Just been diagnosed with moderate right carotid atherosclerosis. Started statins and prescribed aspirin and omeprazole. Just had 70th birthday. The aspirin is 75mg and enteric coated. I would prefer not to take omeprazole if I dont have to. Isn’t this the point of enteric coated?
I dont drink, dont smoke, BMI of 19.8. Do Pilates and Qi Gong and walk a lot. Total cholesterol was 7.3mmom/L September 2023 and has been around 6 - 7 mmol/L for last few years. Statins were mentioned but only in passing and told globally ok as my HDL is high.
Still in shock
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Chickenshahikorma
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Hi, following HA in April I am on 75mg dispersable Aspirin and was initially given Lansoprazole for stomach protection. I suffered terrible diarrhoea for about 3 weeks so GP suggested the Lansoprazole was not needed so gave it up and diarrhea cleared up straight away. However clinical pharmacist over ruled the GP and said I do need some cover if on aspirin and I've been on famotidine for last few weeks and fine. I have read that meds ending in "azole" can be bad for your....(sorry to be crude but rhymes with azole) so if you do suffer a switch to famotidine might work..good luck
Thanks for your reply. I hope you’re recovering well. I notice you’re on dispersible aspirin rather than enteric coated and I’m wondering whether that’s why your pharmacist recommended stomach protection
Yes I guess so, also on blood thinners and all the rest of the cocktail of meds. Good luck on statins too, got my first cholesterol check since HA due in mid August so will see if they're doing any good (although my total cholesterol was only 5.3;so not crazy high..)
I was wondering if there’s something else in your medical or family history to warrant Omeprazole? My husband has enteric coated aspirin and a drug similar to Omeprazole but has a history of tummy troubles.
Anyway, worth talking it through with someone e.g. your dispensing pharmacist or the pharmacist attached to your doc’s group of surgeries.
Thanks for your reply. Pharmacist tends to go along with GP but I’ll try and look into it more. Worried about osteoporosis as my last bone density, 5 years ago, was just on or about borderline
Unfortunately for some of us, it makes no difference what we eat, how low our BMI, how much we exercise, whether we smoke or not, and whether we 'like a drink' or not, our total cholesterol will be higher than most, and for some significantly higher. And the reason is it's genetic. If your cholesterol is consistently above 7 and you already carry out many of the lifestyle measures widely publicised to reduce your heart health risk I suggest your move to trial statins is a good step to reduce the total and achieve a lipid profile that is more in line with current NHS guidelines as below.
As for HDL levels, if they are high as you report, that is generally seen as a good thing, it is LDL that is perceived to be 'bad' at high levels along with other non HDL lipids.
And if you are advised to try tightening up on lifestyle measures to better control your cholesterol be aware that if you are already well into that zone it is likely to not make a significant difference, and even if it does you have to stick with it, literally for life, for if you dont you will be back to square one. That's why medication such as statins is a great help because the effect is immediate.
Finally whether you should be taking a PPI with enteric coated aspirin ( and any other medication) is a discussion between you and your GP and perhaps the pharmacist. My personal view is if you prove can do without the PPI in a trial then don't take it. But if you get gastro problems during the trial then it's best to take it.
this is interesting. I take omeprazole and losec and am now wondering why. I have chronic gastritis but I think one med is enough. Have a pharmacists’ review soon — will query it.
Also enteric coated aspirin. Two blood pressure meds and 80 mg atorvastatin. When I asked cardiologist why, he said’your arteries are wide open and we want them to stay that way.
Thank you for your reply. I really appreciate your take on how for some of us it doesn’t matter how fit and healthy we think we are! With hindsight I should have realized I needed statins much earlier as there was nothing else I could really change. I’ve taken the Pravastatine 10 mg and Aspirin 75 mg on board, just over 2 weeks now, and hope to see some improvement at my cholesterol check in 3 months. I’m still unsure re PPI but think I’ll give it another go.
I was prescribed aspirin and a betablocker. No stomach protection. I have opted myself for the enteric coated but the prescription didn’t state this. I have stomach protection on my list of questions for my next review but I seem to be mostly fine so far. During first week I had terrible indigestion, but in hindsight I wonder if that was chest pain. Nothing since.
Thank you for your reply. Good luck with your next review and maybe you could let me know what they say about stomach protection. I am 70 so perhaps that makes a difference to their advice?
Hi there. I've just been discussing this with the clinical pharmacist. I've become aware of concerns with omeprazole after taking them for several years. I tried discontinuing but got terrible stomach ache. Surgery have changed script to famotidine 20mg which has fewer long term side effects, so far has given complete protection against pain and irritation.
Maybe have a chat with your surgery about your concerns (mine were bone density, B vitamin depletion, hair loss etc). Good luck
Thank you for your reply. Are you on Aspirin 75 mg and is it enteric or dispersible?
