Zegerid (Omeprazole and Sodium Bicarbonate) - Oral

What Is Zegerid?

Zegerid (omeprazole and sodium bicarbonate) is a prescription combination drug consisting of two primary ingredients: a proton pump inhibitor (PPI), omeprazole, and an antacid, sodium bicarbonate. It is used to treat various gastric disorders. The combination of the two products is highly effective at reducing gastric acid production in adults 18 and older.

For context, a PPI is a medication that works by reducing the amount of stomach acid made by glands in the lining of your stomach.

The ingredient omeprazole can also be categorized as an antisecretory agent. Antisecretory are compounds that are used for the long-term treatment of gastroesophageal reflux disease (GERD), a chronic disorder of the esophagus that results in a decrease of the low esophageal sphincter (LES) barrier tone, leading to acid reflux, epithelial (thin tissue forming the outer layer of a body's surface) erosion, and hyperplasia (enlargement of an organ or tissue) accompanied by inflammation.

Omeprazole reduces acid production by binding selectively and irreversibly to the H+/K+ ATPase pump to stop acid production temporarily.

In comparison, sodium bicarbonate, the other primary ingredient present in Zegerid, is classified as an antiacid. Antacids are medicines that neutralize the acid in your stomach to relieve indigestion and heartburn.

Sodium bicarbonate protects omeprazole against stomach acid degradation until it is absorbed and prolongs the antisecretory effects.

Zegerid is available as a prescription drug in the form of either capsules or as a powder to formulate into a liquid suspension.

Made up of the same two primary ingredients (omeprazole and sodium bicarbonate), the medication is available over-the-counter (OTC) as Zegerid OTC.

Drug Facts

Generic Name: Omeprazole and sodium bicarbonate

Brand Name(s): Zegerid, Zegerid OTC

Drug Availability: Prescription, OTC

Therapeutic Classification: Gastric acid secretion inhibitor

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Omeprazole and sodium bicarbonate

Dosage Form(s): Capsules, powder for oral suspension

What Is Zegerid Used For?

The Food and Drug Administration (FDA) approved Zegerid for the following uses in adults 18 and older:

Zegerid OTC is used for short-term use to treat frequent heartburn (heartburn that occurs two times a week).

How to Take Zegerid

Take Zegerid on an empty stomach at least one hour before meals. 

Read the drug label carefully and follow the guidelines:

Oral capsules

  1. Swallow the capsule whole with water.
  2. Do not take any other liquid besides water.
  3. Do not break open capsules or empty the contents into food. 
  4. Two capsules of 20 milligrams are not equivalent to one 40-milligram capsule.

Oral liquid formulation:

  1. Prepare the suspension by emptying the packet contents into a container containing two tablespoons (15 to 30 milliliters) of water.
  2. Do not use liquids other than water or food to prepare the suspension.
  3. Stir the mixture well and administer immediately. 
  4. Refill the cup with water and drink any leftovers to ensure complete dosage. 

Patients with an oral or nasal gastric tube: 

  1. Use oral suspension.
  2. Suspend the enteral feeding approximately three hours before and one hour after administration.
  3. Constitute the oral suspension with approximately 20 milliliters of water.
  4. Use only water to prepare the suspension.
  5. Stir well and administer immediately, using an appropriately-sized syringe.
  6. Instill the mixture in the tube and then flush the tube with an additional 20 milliliters of plain water.


Store at room temperature between 68 to 77 degrees F. Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Do not store your medication in the bathroom.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the FDA's website to know where and how to discard all unused and expired drugs.

You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you travel with Zegerid, get familiar with your final destination's regulations. In general, be sure to make a copy of your Zegerid prescription. Keep your medication in its original container from your pharmacy with your name on the label.

Ask your healthcare provider if you have any questions about traveling with your medicine.

How Long Does Zegerid Take to Work?

Zegerid may take a few days to show its effects fully and relieve the symptoms.

What Are the Side Effects of Zegerid?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Some of the common side effects of Zegerid are:

Call your healthcare provider if the symptoms do not go away or worsen.

