Omeprazole 20mg + Sodium bicarbonate 1100mg

Indications

Omeprazole 20mg + Sodium bicarbonate 1100mg is used for: Peptic ulcer disease, Gastroesophageal Reflux Disease (GERD), Erosive Esophagitis

Adult Dose

Oral Usually once daily on an empty stomach, at least 1 hour before a meal.

Child Dose

Safety and efficacy not established

Renal Dose

Administration

Contra Indications

Patients with known hypersensitivity to any components of the formulation.

Precautions

Exclude malignancy, prolonged use, hepatic impairment. Pregnancy, lactation, children <1 yr. Lactation: Distributes into human breast milk; avoid use

Pregnancy-Lactation

Interactions

Omeprazole: Increased risk of hypomagnesaemia w/ diuretics. May increase INR and prothrombin time w/ warfarin. Increased risk of digoxin-induced cardiotoxic effects. May increase plasma concentration benzodiazepines (e.g. diazepam), clarithromycin and methotrexate. Decreased absorption of itraconazole, ketoconazole, posaconazole, dasatinib, iron salts. May prolong elimination of diazepam, cilostazol, phenytoin and ciclosporin. May reduce the antiplatelet effect of clopidogrel. Potentially Fatal: May decrease plasma concentrations and pharmacological effects of rilpivirine, nelfinavir and atazanavir. Sodium bicarbonate: Increases toxicity of amphetamines, ephedrine, pseudoephedrine, flecainide, quinidine and quinine. Decreases effects of lithium, chlorpropamide and salicylates due to increased clearance. May affect the absorption of certain drugs due to raised intra-gastric pH.

Side Effects

Side effects of Omeprazole 20mg + Sodium bicarbonate 1100mg : >10% Pyrexia (20%), Hypokalemia (12%), Hyperglycemia (11%), Nosocomial pneumonia (11%) 1-10% Hypotension (10%), Hypomagnesemia (10%), Hypertension (8%), Atrial fibrillation (6%), Hypocalcemia (6%), Rash (6%), Tachycardia (5%), Constipation (5%), Sepsis (5%), Hyperpyrexia (5%), Oral candidiasis (4%), Bradycardia (4%), Diarrhea (4%), Edema (3%), Supraventricular tachycardia (3%), Decubitus ulcer (3%), Agitation (3%), Hypernatremia (2%), Hyperkalemia (2%), Urinary tract infection (2%), Hypomotility (2%), Candidal infection (2%) <1% Angina, Fracture, Glycosuria, Anemia, Hepatic failure, Benign gastric polyps, Agranulocytosis, Alopecia, Increased creatinine, Hemolytic anemia, Angioedema, Gynecomastia, Anorexia, Hepatic encephalopathy, Metabolic alkalosis, Pancreatitis, Photosensitivity, Liver disease Potentially Fatal: Anaphylaxis.

Mode of Action

Omeprazole is a substituted benzimidazole gastric antisecretory agent and is also known as PPI. It blocks the final step in gastric acid secretion by specific inhibition of H+/K+ ATPase enzyme system present on the secretory surface of the gastric parietal cell. Both basal and stimulated acid are inhibited. Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.