I have the same concerns as you re bone density having been on Omeprazole for 5 years several years ago for misdiagnosed gastric reflux which I now know is silent reflux and is well controlled by only the occasional Gaviscon Pro. Took the omeprazole for the first fortnight of aspirin, then worried about the side effects so stopped this past week. Being a chronic worrier I now swing between worrying about my bone density and therefore fractures etc, or gastric bleeds because of my age.
I have been on omeprazole for 25 years with absolutely no adverse effects. Just had a Dexa scan last year and bone density is normal. I was prescribed them initially for a hiatus hernia with gastric reflux and then for protection from the effects of Aspirin and now Edoxaban. People jump on these medications too easily from reading non trial clips in newspapers and online and just like antidepressants are an easy target for the knockers. The fact is that some people do need these medications as much as they need the beta blockers, anticoagulants, ace inhibitors and statins etc etc which have far more adverse effects on your system than the PPIs and antidepressants.
I have been taking a PPI for over 15 years for reflux disease and don't appear to suffer any adverse side effects. But it certainly works for my reflux disease and I rarely get get flare ups.
I know as have I been taking them a long time with no ill effects although there is a lot of observational studies which suggest they do cause almost every illness you can imagine. I think given the amount of PPIs prescribed that a couple of clinical studies need to be carried out to determine yay or nay. My cardiologist told me to continue taking omeprazole with Clopidogrel when I had my stent as he said the study was never completed and was flawed so who do you believe?. Anyway they have saved me a hugh amount of suffering and are still prescribed by GPs who will tell you that they are not proven to cause serious harm.
That's all true, the rubbish you read on the daily mail etc needs to be taken with big health/ truth warning. However, the concerns about PPIs are well documented and taken seriously by medics, hence willingness to prescribe alternatives.
They're us another less discussed issue with omeprazole. Some men develop gynocamastia (abnormal breast growth) with this med. It's one of my concerns, I have some indications this may be developing, hence changing medication. As ever, not everyone is affected, so you have to listen to your own body and get checked regularly. (And ignore the tabloid scare stories!)
I can not disagree with you regarding regular checks but not sure there is concrete proof that PPIs cause the problems they are supposed to do. I think most medical literature are based on supposition rather than clinical trials as they are the gold standard for adverse effects. They need to do trials either way on this medication.
Osseous implications of proton pump inhibitor therapy: An umbrella review (2024) meta study, strong correlation bone density issues and long term PPI use.
Be careful also with notions of "gold standard" as a concept, it's problematic in many ways.
I'll put up with 'osseous implications of proton pump inhibitor therapy'; when I take my daily PPI which keeps my reflux disease at bay, in preference to worsening Barrett's Oesophagus which I already have, and which set in before I took PPIs , and which unchecked has the potential to further deteriorate to Oesophageal Cancer, which, by my reckoning, is one of the nastier forms of this affliction.
Hopefully when you tried to come off of the PPI you weaned off slowly, because if you dont you will have a acid problem that will make you think that you need them. I have done lots of research on PPIs and always suggest to people that are prescibed them to do the same.
Hi there, I had terrible gut issues with the PPI’s plus the potential long term effects of taking them led me to stop despite being on aspirin. I take soluble aspirin, considered to have better absorption than enteric. Read up on research of soluble versus enteric aspirin, it’s interesting. I take my aspirin with a lot of water followed by food. Who knows if that is right given science changes like the wind but I’ll plod on. Good luck with your health decisions as you plod onwards and upwards.
I’ve been taking chewable aspirin which I buy myself in the USA (because I like the cherry flavoured ones) for over fifteen years with no problems with my stomach. I don’t take any of the “Azores” and my GP doesn’t think I need to.
Your cholesterol is above what the drs would like for heart problems especially over a certain age,the omeprazole does help in protecting the stomach from medication you need
enteric coated aspirin may be a little gentler than non enteric aspirin, for the stomach, however from 65 years we are considered to be more at risk from gastrointestinal bleeding. I would suggest that you discuss with your prescriber their rationale with regards to your health. All the best.
Have a look at slippery elm for stomach protection. I used it instead of prescribed omeprazole and it worked for me when I was on long term steroids and for gastritis. It has to be taken 1-2 hours away from other medication. Do a search on healthunlocked and you will find other people’s experiences.
Soluble aspirin acts in your stomach and can irritate it and cause bleeding. Enteric aspirin is coated so it doesn't release ingredients until it's in your small intestine and irritation is much less likely. I use enteric coated because even with protection I couldn't tolerate the soluble ones. However, I do still need protection for the intestines. I'm allergic to PPIs so I take famotidine which works in a completely different way and doesn't have the possible long term effects that PPIs may have.
In your opinion, does Famotidine work as well as Omeprazole? Plus, do you know its side effects? I was considering whether I might be able to switch to that medication.
Fo rme, famotidine works just as well as PPIs and for someone who reacts really badly to all sorts of tablets, I have absolutely NO side effects from famotidine. When I used to take PPIs years ago they alway s left me feeling vaguely nauseous,the way you feel with an empt stomach. Absolutely no ill effects from famotidine at all.
