Looking to start taking MXT but currently take Esomeprazole for hiatus hernia.

[Barrister]

I know that these two drugs should not be taken together so what do others take instead of the Esomeprazole ? Thanks for your input. Clemmie

[helixhelix]

Well I guess you have to ask your own docs as we can't give medical advice......

I take omeprazole, also a PPI, and really can't remember if it is contraindicated with MTX or not as a long time since I looked at the leaflet. But my rheumy prescribed it on same bit of paper as the MTX. And as you know there's the ideal world, and the real world. So I also take NSAIDs that aren't supposed to go well with MTX, but again rheumy has said that I can. Isn't that what all the blood monitoring is for - to check that our drug cocktails are not doing us harm?

[Barrister]

Apparently, PPIs increase the toxicity of MTX. I wasn't asking for medical, advice I was just asking what others take, in case there was some other drug that they have been prescribed. But reading another (similar) question and answers on here it appears that the majority are taking PPI's anyway. And as your rheumatologist prescribed both for you then I guess it's okay. Clemmie

[SueB]

Hi Clemmie

I am on mtx and hydroxy and was also diagnosed with a hiatus hernia 2 years ago. I suspect it had been there for years. I take lanprozole which works really well. I started off with 2 tablets but now take one 30 minutes before eating anything in the morning. I take it as soon as I wake up.

Sue

[Dogrose]

I take MTX and Omeprazole, both prescribed by my Rheumy, he didn't say I shouldn't take them together, but I do only take 5mg MTX and 20mg Omeprazole.

[Barrister]

Thanks for your input, everyone. At least I am prepared now for when I see my doctor. Clemmie

[Hidden]

Hi Clemmie. I was having a lot of tummy trouble last year and found that I couldn't take the two Omaprazole I was prescribed for this while injecting MTX. I got terribly ill the day after MTX while taking this PPI. It was okay when I took just one Omaprazole though and I think my reaction varied from week to week. I asked the pharmacist and she actually showed me the bit on the Metoject sheet which said that Proton Pump Inhibitors can sometimes increase the toxicity of the MTX. She suggested I ask my GP to prescribe Ranitidine instead - which worked fine. I think some people can tolerate it but for others it can contraindicate - or maybe it's just at the higher dose. My GP didn't tell me this when she prescribed Omaprazole but as soon as I explained what the pharmacist said she agreed and just switched me at once. Hope this helps. Tx

[Barrister]

Hi Tilda, I really think that sometimes GPs don't know what problems mixing medications can cause and that's why it is so important to read the little information slip that comes with the medication. When I go to see the doctor who will prescribe my MTX, I will be able to make sure that he has all of the information that I can give him. I have just returned to Saudi Arabia and didn't much like the rheumatologist so my GP who is English, said that he was happy to look after the PsA, especially as I went to a rheumatologist in the UK for a second opinion and he wrote a long letter for my doctor in Saudi, detailing all his recommendations. So I consider myself very lucky, all things being equal and my GP here even has a sister with RA so is very understanding. Clemmie