I take apixaban following open heart surgery last year. Initially I was taking Lanzoprazole (PPI) on the pharmacists recommendation but after a few months developed severe diarrhea. After changing various pills it came down to the Lanzoprazole causing the diarrhea. I stopped the PPI and the heart team team seem to think it wasn't an issue as the PPI was initially because I was on aspirin rather than apixaban. However recently the doctors pharmacist recommended a PPI. I took one dose of Lanzoprazole and within 24 hours had a bout of diarrhea. Does anyone on here have any similar issues.
Does anyone have a long term use of apixaban without a PPI ?
Thought s?
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Bobkins99
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Hello there, sorry to hear of your issues with lanzaprazole. Can't find the links but there is research which shows this can happen. I struggled when taking it, whole system upset. Was better when I stopped it. Restarted it at a nurses suggestion and as bad as ever, so stopped it again. In some people it seems to cause the very thing it us supposed to prevent!
Yes, exactly the same for me. Lanzoprazole have me the runs which stopped when I stopped taking it. Later tried Omeprazole, but with the same result. I no longer take any PPI.
I have taken lanzoprazole for many years for acid reflux. My original daily dose was 15mg/day. After bypass surgery I was on aspirin so my lanzoprazole dose was increased to 30mg/day to protect the stomach. I find lanzoprazole affects my digestion and makes me gassy and "loose", but I never had diarrhea. I've got entirely used to it and (for me) this side effect is better than suffering acid reflux. A year ago my aspirin was switched to apixaban and lanzoprazole was reduced back to 15mg. Nothing changed for me - the combo of apixaban and lanzoprazole makes no noticable difference to my guts. I wouldn't expect it to because they are doing very different things and work in very different ways.
I've also been on Lansoprozole for years. Now I'm taking 30mg per day! I don't get any major side effects but if I don't take them, my Acid Reflux is crippling!
Hi, I have been on Apixaban for 8 years without any problems. Just before Christmas my GP prescribed Omeprazole as he thought medication I was taking was possibly irritating my stomach ( I take a lot of tablets for heart issues) I have had no side effects taking Omeprazole. There are plenty of PP's to try, have a chat with someone and try a different one.
hi - I had exact same experience - with Lansoprazole . Was taken off and immediately those symptoms stopped . But not before I’d had a colonoscopy for good measure !
Hi 👋 Bob, following my Double Bypass September 2022 I was on the usual list of medication including 30mg Lansoprazole + Clopidogrel. From the get go I felt slight nausea an hour or so following a morning dose of Lansoprazole. I put up with this for months. I was told it's probably the Lansoprazole but as I was on Clopidogrel I was advised to stick with it. Jan/February onwards I was having anything up to five bowel movements per day. Eventually, I could stand it no more and told my GP I'd had enough and to hell with the consequences I was going to stop taking all my meds!
After I'd calmed down I agreed to try stopping my meds one at a time to see if we could identify which one was causing my symptoms. Fortunately, I'm lucky as I have no underlying health conditions so I wouldn't advise anyone to follow in my footsteps. 1st I stopped the Bisoprol then the Aspirin then Ramipril then the Atorvastatin without any change. (after stopping each one started it again before dropping the next). In an act of desperation I phoned the BHF help line. After a long talk with one of the very understanding Nurses though risky as long as I continued with a daily Aspirin I could drop the Clopidogrel & Lansoprazole. Within days my symptoms vanished. Couple of days later I had a face to face appointment with my GP and following on from that had a call from the cardiologist who diagnosed my stenosis 12 mths go.
In short I'm now only taking a daily Aspirin & 20 gram of Omeprazole that's still a proton pump inhibitor but doesn't seem to effect me and others in the same awful way.
Who knows what the future holds I may well regret my decision but for the 1st time since my Bypass I actually feel well again.
I also had severe diarrhoea with lansaprozole. Had taken it for several months and following colonoscopy to rule anything sinister out I was advised by my cardiologist to take it on a prn basis, however, I asked my gp if I could have gastric resistant aspirin and decided myself to come off it. No more diarrhoea!!!!!! It was definitely the lansaprozole that caused it!
Lansaprazole gave me the runs, and because no-one realised what was causing it I lost a huge anount of weight, had a colonoscopy and a gastroscopy, then started vomiting. I worked out what the cause was and stopped that, tried every PPI there is, couldn't taje any of them. I now take Famotidine, an H2 receptor atagonist, I'd previously been on Ranitidine which worked incredibly well for me. Famotidine has caused some side effects, fatigue & constipation among others, but have now, on medical advice, halved the dose and it's been ok for a while.
