Had a F2F with doctor yesterday regarding IBS and acid symptoms which have got worse since I went up to 25mg Methoject 18 months ago. I am sorry I bothered!
The GP could not have been less interested. He actually said at one point - what do you want me to do about it. Diagnosed severe IBS 'which is very difficult to control'. He then prescribed Omeprazole. I went to the Pharmacy where the Pharmacist asked me to go back go the Doctors and check I was OK to have Omeprazole given I'm on a high dose of MTX. Spent the next 20 mins waiting whilst 2 Doctors discussed whether I should have it or not... eventually told it was OK. But, quite frankly I don't feel comfortable with taking it so am after experience of anyone on here taking Omeprazole with 25mg Methotrexate please.
Sorry for long post - am SO fed up of continual stomach issues - but Methotrexate is working for me so don't want to change.
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Dobcross1
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Hi. Worth looking on other related posts (to the right of yours) as this has been covered before. There’s no problem with taking Omeprazole with MTX and it should be prescribed with all inflammatory medication as you need to have the delicate lining of your stomach protected against these very potent drugs. Don’t give yourself any more problems than you need right now. Best of luck getting rid of stomach problems. They’re a nightmare!
I have been on omeprazole the whole time I have been on MTX (10+ years). May not be ideal, but with RA you don’t live in an ideal world. And we are well monitored.
As Amnesiac says, tummy problems are a nightmare! My dosage of MTX is lower than you (grow too many nodules if it's higher), but I've been on it 31 years alongside steroids, Cyclosporin, hydroxy and Humira, plus a daily NSAID for nearly 40 years. I was on Omeprazole 40mg for about 20 years, and in last few months switched to Esomeprazole 40mg as it didn't seem to be working as well any more. I know side effects are different for everyone, but being on a PPI with these other drugs hasn't been a problem and no-one has ever suggested it might be.
I saw an ENT doc a couple of months ago as I was have strange throat symptoms and losing my voice. He suggested silent reflux as likely culprit. I'd previously been advised to take my full Omeprazole dose (40mg) all at once in the morning. He advised me to try 20mg in morning and 20mg half an hour before evening meal. He also prescribed either Gaviscon advance or Peptac liquid (I was given Peptac) to take just before going to bed. This way of doing things seems to be helping a bit. Don't know if you were told to take it in a particular way?
You probably know (and have tried) these things, but raising up the head end of your bed, smaller but regular meals and not eating after about 7pm can help with acid too. I definitely can't eat large meals now, although I don't mind as it's helped me lose some weight. 😉
As for IBS - it's a bummer (literally)! I've used Colofac (mebeverine) for years on prescription and it has worked for me when it flares up, and there's no interaction with all my other drugs.
Thanks Kags, I'll look into Peptac. I take Colpermin for IBS but it doesn't do much! I've been taking Rennies for years every night - which do help but then saw that you shouldn't take long term as they can cause a build up of calcium in kidneys and my right kidney isn't the best🤦♀️!
There always seems to be something that interacts with something else, doesn't there? It's such a fine balance with treatments all the time. I hope you can tweak things and make yourself more comfortable. 🤞🤞😊
I’ve found that I have most success with Buscopan when my IBS flares. I tried peppermint capsules and Colpermint but they weren’t for me. I’ve got a feeling that I’ve got too little stomach acid rather than too much so Omeprazole is a disaster for me. I was prescribed Naproxen and omeprazole this time last year when I fractured my sacrum and boy did I have the worst diarrhoea ever. In all my 73 years I’ve never felt anything like it.
Eventually the doctor told me to skip the naproxen and double up the omeprazole - no success at all until I stopped that too. Honestly drugs! It’s so hit or miss how you’ll get on with them and I’ve reached a stage where I definitely don’t want to take things that ‘might’ work and I don’t want to take things that will make me feel awful. Awkward patient eh!
