Are PPIs safe to take for 18 months f... - British Heart Fou...

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Are PPIs safe to take for 18 months following heart attack?

Caroline36 profile image
16 Replies

Hi Everyone

I've been taking lanzoprazole for 18 months since I had a heart attack. Primarily because I was having terrible chest pains but now I think the pains were probably due to angina. I've been kept on them and haven't really given them much thought because they're the least of it in terms of drugs I take or so I thought. I've just been reading some really frightening research results about these sorts of drugs and I'm thinking it might be worth coming off it. I know I should speak to my doctor about this but I wondered if anyone had any thoughts or knowledge on the subject?

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Caroline36 profile image
Caroline36
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16 Replies

Good evening Caroline,

I have just checked with my medication, and I too take Lansoprazole (30mg) every day, along with various other meds, due to my having suffered a heart attack in April 2016. This is one tablet which I would definitely not be without.....I suffer with dreadful acid/gastro-reflux, and Lansoprazole is without doubt the best remedy for it. Could your chest pains have been related to what I have just described? Having suffered a heart attack - like me - you will be aware of the symptoms (although apparently, they are different between the sexes) and they can be very closely related to acid reflux symptoms - even down to the same pain in the chest. I realise that people are different, and that what suits one doesn't suit all, but from my personal experience, I only have good things to report about Lansoprazole. I wonder if you have given any thought to as to whether or not you might suffer with a gastric condition of which you were possibly not aware - the initial reason for your having been prescribed this drug may indeed be related to that? I have just consulted my BMA 'Guide to Medicines and Drugs', which states that Lansoprazole is prescribed to treat the situations which I have previously described, and that it works by reducing the amount of stomach acid produced. I had a very frightening gastric-related 'chest pain' experience whilst I was in Telford hospital awaiting an endoscopy; I was taken to the same hospital after my heart attack - having had both experiences, I can vouch that the chest pain is very similar, and equally scary! I sincerely hope that this is of use to you, and if in doubt, maybe a visit to a GP might help you. All the best.

in reply to

If you are only taking aspirin now come off the PPI - even folk with reflux should only be on this med for max of 8 weeks. NHS recommend ensuring you eat before taking aspirin (as a pain killer) to protect stomach so do not see why this should be any different for you. I am post heart op and after 3 months (as per cardiologist prescription) will be off Lapsoprazole and clopidogrel- both of these last two while likely important to take in early stages post HA etc are not proved efficacious long term. In fact studies are still going on (at least in Scotland) - as to optimum duration! My take on this is that even the experts do not know and if they give you horrible side effects how much good are they doing you? In my own case both of these meds cause muscle fatigue which impedes rehab exercising which is surely the best thing for recovery.

in reply to

Apologies for long comment (and Capitals - pasted from my docs): I WILL CONTINUE WITH ASPIRIN

BUT WILL STOP CLOPIDOGREL NOW BEEN ON IT FOR 2 MONTHS

WON’T CONTINUE WITH LANSOPRAZOLE OR ANY PPI–LONG TERM USE IS NOT ADVISED:

AS ACTUALLY CAUSES VASCULAR CALCIFICATION = HEART ATTACKS

ncbi.nlm.nih.gov/pubmed/299...

LANSOPRAZOLE long term has been linked to Osteoporosis

A meta-analysis of 33 studies including 2.7 million participants found a greater risk of fractures the longer people took PPIs (Journal of Bone Metabolism, online, Aug. 31, 2018). Another meta-analysis found that people who take PPI medicines are 26 percent more likely to break a hip than those who do not (Rheumatology International, Aug. 29, 2018).

• Kidney disease

• Infections (C. diff, pneumonia) increased fungal/yeast infections.

• Nutrient malabsorption (magnesium, calcium, zinc, vitamin B12)

• Weakened bones (osteopenia, osteoporosis, fractures)

• Heart attacks (vascular calcification)

• Dementia (Alzheimer disease)

• Blood disorders (iron deficiency anemia, thrombocytopenia)

• Disturbances in the ecology of the gut (microbiome)

• Liver inflammation (liver disease)

• Liver Cancer

• SIDE EFFECTS OF COUGH, BREATHLESSNESS

• AND MUSCLE WEAKNESS

pharmaceutical-journal.com/...?

peoplespharmacy.com/article...

I may well experiment with aspirin versus clopidogrel when I only have to take one med to see which one suits me better re any longer term symptoms. People are different and you really have to research hard and pay attention to what your body is telling you.

NorthantsSteve profile image
NorthantsSteve

Hi Caroline. I was on Lansoprazole (PPI) while I was on dual anti platelet therapy (Aspirin + Ticagrelor) for 12 months following my heart attack and stent. After that I dropped Ticagrelor and also stopped the PPI. The PPI is designed to protect your stomach by blocking acid production caused by the irritation of aspirin/Ticagrelor/Clopidogrel. Some people have problems with acid reflux etc or have other stomach issues (like ulcers) so have to continue with them but I’m told that adults should usually be able to take baby aspirin without a PPI. If you can avoid taking them it’s better as they can have longer term side effects.