Long term use of PPIs can cause some nasty side effects, (do a google). I am currently doing "cold turkey" to get off them (Lansoprazole) and it isnt easy. I have had various possible side effects and my GP has given me Cemetidine to take instead.
Iron deficency, possible magnesium and calcium deficiency you need stomach acid to absorb these minerals. There is also an increased risk of alzheimer's and I don't want that!
Thanks for the reply. I stopped taking Lansoprazole a few weeks back but I'm now suffering with reflux again. I think I will give it a little longer for it to settle down.
I had typical reflux symptoms, burning in my oesophagus, actual stomach fluid coming up my throat and so on. It's settled now, the cemetidine have helped a lot. I am on a high dose of cemetidine (2x40mg daily) but I will start reducing this soon.
Ah! The old thinking bones, might help with my mental performance! Yes thinning of the bones can be caused by calcium and magnesium malabsorption due to lack of acid in the stomach. I have got my Lansoprazole usage down to 15mg every two days or sometimes three days. Thats about the best I can do. Its a difficult drug to get off. John
I came off it three months ago without any problems, but now the reflux has returned, so I am back on it again. I did try Famotidine first, but it caused diarrhoea. I take 15mg twice daily but I don't intend staying on it for life as I have osteoporosis.
Hi. I have been taking apixaban for about 5 years and the only time I have taken a ppi was for a couple of days after my ablation. I can only think it isn’t necessary to take one if you are better off without it but obviously I am not a doctor so it is only my opinion.
I've been taking apixaban since I swapped from warfarin in 2016.It was never suggested I take a PPI. I did end up on them for a while as I had unrelated gastritis and duodenitis but got off them as fast as I could. No side effects but didn't want to be stuck on them for ever.
Long term you have to balance risks with individual need.
I've been on a fairly standard cocktail since my nstemi in November. Been struggling with fatigue and low Hr but also about 2-3 weeks ago started to suffer bad diarrhea, had been fine that end prior to then. Saw cardiologist last week who stopped the bisoprosol because of fatigue/HR byt also the lansaprozole to help with the other problem. He also halved atorvastatin to 40mg. Hopefully things will improve once I've adjusted to new regime.
Hi Bobkins, yes, I take apixaban daily and do not take a PPI, though I had to take omeprazole when I was on aspirin (awful experience) and then lansoprazole when I switched to clopidogrel (also bad). My stomach went through the mill with both anti-clotters, hence the swap to apixaban, after which I was told that I no longer needed a PPI.
I found lansoprazole a big problem; it adversely affected my heart activity as it altered my magnesium levels. Magnesium levels are something to watch out for if anyone out there is taking lansoprazole and notices flutters and keeps feeling inexplicably faint/woozy.
I'm fine without any PPI now. In your position, I'd take the advice of the cardiac clinic. Alternatively, you could go information hunting. Speak with a different pharmacist from a high street or supermarket chemist to get a second opinion about the need to take a PPI while on apixaban. Explain that the PPI is adversely affecting your digestive system. Speak with a third pharmacist if you have two conflicting opinions.
I cast no aspersions, but please do bear in mind that NHS surgery pharmacies, like other pharmacy outlets, are businesses run for profit. They get paid for every drug they dispense.
Just came across your post from 3 mugs ago. So pleased I came across it. Why? I had horrendous diarrhoea that was nothing like I had ever experienced before, after one dose of Lansoprazole which was prescribed to take a few days before taking aspirin and clopidogrel in prep for a stent. The procedure was cancelled due to the diarrhoea. I call it diarrhoea for want of I better word...it was not normal at all. Anyway I have been on apixaban for 3 yrs and have never needed gastro medication. My gut and digestive was perfect until I took one dose of Lansoprazole.
hi there. I too had the same problem once my sacubitrol Entresto was doubled a month after starting it. A whole month of non stop diarrhea resulting in hospital stay, tests , colonoscopy. I read in messages here that Lansoprozol could be causing it. I was put on different PPI and still had diarrhea so am now on a non PPI and am fine.
I am on 30mg Lanzoprazole due to a diagnosis of Afib. I do find a loosened bowel movement after taking it for 4 months. I have also developed a wheezy cough, and never had any symptoms of acid reflux before meds. I am wondering if the Lanzoprozole is actually causing the problem it is meant to control.
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