Severe Side Effects

Contact your healthcare provider right away if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious adverse effects and their symptoms include:

  • Acute tubulointerstitial nephritis (inflammation of kidney tubules and tissues)
  • Bone fracture 
  • Severe cutaneous adverse reactions (skin disease)
  • Cutaneous and systemic lupus erythematosus (autoimmune inflammation of the skin)
  • Cyanocobalamin (vitamin B12) deficiency
  • Hypomagnesemia (decreased serum magnesium levels) and mineral metabolism
  • Fundic gland polyps (polyps in the upper portion of the stomach)

Report Side Effects

Zegerid may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Zegerid Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or powder for suspension):
    • To treat duodenal ulcers, erosive esophagitis, and GERD:
      • Adults—20 milligrams (mg) once a day at least 1 hour before a meal. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • To treat gastric ulcers:
      • Adults—40 milligrams (mg) once a day at least 1 hour before a meal. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (powder for suspension):
    • To prevent upper gastrointestinal tract bleeding in seriously ill patients:
      • Adults—The first day: 40 milligrams (mg) for the first dose, then after 6 to 8 hours, a second 40 mg dose. After the first day: 40 mg once a day for up to 14 days.
      • Children—Use and dose must be determined by your doctor.


The following modifications (changes) should be kept in mind when using Zegerid:

Severe allergic reaction: Avoid using Zegerid if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: We don't know enough about the safety and effectiveness of Zegerid in pregnant people and the unborn fetus based on the available data. Discuss with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Zegerid during your pregnancy.

Breastfeeding: Clinical data indicate that omeprazole and sodium bicarbonate is present in breast milk. There is no clinical data to determine the effects of Zegerid on the breastfed infant. Talk with your healthcare provider to weigh the benefits and risks of taking Zegerid while nursing and the different ways to feed your baby if you plan to breastfeed.

Adults over 65: Clinical studies show that older adults do not respond differently from younger adults. However, older adults with several medical conditions or taking several medications should use caution with Zegerid. Older adults might also be more sensitive to Zegerid's side effects.

Children: The safety and effectiveness of Zegerid have not been established in children.

Other modifications: Avoid using Zegerid in people with hepatic (liver) problems for healing erosive esophagitis. Avoid the use of Zegerid in people of Asian origin for the maintenance of erosive esophagitis.

Missed Dose

If you accidentally forgot your Zegerid dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Try to find ways that work for you to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, Zegerid might be less effective at treating or preventing your condition.

Overdose: What Happens If I Take Too Much Zegerid?

In case of an accidental overdose of Zegerid, seek immediate medical attention. The treatment should be supportive and symptomatic.

What Happens If I Overdose on Zegerid?

If you think you or someone else may have overdosed on Zegerid, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Zegerid, call 911 immediately.


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It is important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood, urine, and other laboratory tests may be needed to check for unwanted effects. If your condition does not improve, or if it becomes worse, check with your doctor.

Do not use this medicine if you are also taking rilpivirine (Edurant®) or products containing rilpivirine (eg, Complera®). Using these medicines together may cause serious side effects.

Tell your doctor if you have Asian relatives, such as Filipino, Chinese, Japanese, Korean, or Taiwanese. You may need a lower dose of this medicine to treat erosive esophagitis.

This medicine is sometimes given together with other medicines to treat ulcers. Be sure you understand about the risks and proper use of any other medicine your doctor gives you together with omeprazole and sodium bicarbonate combination.

Check with your doctor right away if you have a change in frequency of urination or amount of urine, blood in the urine, fever, joint pain, loss of appetite, skin rash, swelling of the body, feet, or ankles, unusual tiredness or weakness, or unusual weight gain after receiving this medicine. These could be symptoms of acute tubulointerstitial nephritis.

Taking this medicine for a long time may make it harder for your body to absorb vitamin B12. Tell your doctor if you have concerns about vitamin B12 deficiency.

Serious stomach conditions may occur while taking this medicine alone or together with antibiotics. Check with your doctor immediately if you have stomach cramps, bloated feeling, watery and severe diarrhea which may also be bloody sometimes, fever, nausea, vomiting, or unusual tiredness or weakness.

This medicine may increase your risk of having fractures of the hip, wrist, and spine. This is more likely are 50 years of age and older, if you receive high doses of this medicine or use it for one year or more.

