine
• Doxercalciferol
• Dronedarone
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Eltrombopag
• Elvitegravir
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Enalapril; Hydrochlorothiazide, HCTZ
• Enzalutamide
• Ephedrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erlotinib
• Escitalopram
• Eslicarbazepine
• Esomeprazole; Naproxen
• Estazolam
• Ethacrynic Acid
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethotoin
• Ezetimibe
• Ezetimibe; Simvastatin
• Fedratinib
• Fenofibrate
• Fenofibric Acid
• Fexofenadine
• Fexofenadine; Pseudoephedrine
• Flavoxate
• Flecainide
• Flibanserin
• Flurazepam
• Fluvastatin
• Fluvoxamine
• food
• Fosamprenavir
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Furosemide
• Gabapentin
• Gastrointestinal Enzymes
• Gefitinib
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycopyrrolate
• Glycopyrrolate; Formoterol
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Pseudoephedrine
• Halofantrine
• Hetastarch; Dextrose; Electrolytes
• Homatropine; Hydrocodone
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydroxychloroquine
• Hyoscyamine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Pseudoephedrine
• Idelalisib
• Indacaterol; Glycopyrrolate
• Indinavir
• Indomethacin
• Iron
• Iron Salts
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ketoconazole
• Lactulose
• Lansoprazole; Naproxen
• Ledipasvir; Sofosbuvir
• Letermovir
• Lithium
• Loop diuretics
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Luliconazole
• Lumacaftor; Ivacaftor
• Magnesium Salicylate
• Mefenamic Acid
• Mefloquine
• Memantine
• Mepenzolate
• Mephobarbital
• Mesalamine, 5-ASA
• Methenamine
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methohexital
• Methotrexate
• Methscopolamine
• Methyclothiazide
• Methylphenidate
• Metolazone
• Mexiletine
• Midazolam
• Mitotane
• Mycophenolate
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nelfinavir
• Neratinib
• Nilotinib
• Nitrofurantoin
• Norfloxacin
• Obeticholic Acid
• Octreotide
• Ombitasvir; Paritaprevir; Ritonavir
• Oritavancin
• Oxybutynin
• Pancrelipase
• Pazopanib
• Penicillamine
• Pentobarbital
• Pexidartinib
• Phenobarbital
• Phenytoin
• Polyethylene Glycol; Electrolytes; Bisacodyl
• Polysaccharide-Iron Complex
• Ponatinib
• Posaconazole
• Primidone
• Propantheline
• Propranolol
• Pseudoephedrine
• Quazepam
• Quinidine
• Quinine
• Rifampin
• Rilpivirine
• Riluzole
• Risedronate
• Ritonavir
• Rosuvastatin
• Salsalate
• Saquinavir
• Scopolamine
• Secobarbital
• Secretin
• Selpercatinib
• Sibutramine
• Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
• Sodium Fluoride
• Sodium Polystyrene Sulfonate
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Solifenacin
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sucralfate
• Tacrolimus
• Telithromycin
• Tetracyclines
• Thiazide diuretics
• Thiopental
• Thiothixene
• Thyroid hormones
• Ticlopidine
• Tipranavir
• Tirofiban
• Tocilizumab
• Tolmetin
• Tolterodine
• Torsemide
• Triazolam
• Trihexyphenidyl
• Trospium
• Tucatinib
• Valproic Acid, Divalproex Sodium
• Voriconazole
• Warfarin