Methotrexate and Omeprozole

[barbieg]

I have another question as I have just seen on this site that you shouldn’t take Omeprozole if you are are taking Methotrexate? I’m very surprised to read this as my consultant said it was fine to take both. Does anyone else take both? I also take Sulfasalazine and a strong ante inflammatory. Thank you .

[helixhelix]

There was a similar question a few weeks ago. Here:

healthunlocked.com/nras/pos...

I take both, and aan anti-inflammatory too.

[barbieg in reply to helixhelix]

Thank you. Can I ask what order you take them? I take a blood pressure pill early morning then my Omeprozole before breakfast . My Sulfasalazine I Take mid morning , this order has helped the heartburn I used to get. When is the best time to slot in the Methotrexate? My consultant gave very little advice. Should you take it before a meal or after and morning or night time? Sorry for all the questions.

[Ruth12345 in reply to barbieg]

I was told not to take sulphasalazine and hydroxychloroquine within 2 hours of omep but everything else was ok. Hope that helps.

[barbieg in reply to Ruth12345]

Yes thanks. I only found out not to take the Sulfasalazine within 2 hrs of taking Omeprozole a few months ago after reading it on this site. My consultant doesn’t seem to tell me much, that’s why I’m asking on here. It’s such a brilliant site.

[helixhelix in reply to barbieg]

I take mine about same order as you, and then MTX after dinner in evening. I inject so do it as I go to bed. When i was takimg tablets i did so straight after dinner with a large glass of water and walked around for 10 minutes - for no particular reason but it made me feel better!

[barbieg in reply to helixhelix]

I eat my dinner midday and take my 2nd lot of Sulfasalazine afterwards. Is it ok to take Methotrexate and Sulfasalazine together or would I be better taking Methotrexate at night. I take Gabapentine (probably spelled it wrong) for Fibromyalgia.

[Ruth12345]

I take both with no problem.

[barbieg in reply to Ruth12345]

Thank you.

[weathervane]

Hi barbieg , i just posted yesterday on lupus site about my son taking omeprazole with methotrexate, the consensus was you shouldn’t take it . I did speak to the pharmacist today who said not to take methotrexate and omeprazole together. My son has nausea the day after methotrexate, he advised an anti nausea treatment would be better but a prescription would be needed. I am hoping to get in contact with rheumy secretary as he is hopefully getting shoulder injection, will also ask about treatment of the nausea. So hard to get talking to anyone!!!

[helixhelix in reply to weathervane]

But all of us who do take the two drugs have been advised to do so. I go by what my rheumatologist says. The pharmacists will go by the book, and quite rightly so. So they will flag up the possible interaction. However the rheumatologist will balance out risks and benefits - ideally discussing that with you as well! Then its your choice.

Bizarre tho' to use a PPI for nausea, does it work at all?

[weathervane in reply to helixhelix]

It actually did appear to help the nausea!! So many of us are given different advice , i was told it would effect how the methotrexate works ???

[helixhelix in reply to weathervane]

Yes, it slows down the way methotrexate leaves your body so at high doses the manufacturers advise caution. Doesn't say what a high dose is tho'! That's from the British National Formulary which is the book that pharmacists use. But it is potentially a severe interaction, which is another reason why our regular blood tests are so importamt.

[weathervane in reply to helixhelix]

Certainly are !! He had to go every 2 weeks now it’s every 4 weeks, our surgery is awful for parking ☹️

[barbieg in reply to helixhelix]

I’m wondering if they mean not to take them both at the same time. I’m going to try taking the Omeprozole when I get up and the Methotrexate after lunch. I really need to carry on taking the Omeprozole because of the Etodolac (anti inflammatory) I take as well. The Sulfasalazine I will take in the morning and evening. All our medications take some working out don’t they? Thank you .

[vonniesims]

Definitely should take advice from a pharmacist.

[Simba1992]

I find knowing the effects of the medicine you are about to take is always of central importance when making the final decision. Here is what wikipedia says about PPIs.

en.m.wikipedia.org/wiki/Pro...

[Hidden]

I take both and have never been told not to take both of them. I take methotrexate on a Sunday evening about an hour after eating. I take omeprazole every evening about two hours before going to bed.

[barbieg]

Thank you to you all for taking the time to answer my questions. It’s such a big help to me.

[Joy_1]

I use to take both.

Then consultant did a deep dive and said the latest research said Lansoprazole combined better with MTX. So now I take Lansoprazole.

A friend who has gastric issues not RA told me that Ome is cheaper than Lanso so that's why they prescribe Ome. Don't know if that is true or not.

However with all these PPI and antacids you must leave a 4 hour gap between taking MTX by mouth, HCQ, steroids etc. I always take my Lanso just before bed and that keeps the gut issues at bay for me.

[barbieg in reply to Joy_1]

That’s really interesting , thank you. I’ve taken my first dose of Methotrexate this afternoon because I have my dinner midday . I take my Omeprazole early morning,3 Sulfasalazine at 11am , Methotrexate at 2.30 ish and 2 Sulfasalazine after tea with my Etodolac. Will see how I get on, but have made a note to maybe change to Lansoprazole . Thank you.

[Mall]

I am still alive and kicking after taking both for 20 years or so. I do take the ppi before breakfast and methotrexate after my evening meal, so maybe the gap between has kept me safe, albeit unintentionally.

[dozzer15]

Hi I've been on Omeprazole for about 20 years and methotrexate for about 10 years. No one has ever told me they shouldn't be taken together and they haven't caused me a problem x