Hydroxychloroquine and Omeprazole

[Biddy47]

Hi everyone, in my search to find something that will alleviate my gastric discomfort, I found an article that says Omeprazole shouldn't be used by people with Lupus. Can a anyone comment on this?

[daisyd]

What make of hydroxychloroquine are you on Zentiva is the best for low side effects, it is the sister company who made placqunil

[Biddy47 in reply to daisyd]

Yes daisy I take Zentiva, I'm not absolutely sure that that's what's causing my problems, I just came across the article about Omeprazole and wondered if anyone knew anything about it.

[daisyd in reply to Biddy47]

I would ask your doctor or a pharmacist as it's a prescription drug and your stomach problems may need further investigations

[maggielee]

Hi Biddy, sadly I was on it for years & though it helped, they now recommend to only take it short term.

A lupus prof in london immediately said to switch to ranitidine, usually I only need it once a day 150mg.

I found cutting out some foods helped, as well as eating early, sensibly and eating something with my many of meds including hydroxy... I slowly found foods that caused me heartburn especially at night.

I hope you find a solution soon....big hug...ml

[Lupiknits in reply to maggielee]

Gosh, I’ve been on Omeprazole ,in a large dose for quite some time. My earliest symptoms were severe reflux. We did try Ranitidine at one point but the Omeprazole seemed better. I know it’s not advisable to take Omeprazole for any length of time, but have always thought that was because it could be hiding other problems. I was investigated with endoscopy, and found to have a narrowed oesophagus. In terms of diet, I can’t take anything acidic, spicy, or coffee. No need to lose weight:I’m underweight.

The usual Rheumy and fancy researchers didn’t advise anything else.

Something else to check, thank you.

[maggielee in reply to Lupiknits]

Hey Lupi, I was shocked too as my husband was also on it for his stomach & he weened himself off after I told him... Check with pharmacist new view & they are still handing it out...

The ranitidine is ok for me, I was diagnosed with hiatus hernia & propped up at night, cut back on most bread which helped (raisin bread seems ok), etc. so just take one at night or two when needed....ml

[maggielee in reply to maggielee]

Lupi specialist didn't specifically say why, but implied that he was advising all his patients off it or switch to another med... Will read links by foggyme to understand this better...ml

[Lupiknits in reply to maggielee]

They found “nothing “ with me except a lot of ulcers down the oesophagus which created a stricture, and slow motility. I left going to a GP far too long. I have to eat a very soft diet now or food gets stuck and won’t go through. I miss rice the most!

I’m not sure (and consultants aren’t) quite what’s going on, but my bowels are pretty knackered too 😳 x

[Sweetnlow in reply to maggielee]

Hey there! Just a comment. I've been on prilosec for years bumped from 20mg to 40 to 80! Clearing my throat to much, wasnt sinus drainage, but reflux. I was give 300mg of Ranitidine. Made me bleed under skin on arms if I bumped anything. I went off it an have no problems. Once I got the clearing of the throat cleared up I reduced myself to 40mg. Wishing you well.

[miccika1 in reply to Sweetnlow]

Sweetnlow, did you ever try baclofen for gerd? It worked like magic for me

[Sweetnlow in reply to miccika1]

No I havent, never heard of it. Will have to look it up. Thanks for sharing

[Foggyme]

Hi Biddy47

Here's a couple of links I've found that might be useful:

lupusuk.org.uk/medical/gp-g... (note - doxycycline and other tetracyclines are not on the drug list here - see additional comment about this below).

ncbi.nlm.nih.gov/pmc/articl...

Also - been told not to take any class of tetracycline's as these can induce lupus flare (several drugs in this class - some with generic and some with trade names).

Before I was aware of this, when I've previously been prescribed doxycycline and ciprofloxacin, both have induced lupus flares (unbeknown to me at the time) 🤷‍♀️😬😬.

Didn't know about the lanzoprazole...been on it for years!! So thanks for flagging it up...something else for me to sort out! But oh what a shame that many doctors (some Rheumatologists included) aren't aware of this.

So...leaves me wondering...how many of us are suffering frequent (and perhaps unnecessary) flares because of potentially inappropriate prescribing practices (for whatever reasons) for those with Lupus - and other AI conditions too 🤷‍♀️😬😬.

