Comprehensive medication guide to Omeprazole/Sodium Bicarbonate including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$60 copay depending on plan; brand Zegerid is not covered by most Medicare or commercial plans. Generic omeprazole/sodium bicarbonate may be covered at Tier 2–3 with prior authorization and step therapy. Some plans offer $0 copay for generic under Tier 1.
Estimated Cash Pricing
$29–$100 retail for generic 30 capsules; as low as $28.63 with a GoodRx coupon for generic omeprazole/sodium bicarbonate. Brand Zegerid retails at $967–$1,253 but can be obtained for $24–$36 with discount coupons.
Medfinder Findability Score
72/100
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Omeprazole/sodium bicarbonate is a prescription combination medication that pairs omeprazole — a proton pump inhibitor (PPI) — with sodium bicarbonate, an antacid. It is sold under the brand names Zegerid (capsules and powder for oral suspension) and Konvomep (oral suspension). An over-the-counter version, Zegerid OTC, is also available for frequent heartburn.
FDA-approved indications include gastroesophageal reflux disease (GERD), active duodenal and gastric ulcers, erosive esophagitis, H. pylori eradication (with antibiotics), and reduction of upper GI bleeding risk in critically ill patients. The medication is available as 20 mg and 40 mg capsules and as a powder for oral suspension (20 mg and 40 mg packets).
Generic omeprazole/sodium bicarbonate is manufactured by Zydus, Dr. Reddy's, Cipla, and others. It is bioequivalent to brand Zegerid and significantly more affordable, especially when combined with discount coupons.
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Omeprazole/sodium bicarbonate works through a two-part mechanism. The sodium bicarbonate component acts immediately as an antacid, neutralizing stomach acid and raising the gastric pH. This alkaline environment protects the omeprazole from degradation, allowing it to be absorbed as an immediate-release formulation — faster than standard enteric-coated omeprazole.
Once absorbed, omeprazole is activated in the acidic secretory canaliculi of parietal cells, where it irreversibly inhibits the H+/K+-ATPase enzyme — the proton pump responsible for the final step of acid secretion. This blocks acid production from all stimuli (food, histamine, gastrin) and reduces gastric acid output by 90-95% or more.
The acid suppression effect lasts far longer than the drug's 1-hour plasma half-life because the enzyme inhibition is irreversible — acid production only recovers as new proton pumps are synthesized over 18-24 hours. This is why once-daily dosing taken before breakfast provides all-day acid control.
20 mg / 1100 mg — capsule
For GERD (heartburn) and active duodenal ulcer — once daily before meal
40 mg / 1100 mg — capsule
For active gastric ulcer and erosive esophagitis — once daily before meal
20 mg / 1680 mg — powder for oral suspension
For patients who cannot swallow capsules — mixed with water before administration
40 mg / 1680 mg — powder for oral suspension
FDA-approved for critically ill patients for upper GI bleed prevention — also for oral/NG tube use
As of 2026, omeprazole/sodium bicarbonate (Zegerid) is not listed on the FDA's official drug shortage database. Generic versions are commercially available from multiple manufacturers. However, real-world availability is inconsistent — many retail pharmacies do not stock it routinely because it has lower prescription volume than plain omeprazole, and brand Zegerid is extremely expensive (over $1,200 retail for 30 capsules).
The powder for oral suspension and Konvomep formulations are particularly difficult to find at retail pharmacies; hospital outpatient pharmacies and specialty pharmacies are more reliable sources. Zegerid OTC (20 mg capsules) is the easiest formulation to find, available at major retailers.
To quickly find a pharmacy near you that has omeprazole/sodium bicarbonate in stock, use medfinder — a service that calls pharmacies on your behalf and texts you results showing which ones can fill your prescription.
Omeprazole/sodium bicarbonate is not a controlled substance, so there are no DEA requirements or special licensing needed to prescribe it. Any licensed prescriber — including physicians, nurse practitioners, and physician assistants — can prescribe it during any visit, including telehealth consultations.
