lansoprozole and dementia risk

[Dramatique]

After having coronary stent, part of my medication I take lansoprozole - which I assume is to protect my stomach from my other medications such aspirin. There is much in the news that there is an increased risk of dementia for those taking lansoprozole. I have been prescribed it for over 4 years and wonder if I choose to stop is there either something else I can take instead, or do differently to protect my stomach.

[ChoochSiesta]

A quick Google search suggests it is scaremongering 🤷. However, the known side effects are less absorption of nutrients which obviously could have serious impacts. To avoid this you could just make sure Aspirin is always taken on a full stomach.

[Amikatari]

I won't take it. I hadn't even heard about the possible dementia risk, though, thanks for sharing. I avoid it because I don't want to get osteoporosis, it runs in my maternal line, and, as ChoochSiesta says, it's known to cause malabsorption of nutrients.

[Farmer63]

Just to add, briefly, my mum was on a similar ppi, she was diagnosed with dementia, I was her primary carer, I went to the pharmacy, as usual to pick up her script, and one med was missing, the ppi. It just disappeared overnight. I request a meeting with the pharmacist to explain why it was removed from her meds. She just said she was not sure why the doctor removed the ppi from her meds.

[Suzz7 in reply to Farmer63]

Did you ask the GP why it was stopped?

[Farmer63 in reply to Suzz7]

No I didn't ask them, just to add I have family in the US, my sister in law had real bad acid reflux, her doctors give her ppi,s for two weeks only, they told her to adjust her diet to avoid any foods that caused her reflux to flare up.

[Lowerfield_no_more]

I have been taking PPIs for over 15years for reflux disease, and within that Lansoprazole for the last 6 years and I haven't got any signs of dementia, nor do I suffer from any side effects, and otherwise appear to be healthy. As for depletion of nutrients, if you eat the right sort of food, in my view that is unlikely to be an issue. Taking any form of medication comes with a risk of one or more side effects, and in the end you have to take a mature balanced view on whether the consequent risks of not taking it outweigh any side effect risks of taking it. In the case of Lansoprazole, apart from reflux disease sufferers, it is prescribed to 'settle the stomach' from the effects of taking other medication. It would be sensible to trial without it in my view to see if the other medication does cause unpleasant stomach upsets, and if they don't there is no need to take it. But if they do, then it is right, in my view, to take it, since long term stomach upsets can cause gastro problems like ulcers and perhaps damage to the oesophagus. But if lansoprazole or other PPIs themselves cause side effects there is other medication available to 'settle the stomach' which others on here have reported and which apparently do the job.

[Alfie33]

I take pantoprazole its for my hiatus hernia

[BobbyCollins]

Hi there sorry to hear your issues.With regard to all PPIs they definitely damage your bones. I was prescribed them a few years ago for GERD. When I saw consultant after taking them without result I mentioned this and the fact that my Mum had osteoporosis he looked horrified and stopped them immediately. I managed for a while with supplements etc (slippery elm and centaurium mainly) however I am now taking Felodipine and aspirin so the problem with reflux is bad again. GP has prescribed Famotidine which hasn't helped much and I think there are similar issues with it. GP says there isn't anything else. Anyone know of an alternative please ?

[Lowerfield_no_more in reply to BobbyCollins]

With respect I think you mean there is a possibility of bone damage. And that has to be balanced against the more serious risk of damage to the oesophagus if you suffer reflux disease by perhaps not taking a PPI, apart from loss of quality of life. So the stark choice could be oesophageal cancer vs. osteoporosis. My wife has taken supplements for many years to inhibit her osteoporosis as do many other women ,and she has no need for PPIs, and she leads a normal life. However if you get oesophageal cancer caused by reflux disease it is unfortunately once of the nastier forms of cancer, with a l ower chance of survival compared to other forms of this affliction.

Anyway I also have reflux disease and for that take PPIs. I also have Barrett's Oesophagus caused before I started taking PPIs and that is now in check. For me I take PPIs and they work for me with no side effect, but in addition I have postural precautions I adopt mainly minimising bending over where possible known to trigger a relapse, and avoid certain trigger foods, although with the PPI these are minimal. I am sure you are aware of foods you should avoid, but there are gas producing, (e.g onions), acidic (e.g. tomatoes, citrus), spicy, and relaxant (coffee and chocolate) and irritants( alcohol esp. spirits ). If you don't keep one I suggest you keep a food diary to help you find your trigger foods. Finally if I have a relapse I go back to food basics for a few days to give my body chance to settle down.