Cutaneous or systemic lupus erythematosus may occur or get worse in patients receiving a PPI. Call your doctor right away if you have joint pain or a skin rash on your cheeks or arms that gets worse when exposed to the sun.

This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking this medicine for more than one year, or if you are taking this medicine together with digoxin (Lanoxin®) or certain diuretics or "water pills". Check with your doctor right away if you have convulsions (seizures), fast, racing, or uneven heartbeat, muscle spasms (tetany), tremors, or unusual tiredness or weakness.

This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS). Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

This medicine may increase your risk for fundic gland polyps (abnormal tissue growth in the upper part of your stomach). This is more likely if you are receiving this medicine for more than 1 year. Talk to your doctor if you have concerns.

Do not stop taking this medicine without first checking with your doctor, or unless told to do so by your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before you have medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (eg, atazanavir, nelfinavir, Reyataz®, Viracept®) or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Zegerid?

Zegerid is discouraged in people with hypersensitivity to Zegerid or its components. Hypersensitivity reactions include:

People with the following conditions should also not use Zegerid:

  • Hepatic disease for maintenance of heating of erosive esophagitis
  • Asian population for maintenance of heating of erosive esophagitis
  • Using rilpivirine-containing products. Rilpivirine is used along with other medications to treat human immunodeficiency virus type 1 (HIV-1)

What Other Medications May Interact With Zegerid?

Use caution when taking Zegerid with the following medications. These drugs may require a change or adjustment of dose depending on your use:

  • Edurant (rilpivirine)
  • Reyataz (atazanavir)
  • Viracept (nelfinavir)
  • Invirase (saquinavir)
  • Warfarin
  • Rheumatrex (methotrexate)
  • Cyclosporine
  • Antabuse (disulfiram)
  • St. John’s wort
  • Rifampin
  • Norvir (ritonavir)
  • Voriconazole
  • Interactions with Investigations of Neuroendocrine tumors
  • Interaction with a secretin stimulation test
  • False positive urine tests for tetrahydrocannabinol (THC; primary ingredient in marijuana)

Ask your healthcare provider or pharmacist for a complete list of drug interactions that can occur with Rexulti. Tell your healthcare provider about all prescription drugs, over-the-counter (OTC) drugs, vitamins, and herbal supplements you take.

What Medications Are Similar?

Zegerid is categorized as a PPI.

There are different brands of PPIs available, including:

Use the specific brand prescribed to you by your healthcare provider. Don't switch between brands or prescription drugs with an OTC formulation without asking your healthcare provider.

Frequently Asked Questions

  • What is Zegerid?

    Zegerid is a combination drug containing omeprazole and sodium bicarbonate and is used to treat various gastric disorders.

  • Is Zegerid available OTC?

    The combination of omeprazole and sodium bicarbonate is available OTC and used for short-term use (14 days) to treat frequent heartburn under the brand name Zegerid OTC.

  • How does Zegerid work?

    Zegerid is highly effective at reducing gastric acid production. it contains a combination of a PPI and an antacid. Omeprazole reduces acid production, and sodium bicarbonate protects against the degradation of omeprazole in the stomach.

  • How long does Zegerid take to work?

    Zegerid may take a few days to show its full benefits and relieve the symptoms.

How Can I Stay Healthy While Taking Zegerid?

Gastric disorders can be very uncomfortable and badly affect a person's daily life.

PPIs are an effective treatment to ease the symptoms of heartburn, acid reflux, dyspepsia, or other symptoms associated with these disorders.

If you're taking Zegerid, consider these tips to help improve your quality of life:

  • Take as recommended by your healthcare provider.
  • If taking this drug OTC, read the label carefully and follow the instructions on how to take this drug.
  • Achieve a healthy diet plan to prevent a worsening condition.
  • Certain foods or stress might trigger gastric disorders. Avoid your triggers.
  • Consider working with a registered dietitian nutritionist to help you identify and manage any food triggers.
  • Don't skip meals.
  • If pregnant or breastfeeding, ask your healthcare provider before taking Zegerid.
  • Don't take Zegerid OTC for more than 14 days.
  • Visit a healthcare provider if your symptoms do not improve.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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