When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to omeprazole or sodium bicarbonate.

How to Use This Medicine:
Capsule, Packet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Take this medicine at least 1 hour before a meal and for the full time of treatment, even if you begin to feel better after a few days.
• Capsule: Swallow whole with water. Do not take this medicine with other liquids. Do not break, crush, chew, or open the capsule.
• Oral packet: Mix with 1 to 2 tablespoons of water in a small cup and drink the mixture right away. Do not mix with other liquids or food. Refill the cup with water and drink it to make sure you get the full dose.
  
  • To prepare the oral packet for a feeding tube: Patients should not receive food for 3 hours before and 1 hour after receiving this medicine.
    
    • Add 20 mL of water to a catheter-tipped syringe. Then add the contents of the package. Shake well.
    • Give the medicine through the tube right away.
    • Refill the syringe with an equal amount of water and shake it.
    • Use the water to flush the tube. This helps make sure all the medicine is given.
• Do not substitute two 20-milligram packets or capsules for one 40-milligram packet or capsule. You will receive too much sodium bicarbonate.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how omeprazole/sodium bicarbonate works. Tell your doctor if you are using any of the following:
  
  • Ampicillin, clarithromycin, clopidogrel, cyclosporine, digoxin, disulfiram, erlotinib, ketoconazole, methotrexate, mycophenolate mofetil, phenytoin, rifampin, St John's wort, tacrolimus, voriconazole
  • Benzodiazepine medicine (such as diazepam)
  • Blood thinner (such as warfarin)
  • Diuretic (water pill)
  • Iron supplements
  • Medicine to treat HIV or AIDS (such as atazanavir, nelfinavir, saquinavir)
• Tell your doctor if you take calcium supplements regularly.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have Bartter syndrome, liver disease, heart failure, or osteoporosis.
• Tell your doctor if you are on a low-salt diet. This medicine contains sodium.
• This medicine may cause the following problems:
  
  • Kidney problems
  • Low vitamin B12 or magnesium levels
  • Increased risk for broken bones in the hip, wrist, and spine
• This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Fever, joint pain, skin rash, swelling in the body, unusual weight gain, change in how much or how often you urinate
• Seizures, dizziness, uneven heartbeat, muscle cramps or twitching
• Severe diarrhea, stomach cramps, fever
• Stomach pain, nausea, vomiting, weight loss

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088