Ruling+ Sachets 40Mg (1 Box = 10 Sachets)

Requires Prescription: Yes

Generics: Omeprazole + Sodium Bicarbonate

Used For: Gastroesophageal Reflux Disease (GERD)

How It Works:

Omeprazole decreases gastric acid secretion through a distinctive mechanism. It is part of the substituted benzimidazole class, which does not have anti-cholinergic or H2 histamine antagonist properties. Omeprazole irreversibly inhibits the enzyme system hydrogen/potassium adenosine triphosphatase (H+/K+ ATPase), the proton pump of the gastric parietal cells. This leads to dose-dependent inhibition of both basal and stimulated gastric acid secretion, regardless of the stimulus.

Ruling+ Sachets Usage and Safety:

Dosage:

Omeprazole + Sodium Bicarbonate

Side Effects:

Common:

Central and Peripheral Nervous System: Headache

Gastrointestinal: Diarrhea, constipation, abdominal pain, nausea/vomiting, flatulence

Uncommon:

Central and Peripheral Nervous System: Dizziness, paraesthesia, somnolence, insomnia, vertigo

Hepatic: Increased liver enzymes

Skin: Rash, pruritis, urticaria

Other: Malaise

Rare:

Central and Peripheral Nervous System: Reversible mental confusion, agitation, aggression, depression, hallucinations (more common in severely ill patients)

Endocrine: Gynecomastia

Drug Interactions:

Ketoconazole, itraconazole

Diazepam, citalopram, imipramine, clomipramine

Phenytoin

Atazanavir

Digoxin, clopidogrel

Posaconazole, erlotinib, saquinavir

Tacrolimus, methotrexate

Clarithromycin

CYP2C19 or CYP3A4 inhibitors/inducers (e.g., rifampicin, St. John’s Wort)

Indication:

Treatment of erosive reflux esophagitis

Long-term management of healed esophagitis to prevent relapse

Symptomatic treatment of gastroesophageal reflux disease (GERD)

When Not to Use:

Contraindicated in patients with hypersensitivity to any component of the formulation or to substituted benzimidazoles

Should not be used with nelfinavir

Ruling+ Sachets Precautions:

Precaution:

Symptomatic relief from omeprazole therapy does not rule out the presence of gastric malignancy.

Ruling+ Sachets Warnings:

Warning 1:

Atrophic gastritis has occasionally been observed in gastric corpus biopsies from patients receiving long-term omeprazole treatment.

Warning 2:

Sodium bicarbonate should be used cautiously in patients with Bartter’s syndrome, hypokalemia, respiratory alkalosis, or issues with acid-base balance. Long-term use of bicarbonate with calcium or milk can lead to milk-alkali syndrome.

Warning 3:

The powder for oral suspension contains sodium from sodium bicarbonate. This should be considered for patients on a sodium-restricted diet.

Additional Information

Pregnancy Category

Always consult your physician before using any medication.

Storage:

Store at room temperature, away from direct light and heat.