ADVERSE REACTIONS
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
In the U.S. clinical trial population of 465 patients, the adverse reactions summarized in Table 2 were reported to occur in 1% or more of patients on therapy with omeprazole. Numbers in parentheses indicate percentages of the adverse reactions considered by investigators as possibly, probably or definitely related to the drug.
Table 2: Adverse Reactions Occurring In 1% or More of Patients on Omeprazole Therapy
|
Omeprazole
(n = 465)
|
Placebo
(n = 64)
|
Ranitidine
(n = 195)
|
Headache
|
6.9 (2.4)
|
6.3
|
7.7 (2.6)
|
Diarrhea
|
3.0 (1.9)
|
3.1 (1.6)
|
2.1 (0.5)
|
Abdominal Pain
|
2.4 (0.4)
|
3.1
|
2.1
|
Nausea
|
2.2 (0.9)
|
3.1
|
4.1 (0.5)
|
URI
|
1.9
|
1.6
|
2.6
|
Dizziness
|
1.5 (0.6)
|
0.0
|
2.6 (1.0)
|
Vomiting
|
1.5 (0.4)
|
4.7
|
1.5 (0.5)
|
Rash
|
1.5 (1.1)
|
0.0
|
0.0
|
Constipation
|
1.1 (0.9)
|
0.0
|
0.0
|
Cough
|
1.1
|
0.0
|
1.5
|
Asthenia
|
1.1 (0.2)
|
1.6 (1.6)
|
1.5 (1.0)
|
Back Pain
|
1.1
|
0.0
|
0.5
|
Table 3 summarizes the adverse reactions that occurred in 1% or more of omeprazole-treated patients from international double-blind, and open-label clinical trials in which 2,631 patients and subjects received omeprazole.
Table 3: Incidence of Adverse Reactions ≥ 1% Causal Relationship not Assessed
|
Omeprazole
(n = 2631)
|
Placebo
(n = 120)
|
Body as a Whole, site unspecified
|
Abdominal pain
|
5.2
|
3.3
|
Asthenia
|
1.3
|
0.8
|
Digestive System
|
Constipation
|
1.5
|
0.8
|
Diarrhea
|
3.7
|
2.5
|
Flatulence
|
2.7
|
5.8
|
Nausea
|
4.0
|
6.7
|
Vomiting
|
3.2
|
10.0
|
Acid regurgitation
|
1.9
|
3.3
|
Nervous System/Psychiatric
|
Headache
|
2.9
|
2.5
|
A controlled clinical trial was conducted in 359 critically ill patients, comparing ZEGERID 40 mg/1680 mg suspension once daily to I.V. cimetidine 1200 mg/day for up to 14 days. The incidence and total number of AEs experienced by ≥ 3% of patients in either group are presented in Table 4 by body system and preferred term.
Table 4: Number (%) of Critically Ill Patients with Frequently Occurring (≥ 3%) Adverse Events by Body System and Preferred Term
* Clinically significant upper gastrointestinal bleeding was considered a serious adverse event but it is not included in this table.
|
NOS = Not otherwise specified.