Gastric issues are a nightmare - hope you find something that works for you 🤞

xx

[Biddy47 in reply to Foggyme]

Thanks Foggyme and everyone else who has commented on this. The links are very interesting and for me quite alarming. I was diagnosed 5 years ago with SCLE and Sjogren's Syndrome........I had been taking Omeprazole for a few years at this time! I also have Bronchiectasis and have to take antibiotics quite frequently, one of my standby antibiotics is Doxycycline so I just checked the NHS site and it says it shouldn't be given to people with Lupus! It was prescribed by my chest consultant who has also prescribed Ciprofloxacin in the past, as has my GP. I was also prescribed Trimethoprim for a UTI by my GP and then discovered that it was a sulphur based antibiotic which we shouldn't take. So what are we to do? I'm just confused. Thanks again everyone.

[Sweetnlow in reply to Biddy47]

Be very careful on some antibiodics. They can cause an aorta tear. Anuresym! I got one! Cipro is in this group. Docs dont tell you about it though. You learn the hard way.

[miccika1 in reply to Biddy47]

Sulpha drugs are a definite big no no for lupus.

[maggielee in reply to Biddy47]

Just reading some of the current info on Omeprazole ....never knew it linked to lupus & why the prof. wanted me off it. It was implied, but not said clearly there might be a link & I was on it for years & was diagnosed with SCLE & Sjogrens too!

Will read more as there certainly more warnings now then when I was diagnosed....

Nice to have a list of meds we should not take if there are other options. Thanks too for the discussion...😊 ml

[Hamptons]

I challenged this when I was initially given both. GP said that it depended on symptoms. Rheumy said same thing. Ultimately together they are a godsend so I won’t mess with it.

[CecilyParsley]

Hi I was on Hydroxychloroquine and Omeprazole for years. I had severe acid reflux and ulcerated oesophagus which caused choking. The ranitidine and gaviscon just did not work as well. My then Rheumatologist told me to half my dose and take it two hours after my Hydroxychloroquine. I had no real issue with it. I hope you can find a solution.

[Lily77]

Dear Biddy47, I was started on omeprezole on diagnosis of lupus but a high level of steroids made my gut feel like it was on fire and my dose was doubled. Within three days of the higher dose, I broke out into the most massive, itchy rash literally from the tips of my ears to my toes - I would not want anyone else to go through this. I was immediately taken off the omeprezole and put onto ranitidine which I have been in ever since, with no problems....touch wood. (The move to ranitidine stopped the rash in its tracks but the rash took weeks to disappear completely). With my best regards, Lily

[miccika1]

The article from foggyme tells only about subcutaneous lupus. I have been on Omeprazole for years due to GERD ,it didn't cause subcuticular lupus, and i already had regular lupus. Omeprazole never did anything for me for GERD so my gastro put me on baclofen that works much better. I have been on baclofen for almost 7 years now...

[Foggyme in reply to miccika1]

Hi miccika1

For clarification 😉...

The lupus.org article in the first link in my reply above states as follows...

'reference to DIL in this chapter means the term to encompass drug-induced SLE, SCLE and CCLE (chronic cutaneous lupus erythematosus). The use of the abbreviation ‘SLE’ means idiopathic SLE throughout this chapter'.

So this article presents information that is relevant to SLE, SCLE and CCLE.

The second link in my reply above is to a research paper that speaks specifically to drug induced SSLE...

There are other research articles that speak to SLE too (but sorry, not enough time provide links to those. Searchable via the internet or better still, google scholar.

The extract below outlines some of the symptomatic differences between drug induced lupus and (DISLE) and systemic lupus erythematous (SLE)

'Differences Between Drug-induced Lupus and Systemic Lupus Erythematosus

Patients with DIL usually experience mild or few lupus-like symptoms initially. These symptoms include fever, malaise, weight loss, arthritis, arthralgia and myalgia3. Symptoms generally worsen the longer the patient is maintained on the suspect medicine3. Some symptoms such as malar or discoid rash, photosensitivity, oral ulcers, hair loss and renal or neurological disorders are common in SLE, but are uncommon in DIL.'

Extracted from: medsafe.govt.nz/profs/PUArt...

So...there are certain drugs that can induce SLE, SCLE and CCLE (or lupus like autoimmune disease). Evidence suggests that where drugs are identified as causing drug induced Lupus (in its various guises), this can remit once the offending 'causative' drug is stopped (though evidence also shows that in some cases it can persist even when the drug is removed).