I know exactly what you mean! Everything I take to try to help myself ,(even just supplements) makes me feel worse. I'm trying Centaury drops before I give in to the Omeprazole but now both kidneys are painful - I give up!
Hi Dobcross1, I was on 25mg mtx but it was affecting everything in my body, all my blood tests were coming back wrong, red cells, white cell, kidney you name it came back either to high or to low, also triggered off my ibs very bad, rang hospital helpline as doctors did not know what was going on, had emergency appointment on phone next day, reduced my mtx to 20mg, folic acid 6 out of 7 days, omeprazone, last blood tests were all OK. Strange things seam to happen when you higher mtx to much. Taking a time to settle down but getting there. Hope you can sort out yours.
Hi, I was on 25mg Methotrexate for several years alongside Omeprazole and it seemed fine.Since adding Benepali to my daily cocktail of drugs I have reduced to 10mg MXT. I still take Omeprazole, and I’m not aware of any concern about me taking it now or in the past - seems a standard tummy protection.
I take 25mg MTX and used Omeprazole at 40mg strength for a long time. I suffered lung damage from aspirating acid, so I now take Pantoprazole. Was initially changed to Esomeprazole but gp refused to issue as it interacts with Clopidogrel and put me at risk of a further stroke. I’ve never been told I can’t take MTX and Omeprazole together, did they explain why. Like Kags my respiratory specialist advises I take my PPI before my evening meal, and take Gaviscon advance just before bed.
Thanks, yes I was aware it reduces clearance of methotrexate at high doses. I was always led to understand that is for patients on it for chemotherapy at much higher doses. Most PPIs have that interaction, it’s due to the enzyme that’s used metabolising the drug. Sometimes it inhibits clearance as with PPIs, other meds may clear the system quicker. My pantoprazole has the same issue. About 50% of our meds use the same enzyme in metabolising, it’s called cypd450. I wouldn’t worry too much at the 25mg dose. Take care
Good morning l had a lot of gastric issues earlier in the year following two courses of antibiotics. I was put on esomeprazole instead of Omeprazole a stronger stomach med. Then another doctor put me on famotidine twice a day as well and eventually l chose to just take the famotidine and neither of the other two. It has worked very well for me.
I have started to get stomach problems after years on Methotrexate now on 20mg ,I get awful bloating in my upper stomach and feeling sick ,it lasts about a week then goes away for a few days then comes back again ,I didn’t bother mentioning it me to Rhummy I had a FtoF last week ,I will mention it to my GP this week .
I’m on 20mg of Mthx and about a year ago was on 40mg of Omeprazol as I have GERD and a hiatus hernia. It really didn’t work for me as the high dose of Omeprazol made the Mthx more toxic and my ALT was in the 100’s. My Rheumatologist didn’t really make the connection between the two drugs, and wanted to take me off Mthx, but as I’d read up about a possible interaction, I spoke to my GP who recommended I change to just one dose of 15mg Lansaprozal per day, which works for my GI issues, unless I’m taking oral steroids, so I tend to ask for the Depo injection instead as it bypasses the stomach.
Almost immediately my ALT reduced to 17, which it hadn’t been for years, and it’s continued like that, fingers crossed, as now I’m on sulphasalazine as well as Mthx.
I also have IBS and take Buscopan or Mebeverine. I’ve also been prescribed Amytriptiline (can’t spell it), but I don’t take it anymore as it just makes me drowsy.
You could do a trial and error with different types and dosages of PPI to see what works for you if your GP is ok with you experimenting to see what’s best?
I hope you get some relief from your acid problems, it’s very debilitating and painful.
Although I still have intestinal hurry and occasional bloating, I have found following this dietary advice helpful. You probably know all about it if you've had IBS for ages but in casehealthline.com/health/ibs-diet
Hi. Thank you so much for posting this! I’ve been omeprazole for years, was 20 mg a day but then dropped after about 10 years to 10mg a day in the morning. I started methotrexate injections late last year. I’ve been on and off it since then because of coughs, vaccines, and hubby getting COVID. In March I was getting terrible upper tummy pain and after examining me my gp ordered an ultrasound scan as my upper tummy was really tender.The scan came back ok. And my omeprazole was upped to 20mg morning and night. I had to stop my MTX again due to an infection and was off it for 3 weeks. My tummy pain went, I thought it was because of the extra omeprazole. I was able to lower it again to 20mg a day.
