What Is Omeprazole/Sodium Bicarbonate? Uses, Dosage, and What You Need to Know in 2026

Omeprazole/sodium bicarbonate is a combination prescription medication used to treat conditions caused by excess stomach acid. It is sold under the brand names Zegerid (capsules and powder for suspension) and Konvomep (oral suspension). An OTC version, Zegerid OTC, is available without a prescription for frequent heartburn.

While most people are familiar with plain omeprazole (Prilosec), the addition of sodium bicarbonate in Zegerid makes it fundamentally different in how it works — and when it might be the right choice for you.

What Does Omeprazole/Sodium Bicarbonate Treat?

Omeprazole/sodium bicarbonate is FDA-approved for the following conditions in adults:

• Gastroesophageal reflux disease (GERD): Heartburn and other symptoms of acid reflux — 20 mg once daily for up to 4 weeks
• Active duodenal ulcer: 20 mg once daily for 4 weeks (some patients may need an additional 4 weeks)
• Active benign gastric ulcer: 40 mg once daily for 4 to 8 weeks
• Erosive esophagitis (EE): Damage to the esophagus from chronic acid exposure — 20 mg once daily for 4 to 8 weeks
• H. pylori eradication: Used in combination with antibiotics (e.g., amoxicillin and clarithromycin) to treat Helicobacter pylori infections that cause ulcers
• Upper GI bleed prevention in critically ill patients: The 40 mg oral suspension ONLY — 40 mg initially, then 40 mg 6-8 hours later, then 40 mg daily for 14 days

What Forms Does It Come In?

Omeprazole/sodium bicarbonate is available in several formulations:

• Capsules: 20 mg or 40 mg omeprazole + 1,100 mg sodium bicarbonate. Available as Zegerid (brand) or generic.
• Powder for oral suspension (Zegerid packets): 20 mg or 40 mg omeprazole + 1,680 mg sodium bicarbonate. Mixed with water and taken by mouth or via NG/OG tube.
• Konvomep oral suspension: Pre-mixed liquid suspension for oral or tube administration; dispenses 2 mg/mL omeprazole + 84 mg/mL sodium bicarbonate.
• Zegerid OTC: 20 mg omeprazole + 1,100 mg sodium bicarbonate capsules, available without a prescription for heartburn treatment.

How Do You Take Omeprazole/Sodium Bicarbonate?

Follow your doctor's instructions exactly. General guidelines:

• Take on an empty stomach, at least 1 hour before a meal. Food can reduce the absorption of omeprazole.
• Swallow capsules whole with water only. Do not open, crush, or chew the capsule. Do not take with other liquids.
• For powder suspension: Empty one packet into a small cup with 5-10 mL of water, stir, and drink immediately. Do not mix with any other liquid or food.
• For Konvomep suspension: Shake well before each use. Measure with a marked measuring spoon or oral syringe.

What Is the Difference Between Zegerid and Regular Omeprazole?

Both contain omeprazole as the active ingredient. The key difference is absorption speed:

• Standard omeprazole (Prilosec): Enteric-coated delayed-release. The coating prevents dissolution until it reaches the alkaline small intestine, delaying absorption.
• Zegerid (omeprazole/sodium bicarbonate): Immediate-release. The sodium bicarbonate neutralizes stomach acid immediately, protecting omeprazole without the need for enteric coating and allowing faster absorption into the bloodstream.

For most patients treating GERD or heartburn, the end result (acid suppression) is similar. The difference matters most when rapid onset is needed — such as in the ICU for upper GI bleed prevention.

Who Should NOT Take Omeprazole/Sodium Bicarbonate?

Do not take omeprazole/sodium bicarbonate if you:

• Are allergic to omeprazole, sodium bicarbonate, or any substituted benzimidazole
• Take rilpivirine-containing HIV medications (Edurant, Juluca, Complera, Odefsey) — contraindicated
• Are on a strict low-sodium diet without discussing this with your doctor first — each dose adds significant sodium
• Take clopidogrel (Plavix) — discuss with your cardiologist, as omeprazole reduces clopidogrel's antiplatelet effect

How Do I Get It and What Does It Cost?

Brand Zegerid retails at over $1,200 for 30 capsules, but the generic with a GoodRx coupon costs as low as $28.63 for 30 capsules. Zegerid OTC costs about $13-17 without discounts. For help finding a pharmacy near you that has omeprazole/sodium bicarbonate in stock, use medfinder. For a full breakdown of savings strategies, see our guide on how to save money on omeprazole/sodium bicarbonate.