The crucial thing is that in those who already have Lupus (again, in it's various guises 😉) the drugs concerned have the potential to cause Lupus flares (as opposed to drug induced lupus). The potential may be realised in some but again, the crucial thing is that not being aware of this fact may leave some who take the drugs having frequent flares - which may be drug induced - flares which may be reduced or eradicated if the drugs are changed for alternatives that do not cause flares. (Don't think I've said this very well - sometimes getting words out is like knitting with sphagetti 🤷‍♀️😉🤣).

I have an unfortunate and growing list of adverse drug reactions... and so far I've discovered (the hard way) that ciprofloxacin, doxycycline...and now possibly lanzoprazole...all induce lupus flare - for me, at least 🤨.

I also had a rare adverse reaction to ranitidine so I seem to have a problem with Histamine-2 blockers too. The pharmacist at the surgery is now on a mission to come up with an alternative 'acid-blocker' - crucial 'cause of a history of peptic ulcers, multiple GI issues...and the drugs we take. So, we'll see 🤞.

My goodness...as if we didn't have enough to contend with without having to consider whether the drugs we are prescribed to 'fix' us are actually 'breaking' us instead 🤣🤣🤣🤣🤣.

[KayHimm in reply to Foggyme]

Thanks for this important information, Foggeme. You really have a miserable time with drug reactions. I wish there were more they could do for you. You need the medications!

Xk

[HazelW]

I took Omeprazole for several years but was advised by a consultant I was seeing for an unconnected event that I should stop taking it as research has shown that it should not be taken long term. That was about 2 years ago & until now I have been fine but have recently had some digestive problems so am going back to my GP .

[happytulip]

Just a comment about hydroxychlorquine and ciprofloxacin....they should NEVER be taken together as it can cause something called Long QT Syndrome. This syndrome only lasts while you take the course of antibiotics but it is basically a disruption in your heart rhythm. Long QT syndrome is a "drop dead syndrome." Don't mean to alarm but I worked in medicine for 15 years. I have lupus and pointed this out to my rheumatologist when she tried to prescribe it for me. She looked it up and to her horror agreed that I was correct. Everyday is a school day, even for those treating us.

[Biddy47 in reply to happytulip]

Yes I know that to my cost. I had a UTI in January which wasn't being cleared and GP prescribed Cipro. I ended up having to call 111 who sent me to hospital. I had a heart rate of 134, so needless to say they were stopped, but I do wonder why GPs don't check 'cause I also have atrial tachycardia which didn't help. Thanks happyTulip.

[happytulip in reply to Biddy47]

In my opinion it's because GPs know so little about lupus that they treat us as they would any other patient and don't take our specialist rare disease into account.

I feel that I always have to be one step ahead each and every time.

[Imom]

Hello. I have SLE, MCTD and Reynauds along with Gerds. I’ve tried all the stomach aids and was advised by rheumotoligst to take ranitidine. I found taking probiotics cured me. I only take it for two weeks once a day when I have an issue and it helped. I was bad, too, with choking and sore throat. I also drink apple cider vinegar every morning. Gastroenterologist said to eat a small yogurt everyday that has probiotics in it - cheaper than the pills. It really helps and alleviates the need for ranitidine -only now taken on occasion when needed. I also am on hydroxy. Give it a try!,

[Jmiller623]

Omeprazole is a proton pump inhibitor or PPI. It causes increased bone turnover and had been shown to contribute to osteoporosis. Since lupus already seems to predispose to vit D deficiency and brittle bones, PPI are not preferred for GERD in lupus.

Pepcid/famotidine is your best option and can be taken twice a day. Many with lupus have reactions to Zantac/ranitidine. To each their own. I’d start with famotidine 20 once a day on 10 twice a day. Both ranitidine and famotidine are H2 blockers so they minimally help with some allergies as well.

[Spotty-ewe]

I have stopped my Lanzoprozole today based on what I have read here due to your post. Thank you Biddy! I’ve been on it since early June following a very bad attack of gastritis. Since the end of July I’ve developed a lupus rash which is spreading. Although the Dermavate is knocking back existing spots new ones are continually arriving and growing to the size a 1p coin before eventually fading. My Rheumy told me to start taking a higher dose of Hydroxychloroquine and asked how long I’d been on the Lanzoprazole. She thought maybe I’ve been on it too long for it to be the cause. However it took a month on Terbinafine before my first Lupus rash appeared 6 years ago which spread from head to toe. So I’ve stopped the Lanzoprazole today and hope the rash will calm down. Once gone I’ll reduce the Hydroxychloroquine back to what I was on before this started. I’ve been under a LOT of stress recently too which has no doubt made matters worse. So thanks again for your post and everyone’s input. VERY helpful.