|
| ZEGERID® (N=178)
|
Cimetidine (N=181)
|
MedDRA Body System Preferred Term
|
All AEs n (%)
|
All AEs n (%)
|
BLOOD AND LYMPHATIC SYSTEM DISORDERS
|
|
|
Anemia NOS
|
14 (7.9)
|
14 (7.7)
|
Anemia NOS Aggravated
|
4 (2.2)
|
7 (3.9)
|
Thrombocytopenia
|
18 (10.1)
|
11 (6.1)
|
CARDIAC DISORDERS
|
|
|
Atrial Fibrillation
|
11 (6.2)
|
7 (3.9)
|
Bradycardia NOS
|
7 (3.9)
|
5 (2.8)
|
Supraventricular Tachycardia
|
6 (3.4)
|
2 (1.1)
|
Tachycardia NOS
|
6 (3.4)
|
6 (3.3)
|
Ventricular Tachycardia
|
8 (4.5)
|
6 (3.3)
|
GASTROINTESTINAL DISORDERS *
|
|
|
Constipation
|
8 (4.5)
|
8 (4.4)
|
Diarrhea NOS
|
7 (3.9)
|
15 (8.3)
|
Gastric Hypomotility
|
3 (1.7)
|
6 (3.3)
|
GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS
|
|
|
Hyperpyrexia
|
8 (4.5)
|
3 (1.7)
|
Edema NOS
|
5 (2.8)
|
11 (6.1)
|
Pyrexia
|
36 (20.2)
|
29 (16.0)
|
INFECTIONS AND INFESTATIONS
|
|
|
Candidal Infection NOS
|
3 (1.7)
|
7 (3.9)
|
Oral Candidiasis
|
7 (3.9)
|
1 (0.6)
|
Sepsis NOS
|
9 (5.1)
|
9 (5.0)
|
Urinary Tract Infection NOS
|
4 (2.2)
|
6 (3.3)
|
INVESTIGATIONS
|
|
|
Liver Function Tests NOS Abnormal
|
3 (1.7)
|
6 (3.3)
|
METABOLISM AND NUTRITION DISORDERS
|
|
|
Fluid Overload
|
9 (5.1)
|
14 (7.7)
|
Hyperglycaemia NOS
|
19 (10.7)
|
21 (11.6)
|
Hyperkalaemia
|
4 (2.2)
|
6 (3.3)
|
Hypernatraemia
|
3 (1.7)
|
9 (5.0)
|
Hypocalcaemia
|
11 (6.2)
|
10 (5.5)
|
Hypoglycaemia NOS
|
6 (3.4)
|
8 (4.4)
|
Hypokalaemia
|
22 (12.4)
|
24 (13.3)
|
Hypomagnesaemia
|
18 (10.1)
|
18 (9.9)
|
Hyponatraemia
|
7 (3.9)
|
5 (2.8)
|
Hypophosphataemia
|
11 (6.2)
|
7 (3.9)
|
PSYCHIATRIC DISORDERS
|
|
|
Agitation
|
6 (3.4)
|
16 (8.8)
|
RESPIRATORY, THORACIC AND MEDIASTINAL DISORDERS
|
|
|
Acute Respiratory Distress Syndrome
|
6 (3.4)
|
7 (3.9)
|
Nosocomial Pneumonia
|
20 (11.2)
|
17 (9.4)
|
Pneumothorax NOS
|
1 (0.6)
|
8 (4.4)
|
Respiratory Failure
|
3 (1.7)
|
6 (3.3)
|
SKIN AND SUBCUTANEOUS TISSUE DISORDERS
|
|
|
Decubitus Ulcer
|
6 (3.4)
|
5 (2.8)
|
Rash NOS
|
10 (5.6)
|
11 (6.1)
|
VASCULAR DISORDERS
|
|
|
Hypertension NOS
|
14 (7.9)
|
6 (3.3)
|
Hypotension NOS
|
17 (9.6)
|
12 (6.6)
|
Postmarketing Experience
The following adverse reactions have been identified during post-approval use of omeprazole. Because these reactions are voluntarily reported from a population of uncertain size, it is not always possible to reliably estimate their actual frequency or establish a causal relationship to drug exposure.
Body as a Whole: Hypersensitivity reactions, including anaphylaxis, anaphylactic shock, angioedema, bronchospasm, interstitial nephritis, urticaria (see also Skin below), fever, pain, fatigue, malaise.
Cardiovascular: Chest pain or angina, tachycardia, bradycardia, palpitation, elevated blood pressure, and peripheral edema.
Gastrointestinal: Pancreatitis (some fatal), anorexia, irritable colon, flatulence, fecal discoloration, esophageal candidiasis, mucosal atrophy of the tongue, dry mouth, stomatitis and abdominal swelling. During treatment with omeprazole, gastric fundic gland polyps have been noted rarely. These polyps are benign and appear to be reversible when treatment is discontinued. Gastroduodenal carcinoids have been reported in patients with Zollinger-Ellison syndrome on long-term treatment with omeprazole. This finding is believed to be a manifestation of the underlying condition, which is known to be associated with such tumors.
