Omeprazole, sodium bicarbonate (Zegerid)

SELF ADMINISTRATION

FDA Approved Indications:
  • Short-term treatment of active duodenal ulcer
  • Short-term treatment of active benign gastric ulcer
  • Treatment of gastroesophageal reflux disease (GERD)
  • Maintenance of healing of erosive esophagitis
  • Reduction of risk of upper GI bleeding in critically ill patients
Prior authorization criteria:
  • Diagnosis of FDA approved indication (see above), AND
  • Patient is 18 years of age or older, AND
  • Patient has tried and failed PPI alternatives (e.g., omeprazole capsules) with concomitant sodium bicarbonate (available OTC), and Zegerid OTC, OR
  • For packets: patient has a G-tube in place and has tried and failed PPI alternatives that are compatable with G-tube administration
Dosing:
  • Short-term treatment of active duodenal ulcer: 20 mg once daily for 4 weeks (some patients may require an additional 4 weeks of therapy)
  • Gastric ulcer: 40 mg once daily for 4-8 weeks
  • Gastroesophageal reflux disease (GERD):
    • Symptomatic GERD (with no esophageal erosions): 20 mg once daily for up to 4 weeks
    • Erosive Esophagitis: 20 mg once daily for 4-8 weeks
  • Maintenance of healing of erosive esophagitis: 20 mg once daily
  • Reduction of risk of upper GI bleeding in critically ill patients: (40 mg oral suspension only) 40 mg initially followed by 40 mg 6-8 hours later and 40 mg daily therafter for 14 days
Approval:
  • Dependent on diagnosis

The site you are transferring to is not hosted by WHA. WHA's Terms of Use and internet Privacy Practices do not apply to your use of this linked site. Please review the policies on privacy and terms of use for the linked site. WHA does not control the accuracy, completeness, or timeliness of the content on the linked site.

Press Esc to cancel

El sitio Web al que está siendo transferido no es provisto por WHA. Las Condiciones de Uso y las Prácticas de Privacidad en Internet de WHA no se aplican a este sitio Web asociado que usted está usando. Revise las políticas sobre la privacidad y condiciones de uso de este sitio Web asociado. WHA no tiene control sobre la exactitud, la totalidad o la actualidad del contenido del sitio Web asociado. WHA no puede garantizar que los servicios de traducción de idiomas estarán disponibles en el sitio vinculado.

Presione «Esc» para cancelar