Overview
Omeprazole/sodium bicarbonate is a combination proton pump inhibitor (PPI) and antacid used for acid suppression. It is indicated for short-term treatment of duodenal and gastric ulcers, GERD symptoms, and erosive esophagitis, with maintenance therapy for healed erosive esophagitis. The sodium bicarbonate component provides rapid antacid effect while protecting omeprazole from gastric acid degradation.
Mechanism of Action
Omeprazole is a proton pump inhibitor that irreversibly inhibits the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells, suppressing gastric acid secretion. Sodium bicarbonate provides immediate antacid effect and protects omeprazole from acid degradation in the stomach.
Indications
- Short-term treatment (4-8 weeks) of active duodenal ulcer
- Short-term treatment (4-8 weeks) of active benign gastric ulcer
- Treatment of heartburn and other GERD symptoms for up to 4 weeks
- Short-term treatment (4-8 weeks) of erosive esophagitis due to acid-mediated GERD
- Maintenance of healing of erosive esophagitis due to acid-mediated GERD
Common Doses
- 20 mg omeprazole/1100 mg sodium bicarbonate
Dosage
Typically administered once daily before a meal. For active duodenal ulcer: 20 mg omeprazole/1100 mg sodium bicarbonate daily for 4-8 weeks. For gastric ulcer, GERD, and erosive esophagitis: 20 mg omeprazole/1100 mg sodium bicarbonate daily for 4-8 weeks. Maintenance therapy: 20 mg omeprazole/1100 mg sodium bicarbonate daily.
Contraindications
- Hypersensitivity to substituted benzimidazoles or any component of the formulation
- Concomitant use with rilpivirine-containing products
Side Effects
- Headache
- Diarrhea
- Abdominal pain
- Nausea
- Flatulence
- Acute tubulointerstitial nephritis
- Clostridium difficile-associated diarrhea
- Bone fractures
- Severe cutaneous reactions
- Lupus erythematosus
- Vitamin B-12 deficiency
- Hypomagnesemia
Interactions
- Rilpivirine: Contraindicated
- Atazanavir: Avoid concomitant use
- Nelfinavir: Avoid concomitant use
- Warfarin: Monitor INR and prothrombin time
- Methotrexate: May increase serum concentrations
- Clopidogrel: Avoid concomitant use
- Citalopram: Limit dose to 20 mg daily
- Cilostazol: Reduce dose to 50 mg twice daily
- Drugs dependent on gastric pH for absorption (iron salts, ketoconazole, etc.): Reduced absorption
- Tacrolimus: Monitor concentrations
Counseling Points
- Take once daily before a meal
- Swallow capsule whole; do not chew or crush
- May take with or without food but consistent timing is recommended
- Report severe diarrhea, joint pain, or skin rash to healthcare provider
- Long-term use may require monitoring of magnesium and vitamin B-12 levels
- Do not take with rilpivirine-containing HIV medications