Carafate vs. Zegerid for Heartburn and GERD: Important Differences and Potential Risks.

Key takeaways

Sucralfate (Carafate) and Zegerid (omeprazole/sodium bicarbonate) are both used to treat ulcers, but they work in different ways. Sucralfate is an antiulcer medication that forms a protective barrier over ulcers to help them heal, and it is taken up to 4 times a day on an empty stomach. In contrast, Zegerid (omeprazole/sodium bicarbonate) is a combination of a proton pump inhibitor (PPI) and an antacid, which reduces stomach acid and is typically taken once daily. Sucralfate is available only by prescription, while Zegerid can be found both over-the-counter and by prescription. Sucralfate has fewer side effects because it is not absorbed into the body, whereas Zegerid can cause more serious side effects like bone fractures and low magnesium levels with long-term use. Additionally, Zegerid contains sodium, which may not be suitable for those on a low-sodium diet.

Sucralfate

(Carafate)

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Zegerid

(omeprazole / sodium bicarbonate)

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Summary for Carafate

Prescription only

Sucralfate (Carafate) is a prescription ulcer medication. It treats ulcers in the intestine (duodenal ulcers) in adults. Sucralfate (Carafate) is a protectant; the medication works directly at the site of the ulcer to protect it so it can heal. Although the medication helps ulcers heal, it isn't used to prevent future ulcers. Sucralfate (Carafate) comes in an oral suspension and tablets that are available as brand-name and generic versions. It's taken by mouth up to 4 times per day and it doesn't have many side effects since very little is absorbed from the gut.

Indications for Carafate

Short-term treatment (up to 8 weeks) of duodenal ulcer (open sore in the first part of the small intestine) - tablets and oral suspension
Maintenance treatment of duodenal ulcer after it's healed - tablets only

Pros and Cons for Carafate

Pros

Few side effects since the medication doesn't get absorbed into the body
Available as tablets, as well as a liquid for people with trouble swallowing pills
Available as a lower-cost generic

Cons

Need to take 4 times per day on an empty stomach for the first 1 to 2 months
Can affect how other medications are absorbed in the stomach since sucralfate (Carafate) creates a layer that covers the stomach lining
Risk of high aluminum levels in the body in people with kidney problems

Common Side Effects for Carafate

Constipation (2%)

Warnings for Carafate

High aluminum levels

Summary for Zegerid

Prescription or over-the-counter

Zegerid (omeprazole / sodium bicarbonate) is a combination medication used to treat conditions related to having too much stomach acid. This medication is typically taken by mouth once daily. But don't take it longer than what your provider recommends. Doing so raises your risk for side effects, such as bone fractures or low magnesium levels. Zegerid (omeprazole / sodium bicarbonate) is available as a powder that can be made into a liquid suspension for people who have trouble swallowing pills.

Indications for Zegerid

Prescription-strength Zegerid (omeprazole / sodium bicarbonate) capsules and suspension:

Stomach ulcer
Duodenal (first part of small intestine) ulcer
Heartburn and other symptoms related gastroesophageal reflux disease (GERD)
Erosive esophagitis (inflammation of the esophagus) due to GERD
Lower the risk of stomach bleeding in hospitalized people (suspension only)

OTC Zegerid (omeprazole / sodium bicarbonate) capsules:

Frequent heartburn

Konvomep (omeprazole / sodium bicarbonate) suspension:

Stomach ulcer
Lower the risk of stomach bleeding in hospitalized people

Pros and Cons for Zegerid

Pros

Available over the counter
Packet form is a good option if you have trouble swallowing pills
Typically taken once daily
Available as lower-cost generics
Longer-lasting relief than some other medications for heartburn

Cons

Takes 1 to 4 days to ease heartburn
Has sodium, so not a good option for people on sodium-restricted diets
Typically has to be taken on an empty stomach before meals for best results
Can interact with other medications
Long-term use can weaken your bones and cause low vitamin B12 and magnesium

Common Side Effects for Zegerid

Headache (3-7%)
Stomach pain (2-5%)
Diarrhea (3-4%)
Nausea (2-4%)
Gas (3%)
Vomiting (2-3%)

Please note: These side effects were reported in clinical trials by people who took omeprazole only. The side effects you experience from Zegerid (omeprazole / sodium bicarbonate) might differ.