omeprazole, omeprazole/sodium bicarbonate, Prilosec, Zegerid (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
Through unknown mechanisms, omeprazole may increase blood levels of saquinavir and reduce blood levels of nelfinavir and atazanavir, drugs that are used for treating patients with infection caused by the human immunodeficiency virus (HIV). Accordingly, the dose of saquinavir may need to be reduced to avoid toxicity, and the doses of nelfinavir and atazanavir may need to be increased to maintain efficacy.
Clopidogrel (Plavix) is converted to its active form by enzymes in the liver. Omeprazole reduces the activity of these enzymes and potentially can reduce the activity of clopidogrel. Omeprazole should not be used with clopidogrel.
Omeprazole increases the concentration of cilostazol (Pletal). The dose of cilostazol should be reduced from 100 mg twice daily to 50 mg twice daily when given with omeprazole.
PREGNANCY: Use of omeprazole in pregnant women has not been adequately evaluated. Omeprazole should be used during pregnancy only if the benefits justify the unknown risks.
NURSING MOTHERS: Omeprazole is excreted in breast milk and potentially could cause adverse effects in the infant.
SIDE EFFECTS: Omeprazole like other PPIs is well-tolerated. The most common side effects are diarrhea, nausea, vomiting, headaches, rash and dizziness. Nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps, and water retention occur infrequently.
Each packet of Zegerid powder for oral suspension contains 460 mg of sodium and each capsule contains 304 mg of sodium. This should be taken into consideration in patients who need a sodium restricted diet.
High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.
Reference: FDA Prescribing Information
Last Editorial Review: 1/4/2011
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