I’ve now had 5 weeks (the longest run ever) of having my MTX injection. On Saturday night last week I thought I was having a heart attack as I got such a stabbing pain hubby was going to call an ambulance. But I waited and the stabbing pain stopped so not a heart attack so no 999 call. The whole weekend My upper tummy was really hurting. I couldn’t get to see my gp so I went to the walk in centre on Tuesday. Again they said double the omeprazole and take gaviscon extra in the day.
Don’t you think it’s a bit of a coincidence that after a 4 week run on MTX I ended up having terrible pain and after 3 weeks off it I was fine. Now after a 5 week run of it I’m back to square one with bad pain in my tummy. After reading all the comments on here I think I’m done with the MTX. I’ve given it chance after chance but this is too much. I’m going to write an email to my rheumatologist to see what she says. I’ve just had my 5th covid jab yesterday so am off MTX for 2 weeks anyway. Then 2 weeks after having it again I’m having my flu jab so will be off it again. Sorry for long reply. But it deffo seams like it’s the MTX jab causing my tummy problems.
Ach! There doesn't seem to be a definitive answer to this does there? I would have said that taking omeprazole or another PPI should help protect your stomach but I'm always in two minds about it. I take 20 mg of omeprazole in the morning but I am not on methotrexate. My husband who has silent reflux and a hiatus hernia takes esomeprazole in the morning before breakfast and before evening meal and gaviscon extra before bed which seems to control the reflux to a degree. However all ppis can cause b12 deficiency because PPI s can inhibit the absorption of b12 from food intake. Consequently my husband has to have b12 injections every 3 months. Again it all seems to depend on the individual. My brother got so fedup of the side issues of methotrexate that he stopped taking it because it didn't seem to be controlling his RA anymore. His stomach problems have now ceased and he has been put on sulphasalazine. Early days but so far so good. Sorry I don't think my ramblings help you much Dobby xx
Aw thanks - it does help to know the experiences others have. I've had IBS for as long as I can remember butMTX has definitely made it worse, along with acid refund etc. The trouble is , at 25mg MTX is controlling my RA well so I'm reluctant to give up on it!
Hi DobcrossMethotrexate is only contraindicated with omeprazole where methotrexate is prescribed at the very high dose used for cancer treatment, it is fine at the doses we are on. Doctors and pharmacists just glance at their notes and see that it has a 3 star indication and don't bother reading any further. I have had several arguments with my practice and pharmacist, I sometime wonder whose side they are on.
I only take omeprazole if I have to when taking naproxen. It isn't a great thing to take long term (longer than 3 months). I started taking a probiotic called acidophilus after several years on methotrexate and it made a huge difference to my stomach problems, I would heartily recommend it. You can get it online or at Holland and Barrett in the high street. However this may not be the best solution for you if you have IBS (my sympathies). You could give it a go for a couple of days and see.
Hi there, sorry to hear you had such a horrible experience with your GP. I’ve been injecting 25mg of methotrexate for a few years now and also taking Omeprazole at the same time. I wasn’t aware that there was a conflict between the two. Do you know what it is?
Thanks, so glad you've taken both without problem. As Jennifer says in the above reply, the concern may be around higher doses of MTX than we take for RA but no-one explained that!
Hi, I've been on both MTX and Omeprazole For well over 5 years now and have never had any problems with them. I do however get flare ups of my IBS and I take Buscopan which works brilliantly in the short term. If your doctors put you through the situation they did then maybe you should think of changing doctors.
I am on 25mg Mtx and have been taking omeprazole for a couple of years. Everything is fine; no issues.
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