Common prescribers include:
Telehealth prescribing is widely available for omeprazole/sodium bicarbonate. Platforms including MDLive, Teladoc, Doctor On Demand, and many insurance-provided virtual care programs can prescribe this medication after an online visit for GERD or heartburn symptoms.
No. Omeprazole/sodium bicarbonate (Zegerid, Konvomep) is not a controlled substance and has no DEA scheduling. It can be prescribed by any licensed prescriber — including nurse practitioners and physician assistants — without any special DEA requirements.
Because it is not a controlled substance, there are no restrictions on telehealth prescribing, and prescriptions can be called in or sent electronically to any pharmacy. Refills can be prescribed without in-person visits. The OTC version (Zegerid OTC, 20 mg) requires no prescription at all for heartburn treatment.
Most common side effects (generally mild and temporary):
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Omeprazole (Prilosec)
Same active ingredient (PPI) without sodium bicarbonate. Delayed-release enteric-coated formulation. Available OTC and by prescription. Much lower cost — generic as low as $6 with GoodRx. For most GERD and heartburn indications, equivalent efficacy.
Pantoprazole (Protonix)
PPI with minimal CYP2C19 drug interactions — preferred for patients on clopidogrel (Plavix) or multiple medications. Prescription only. Widely stocked, inexpensive generic.
Esomeprazole (Nexium)
S-isomer of omeprazole with slightly longer half-life. Available OTC (20 mg) and by prescription. Generic widely covered by insurance.
Lansoprazole (Prevacid)
PPI with rapid onset; available as orally disintegrating tablets — useful for patients who can't swallow capsules. Available OTC and by prescription.
Famotidine (Pepcid)
H2 blocker — faster onset than PPIs (30-60 minutes) but shorter duration (6-12 hours). Good for on-demand or occasional heartburn relief. Available OTC, very inexpensive.
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Rilpivirine (Edurant, Juluca, Complera, Odefsey)
majorContraindicated. Omeprazole raises gastric pH and reduces rilpivirine absorption by over 90%, potentially causing HIV treatment failure.
Clopidogrel (Plavix)
majorOmeprazole inhibits CYP2C19 activation of clopidogrel, reducing antiplatelet effect. Can increase cardiovascular event risk. Consider pantoprazole instead.
Atazanavir (Reyataz)
majorOmeprazole 40 mg reduces atazanavir AUC by 94%. Avoid combination. Consider alternative antiretroviral regimen.
Methotrexate
majorPPIs may reduce renal clearance of methotrexate, increasing toxicity risk. Monitor methotrexate levels closely, especially at high doses.
Warfarin (Coumadin)
moderateOmeprazole inhibits CYP2C19 metabolism of warfarin, potentially raising INR. Monitor INR when starting or changing omeprazole doses.
Iron supplements
moderateOmeprazole reduces gastric acid needed for iron absorption. Separate doses by at least 2 hours.
Ketoconazole, itraconazole (antifungals)
moderateThese antifungals require acidic environment for absorption. Omeprazole reduces their bioavailability. Separate by 2 hours; monitor antifungal efficacy.
Digoxin (Lanoxin)
moderateOmeprazole may increase digoxin levels by raising gastric pH and improving digoxin absorption. Monitor for digoxin toxicity.
Omeprazole/sodium bicarbonate (Zegerid) is a well-established, FDA-approved medication for treating GERD, peptic ulcers, erosive esophagitis, and upper GI bleeding prevention in critical care settings. Its unique immediate-release formulation offers faster absorption compared to standard enteric-coated omeprazole — a clinically meaningful difference in specific patient populations.
The primary challenges in 2026 are cost and availability. Brand Zegerid is extremely expensive and not routinely covered by most insurance plans. The good news is that the generic is therapeutically equivalent and can be obtained for under $30 per month with discount coupons. Finding the medication in stock requires some effort due to inconsistent pharmacy inventory, but it is not in a nationwide shortage.
If you are struggling to fill your omeprazole/sodium bicarbonate prescription, medfinder can help by calling pharmacies near you to find which ones have it in stock, then texting you results. It's a fast, efficient way to get your medication without calling pharmacies individually or driving around.
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