Hepatic: Mild and, rarely, marked elevations of liver function tests [ALT (SGPT), AST (SGOT), γ-glutamyl transpeptidase, alkaline phosphatase, and bilirubin (jaundice)]. In rare instances, overt liver disease has occurred, including hepatocellular, cholestatic, or mixed hepatitis, liver necrosis (some fatal), hepatic failure (some fatal), and hepatic encephalopathy.
Metabolism and Nutritional Disorders: Hyponatremia, hypoglycemia, hypomagnesemia, and weight gain.
Musculoskeletal: Muscle cramps, myalgia, muscle weakness, joint pain, bone fracture, and leg pain.
Nervous System/Psychiatric: Psychic disturbances including depression, agitation, aggression, hallucinations, confusion, insomnia, nervousness, tremors, apathy, somnolence, anxiety, dream abnormalities; vertigo; paresthesia; and hemifacial dysesthesia.
Respiratory: Epistaxis, pharyngeal pain.
Skin: Severe generalized skin reactions including toxic epidermal necrolysis (TEN; some fatal), Stevens-Johnson syndrome, and erythema multiforme (some severe); purpura and/or petechiae (some with rechallenge); skin inflammation, urticaria, angioedema, pruritus, photosensitivity, alopecia, dry skin, and hyperhidrosis.
Special Senses: Tinnitus, taste perversion.
Ocular: Blurred vision, ocular irritation, dry eye syndrome, optic atrophy, anterior ischemic optic neuropathy, optic neuritis and double vision.
Urogenital: Interstitial nephritis (some with positive rechallenge), urinary tract infection, microscopic pyuria, urinary frequency, elevated serum creatinine, proteinuria, hematuria, glycosuria, testicular pain, and gynecomastia.
Hematologic: Rare instances of pancytopenia, agranulocytosis (some fatal), thrombocytopenia, neutropenia, leukopenia, anemia, leucocytosis, and hemolytic anemia have been reported.
The incidence of clinical adverse experiences in patients greater than 65 years of age was similar to that in patients 65 years of age or less.
Additional adverse reactions that could be caused by sodium bicarbonate include metabolic alkalosis, seizures, and tetany.
|
REPORTS OF SUSPECTED ZEGERID SIDE EFFECTS / ADVERSE REACTIONS
Below is a sample of reports where side effects / adverse reactions may be related to Zegerid. The information is not vetted and should not be considered as verified clinical evidence.
Possible Zegerid side effects / adverse reactions in 69 year old male
Reported by a consumer/non-health professional from United States on 2012-04-27
Patient: 69 year old male weighing 88.9 kg (195.6 pounds)
Reactions: Abdominal Discomfort, Hypophagia, Pain, Abdominal Distension
Adverse event resulted in: hospitalization
Suspect drug(s):
Zegerid
Other drugs received by patient: Entocort EC
Possible Zegerid side effects / adverse reactions in 69 year old male
Reported by a consumer/non-health professional from United States on 2012-05-17
Patient: 69 year old male weighing 88.9 kg (195.6 pounds)
Reactions: Abdominal Discomfort, Increased Upper Airway Secretion, Pain, Hypophagia, Abdominal Distension, Unevaluable Event
Adverse event resulted in: hospitalization
Suspect drug(s):
Zegerid
Other drugs received by patient: Entocort EC
Possible Zegerid side effects / adverse reactions in 65 year old female
Reported by a consumer/non-health professional from United States on 2012-08-27
Patient: 65 year old female weighing 72.6 kg (159.7 pounds)
Reactions: Vomiting, Drug Ineffective, Hypoaesthesia, Headache, Abdominal Pain Upper, Malaise, Road Traffic Accident, Gastrointestinal Pain, Withdrawal Syndrome, Hypertension, Muscle Spasms, Neuralgia
Suspect drug(s):
Neurontin
Dosage: unk
Lyrica
Dosage: 100 mg, 3x/day
Indication: Neuralgia
Start date: 2008-01-04
Zegerid
Dosage: unk
Indication: Abdominal Pain Upper
|