Thank you, Qualipop. I have been taking Omeprazole since about 1998. I was diagnosed with GERD and I have gallstones (gallbladder attacks).
Lately, I have begun to have the gallbladder attacks occasionally, so the medication is not working as well for me. Plus, I do worry about possible long-term effects. Anyway, I am going to talk about this with my doctor.
It'['s supposed to work for Gerd but I'm no expert. NO idea about gallstones though. You have my sympathy. I almost lost a friend last year whose gallbladder got so infected it caused sepsis. I still can't imagine how he could ignore the pain for so along.
The pain from a gallbladder attack is ridiculously awful. 😢 I’m planning on talking with my doctor about all of this.
First, I’m trying to get through a series of mammograms. I had a mammogram in April—both breasts—routine. They found some suspicious-looking calcifications in my left breast, so I had to go back in May for a focused mammogram. They think that everything is probably benign, but I have to go back in November for another focused mammogram of my left breast. So, I am just hoping to end this before adding something new. Fingers crossed. 🤞
Hope you're ok but it's all such a worry.I h ad 6 monthly mammograms for ages- turned out to be cysts. Every time I get pain they insist it's gallstones because my gallbladder is packed with stones. Every time I have an x ray they ask if I get gall b ladder pain. I don't but you shouldn't leave it. IT can turn very nasty. They couldn't remove my friend's as the infection had stuck it to his liver.
A Protein Pump Inhibitor (PPI) is, as I understand it, advised when taking Aspirin because they are considered the best way of reducing stomach acid. However, there is a lot of discussion around their long term use and side effects.
Some people are fine and have no issues (my sister) others (me) do. You will need to discuss weighing up the risks with whoever is prescribing them and decide what is best for you. You can always move off them at a later date, just understand stopping them takes some effort, due to the ‘bounce back’ effect on acid production.
I was prescribed Lansoprazole as part of the package when I was discharged from hospital following a triple bypass. I had no issues for about 12 months then I hit serious side effects. I wont bore you with the details but to suffice to say after 4 years on different PPIs I am now off them completely and use famotidine which is so much better for me.
My understanding is that all aspirin can cause stomach bleeding over time. The enteric coating does provide some protection against this. My question would be whether you are taking the omeprazole to help offset the side effects of the aspirin, or whether your doctor is prescribing it for some other condition such as acid reflux, GERD, or gallstones, etc.
Sometimes people take Omeprazole for other medical conditions. I would suggest speaking with your doctor about why you have been prescribed this drug and what benefits it is providing for you. If you both agree after that discussion, then, perhaps you might be able to stop taking it.
I wa prescribed enteric coated aspirin and declined omeprazole. Started to get some stomach discomfort and now take 10mg omeprazole which has worked. Drs tend to prescribe 20mg by default, so you have to ask for this.
my cardiologist recommended not taking the coated ones as not as effective, I just take my regular soluble aspirin after my breakfast rather than on an empty stomach, seven years in and no problems so far, good luck with your ongoing journey, take care x
Thank you for your reply. Not seeing cardiologist for my first appointment until end of September so will ask about this. Do you take PPI’s with it? Reassuring to know you’re seven years in with no problems. Wishing you well.
I am not trying to scare you in any way, but I noticed that you are 70 years of age—a couple of years beyond me. Last August, I took my Mom (85 yo) to her doctor for her annual checkup. I was concerned because her total cholesterol and LDL levels were somewhat high. I asked her doctor about putting her on a statin in order to help lower her cholesterol levels. He assured me that her “good” cholesterol was so high that it provided enough protection for her. I was skeptical, but went along with his decision. That was in August 2023.
In December 2023 (4 months later), my Mom suffered a scary TIA event. This involved an emergency room visit, testing, additional testing post hospital visit, having additional appointments with specialized heart surgeons, neurologists, specialized eye doctors, and a new GP. When I spoke with that new GP later, she agreed with me that Mom should be on a statin to help lower her cholesterol and to stabilize the existing plaque. You might want to talk with your doctor about the pros and cons of starting on a statin.
Also, I noted that several people were discussing whether to take enteric or soluble low-dose aspirin. You might want to discuss this with your doctor before deciding. I take soluable daily, but you have choices.
If your doctor approves, you might be able to take enteric aspirin daily. I keep a bottle of orange-flavored, chewable, low-dose aspirin in my purse just in case that I need them. I have read that emergency responders state that you should immediately take 350 mg. Of chewable aspirin at the first sign of a possible heart attack. You might want to check about that information with your doctor, but having soluble aspirin available can potentially help save a life.
Thank you for your reply. As you will have seen I was also told that my high HDL would be protective. This has been the response over the past five years but I must admit I was also reticent about starting statins if they weren’t necessary. It’s my biggest regret now as a scan has shown I have moderate right carotid artery atherosclerosis. I started on pravavastatin 10mg and aspirin 75mg treatment two weeks ago. Unsure re Omeprazole 20mg
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When to take aspirin
No 75mg aspirin 
Alternatives to Aspirin ?
Aspirin
