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This document outlines critical safety information and warnings associated with the use of Zegerid (omeprazole/sodium bicarbonate). Please review these details carefully and consult your healthcare provider if you have any questions or concerns.

• Follow-up with Provider Needed: If Zegerid alleviates your symptoms but they reoccur, contact your healthcare provider. This could indicate a more serious condition, such as stomach cancer, requiring further medical evaluation.

• Kidney Damage: There have been incidents of kidney damage during the use of PPIs like omeprazole. Symptoms include blood in urine, changes in urination frequency, nausea, fever, or confusion. If these occur, discontinue use and consult your healthcare provider immediately.

• Severe Skin Reactions: Rare but serious skin reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) can occur. Seek immediate medical attention if you experience flu-like symptoms with a skin rash, blisters, or peeling.

• High Sodium Content: Zegerid contains sodium, which can lead to swelling and weight gain. This is particularly concerning for individuals on a low-sodium diet or with conditions like heart failure or hypertension. Consult your provider if you need to limit sodium intake.

• Acid-Base Imbalance (Milk-Alkali Syndrome): Using Zegerid long-term or with calcium supplements/milk can shift the body's acid/base balance, potentially harming the kidneys. Symptoms include nausea, frequent urination, headache, or dizziness. Discuss these risks with your provider.

• Severe Diarrhea: Zegerid can increase the risk of bacterial infections causing severe diarrhea. Symptoms include persistent watery diarrhea, fever, or stomach pain. Use the lowest effective dose for the shortest duration to minimize risk. This is especially important if you're hospitalized.

• Bone Fractures: Long-term or high-dose use of Zegerid can increase fracture risk. Your provider may recommend vitamin D and calcium supplements. Discuss additional methods to maintain bone health.

• Lupus: Though rare, Zegerid can trigger or exacerbate lupus. Symptoms vary but may include joint pain or rash. Monitor for symptoms and consult your provider, as they typically improve within 1-3 months after stopping the medication.

• Drug Interactions: Zegerid may interact with various medications, such as reducing the efficacy of warfarin or increasing methotrexate levels, raising toxicity risk. It may also impact HIV treatments. Inform your healthcare provider of all medications and supplements you're taking.

• Low Vitamin B12 and Magnesium Levels: Long-term Zegerid use (over 1 year for magnesium, over 3 years for B12) can lead to deficiencies. Monitor levels if using Zegerid for extended periods.

• Stomach Growths: Prolonged use of Zegerid can increase the risk of developing small stomach growths. These typically have no symptoms, but minimizing treatment duration is recommended.

Contraindications: Do not use Zegerid if taking rilpivirine-containing medications or if allergic to benzimidazoles. Consult your healthcare provider before use if these apply to you.

For any concerns or unusual symptoms, seek medical guidance promptly. Your health and safety are of utmost importance.

When taking this medication, you may experience some mild side effects such as headaches, stomach pain, diarrhea, nausea, gas, or vomiting. These are common and generally not cause for concern. However, if they persist or worsen, it's advisable to consult with your healthcare provider.

Some individuals might also report other less common side effects like upper respiratory infections, dizziness, rash, constipation, or a lack of energy. Again, while these are not typically serious, you should consult a healthcare provider if they become troublesome.

There are, however, some rare but serious side effects that require immediate medical attention. These include severe diarrhea characterized by watery stools, fever, and persistent stomach pain; serious kidney issues such as changes in urination habits or blood in the urine; and severe skin reactions with symptoms like fever, body aches, or rash with blisters. Additionally, seriously low magnesium levels can occur, presenting with symptoms such as irregular heart rate, muscle cramps, tremors, or seizures. If you experience any of these severe side effects, seek medical care promptly.

A very serious allergic reaction is also rare but possible. Watch for signs such as fever, swollen lymph nodes, swelling of the face or throat, severe dizziness, or trouble breathing, and get immediate medical help if these occur. Lastly, though uncommon, prolonged use of this medication over several years may lead to vitamin B-12 deficiency, indicated by unusual weakness, a sore tongue, or numbness in the extremities. If you notice these symptoms, inform your healthcare provider right away.

When taking Zegerid (omeprazole/sodium bicarbonate), it's important to be aware of potential interactions with other medications. This drug can interact with several substances, potentially impacting how they work or increasing the risk of side effects.

Certain medications, such as rilpivirine, should not be used with Zegerid. If you are prescribed both, your doctor may suggest an alternative treatment. Some drugs, like Clopidogrel, Methotrexate (especially in high doses), Atazanavir, Erlotinib, and others, may require dosage adjustments or careful monitoring if taken with Zegerid. This is because Zegerid decreases stomach acid, which can affect the absorption and effectiveness of these medications.

Additionally, omeprazole is similar to esomeprazole, so avoid taking these two medications together. It's also worth noting that Zegerid can interfere with certain lab tests, leading to inaccurate results. Always inform your healthcare providers and lab personnel that you are using this medication.

Remember to inform your doctor and pharmacist about all the medications, supplements, and herbal products you are taking to prevent any unwanted interactions.