[BobbyCollins in reply to Lowerfield_no_more]

Thanks for your detailed reply. Obviously I have family history of Osteoporosis which was very severe in my Mother and her twins case (lost 5 inches in height) so it worries me considerably. But yes each case on its merits . Good luck to you !

[Golf123 in reply to Lowerfield_no_more]

Could I ask what dosage of PPI do you take ? I have a hiatus hernia and take 20 mg daily, but seem to get a feeling of mucus in my lower esophagus.

[Lowerfield_no_more in reply to Golf123]

When was first diagnosed with reflux I was prescribed 40mg Nexium (esomeprazole) which I found I could reduce to 20mg after a couple of years and which kept my symptoms mostly under control. When I had my NSTEMI over six years ago this was changed to 30mg Lansoprazole since Esomeprazole interacts wth Clopidigrel which I was prescribed after the HA. 30mg Lanso is apparently equivalent to 20 mg Esome. If you are experiencing reflux symptoms in spite of taking the PPI I suggest you talk to your GP who might offer an alternative or suggest upping your omeprazole dose as a trial. And if you taking low dose aspirin in dispersible form try coated which is what I take.

[1a2b3 in reply to BobbyCollins]

In reference to low dose aspirin, I was told by my cardiologist that if one needs to be on an anti coagulant and can’t tolerate aspirin , often clopidogrel will be prescribed instead. I had a stent placed in April and am currently taking low dose aspirin and clopidogrel for one year. After one year, I am to discontinue the clopidogrel and continue on with the aspirin.. Some cardiologists do the opposite , discontinue aspirin and continue with clopidogrel.

[honeybubs]

hi Dramatique I was on Lansoprazole but had stomach problems with it. People on here helped me by telling me to change to Famatedine (think I’ve spelt it wrong) and I was ok after that. I have osteoporosis in my right hip and osteopenia everywhere else. When they did an assessment on me they stopped some of my tablets which included the aspirin because they said with my condition dilated cardiomyopathy and my arteries are clear I didn’t need the aspirin after all so I just take 3 heart tablets now with a CRT-D device fitted. Ask lots of questions next time when you have a check up. Good luck.

[Teddy2022]

I stopped taking it about a year ago with no affects. I take all the normal heart meds plus several others including Pregabalin and Ursodeocycholic acid and aspirin. Just have breakfast as I do.

[AspiringVet]

I think a conversation with your GP or pharmacist would be the best route to take in finding out more information on this. They have the training and likely stay up to date with the relevant research and should be able to give you some well-rounded information about whether lansoprazole is suitable for you. I do know that part of the reason that PPIs like lansoprazole are prescribed alongside blood thinners like aspirin is because there is an increased risk of developing a stomach ulcer when taking aspirin. If you did develop a stomach ulcer while taking aspirin you would bleed internally much faster than someone not taking aspirin, which would obviously be very serious. Lansoprazole drastically reduces this risk by protecting the lining of the stomach in the first place. This is one of the more common side effects of aspirin and so I think this is where balancing the pros and cons of your medications comes into play. There is a greater proven risk of developing a stomach ulcer from aspirin than there is the potential risk of developing dementia from lansoprazole. I don’t say any of this to scare you or to make you question whether you should be taking aspirin either - it’s very effective at what it does and the doctors have mitigated the risks as much as possible by prescribing both medications together! Best of luck 😊

[BobbyCollins in reply to AspiringVet]

Thanks so much. I have been prescribed Clopidogrel instead of aspirin and changed back and forth for various reasons. The question I will ask GP next time is around Clopidogrel. I haven't had any heart issues as such (mild cad) and no Tia or stroke so Clopidogrel as a permanent solutions seems a bit much ? Any thoughts anyone?

[polenta]

I am in the US and have been on many HF meds for HF for the last 10 years and a daily baby aspirin is included. I space all of my meds out and ALWAYS eat a little something when taking any of them. I have never been prescibed or taken any PPIs for my stomach and haven't had any problems.

[Qualipop]

I can't take PPIs; they make me sick so I take famotidine instead which works in a completely different way. It's supposed t o be not quite as effective but it works ok for me.