Zac11 profile image
Zac11

Lansoprazole gave me terrible runs, so GP took me off it. Now still loose, but at least I only now have to go once a day in the morning instead of every few hours! Other meds are Apixaban, Bisoprolol, Ramipril, Atorvastatin and Citalopram.

benjijen profile image
benjijen

I've been on Lanzoprazole for just over 3 years due to having daily aspirin. Prior to starting it I always had terrible acid reflux - now I very rarely have it. I must admit I do worry about taking so many meds - I also have RD and underactive thyroid so am on 9 pills a day. I'm sure they must interact at some point but unfortunately I need to take them so try not to worry too much.

dickielex profile image
dickielex

I've been on Lanzoprazole after a terrifying internal bleed about 5 years ago which was caused , I am told, by a gastric ulcer probably not helped by the daily dose of aspirin I then took. I don't think that it's a scary drug and is much more like some of the anti-heartburn stuff like Gaviscon which can be bought over the counter. If you are in doubt about, speak to your GP about your worries.

thetidders profile image
thetidders

I was given Lanzoprazole after my bypass in April 18 & had no problems until October 19 when I started suffering from acute diarrhoea roughly weekly. By trial & error I narrowed it down to the Lanzoprazole & stopped it for a week & the diarrhoea started again. I saw my GP who said that yes it could happen with Lanzoprazole & put me on a low dose of Omeprazole. Unfortunately after a week the same thing has happened & so I have stopped it & have an appointment to see what he recommends or if I can just take an aspirin straight after a meal so it’s not on an empty stomach. I don’t take Clopidogrel now as it was stopped after 12 months.

All these drugs we are all on effect everyone differently, I think.

Jean

Qualipop profile image
Qualipop

You are on them to protect your stomach from the damage that aspiring and ticagrelor can do which I presume you were given. I assume you are still on aspirin which can cause stomach bleeding. Don't stop them without talking to your GP

Saffron63 profile image
Saffron63

Hi CarolineI was on omeprazole prior to my heart attack, It was then changed to lansoprazole as apparently it can reduce the effects of clopidogrel, so I’ve been on lansoprazole a year now. The last 2 months I’ve had intense dizzyness and strangely acid reflux type symptom. A blood test revealed I’m anemic, probably due to lansoprazole blocking the absorption of some vitamins. I have tried to reduce it but I think I’m getting a rebound affect as the acid reflux is awful. If I could go without it I would, I wish I’d never started it. Although you haven’t been on it that long so I wouldn’t worry too much, check with your GP if you really need it.

mauschen profile image
mauschen

I suggest you speak to your doctor regarding the reason you have been taking a PPI so long. For example, is it to protect your stomach against the potential problems of other drugs or do you have a chronic condition?

If you need to continue taking a PPI, perhaps a bone density test would be a good idea as PPI long term has been linked to Osteoporosis.

Janma123 profile image
Janma123

My hubby has been on omeprazole and now esomeprazole since 2007, to protect his stomach. One of the long term side effects is that stomach acid production is reduced and you are no longer able to extract vitamin b12 from food.

Metformin (for diabetes) has a similar effect but prevents you from absorbing b12.

Hubby is now on 3 monthly b12 injections to counteract this.

Caroline36 profile image
Caroline36

Thanks so much for taking the time to answer my question, you've given me quite a few things to think about. I think a trip to the doctor is in order, especially as I hadn't known about the problems absorbing some vitamins. Thanks again :)

juglansjames profile image
juglansjames

Hi Caroline

I had an allergic reaction to Asprin in 2004 and had Lansoprazole for 3 years afterwards as PPI to stabilise my stomach and diminish and finally stop reflux. And no asprin!! Jump forward to May 19 and I had a mild MI, an angiogram and one stent and onto dissolvable asprin again!! But this time I agreed to PPI Omeprazole to give me assurance and avoid reaction to asprin and reflux. No reflux no discomfort and back to a Tri-athlete level of fittness.

So I had 3 years previous on PPI and am now on PPI again and very happy. Your reflux ... check things like eating early in the evening, don’t sleep on an full meal. Diet!! Avoid acidic foods last mouthfuls; tomatoes, coffee, fruit juices, chocolate alcohol

Good luck

Radars profile image
Radars in reply tojuglansjames

Some people can never come off ppis i have been taking 20mg of rabeprazole for years for my hiatus hernia but now that I'm on isosorbide mononitrate statins and aspirin indigestion got worse so had to increase to 20mg twice a day what else can you do.

Farmer63 profile image
Farmer63

Hi, just seen this post while browsing, my mum was on a ppi for years, she suddenly developed dementia,as I was her primary carer I would collect her prescriptions, after she was officially diagnosed with Alzheimer's her ppi prescription just vanished from her med list. Without any explanation from her doctor or pharmacist,I did enquire to why this med was removed from her list, I just got a blank look and shouder of her shoulder from the pharmacist. Was the ppi the cause of her dementia ?

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