Description

The combination of Omeprazole and Sodium Bicarbonate is a unique pharmaceutical formulation designed to provide both rapid and sustained relief from acid-related symptoms. It is a dual-action product that combines a proton pump inhibitor (PPI) with a fast-acting antacid.

• Omeprazole: The PPI component, which blocks the production of stomach acid.
• Sodium Bicarbonate: An alkaline compound that neutralizes existing stomach acid.

This combination is typically formulated as an immediate-release powder or capsule. The sodium bicarbonate serves a dual purpose: it acts as an antacid to neutralize stomach acid for immediate relief and, more importantly, it protects the acid-sensitive omeprazole from degradation in the stomach, allowing it to be absorbed quickly and begin its long-term acid-suppressing action.

Indications

This combination is specifically indicated for conditions where both immediate relief and long-term acid control are needed. Its key indications include:

• Heartburn: It is used for the treatment of frequent heartburn (two or more days a week). The sodium bicarbonate provides quick relief, while the omeprazole provides sustained acid suppression over 24 hours.
• Gastroesophageal Reflux Disease (GERD): It is used for the treatment and maintenance of GERD and associated symptoms.

• Healing of Erosive Esophagitis: For the short-term healing of damage to the esophagus caused by acid reflux.

• Other Hypersecretory Conditions: Similar to omeprazole alone, it can be used for conditions like Zollinger-Ellison syndrome, where there is an excessive production of stomach acid.

Mechanism of Action

The therapeutic effect of this combination is based on the synergistic action of its two components:

1. Immediate Action (Sodium Bicarbonate):
   • Sodium bicarbonate (NaHCO3​) is a potent, fast-acting antacid.

1. • Upon entering the stomach, it reacts with hydrochloric acid (HCl) to produce carbon dioxide, water, and a neutral salt (sodium chloride). This neutralization reaction is: HCl+NaHCO3​→NaCl+H2​O+CO2​
   • This action rapidly increases the gastric pH, providing immediate relief from heartburn and indigestion. This effect is why the combination is considered “immediate-release.”
2. Delayed and Sustained Action (Omeprazole):
   • The sodium bicarbonate’s most critical role in this formulation is to protect the omeprazole. Without it, the omeprazole would be degraded by stomach acid.
   • By neutralizing the stomach acid, the sodium bicarbonate creates a higher pH environment, which allows the omeprazole to pass safely into the small intestine where it is absorbed.
   • Once absorbed, the omeprazole, which is a prodrug, travels to the parietal cells in the stomach.
   • In the acidic environment of the parietal cells’ secretory canaliculi, omeprazole is activated and irreversibly binds to the H+/K+-ATPase enzyme (the proton pump).

• • This irreversible inhibition of the proton pump blocks the final step of gastric acid secretion, providing a powerful and sustained reduction in acid production for over 24 hours.

In summary, the sodium bicarbonate provides a rapid-onset buffering effect to relieve symptoms and, at the same time, ensures that enough omeprazole survives to be absorbed and provide long-term acid control.