good morning. Can I ask what antacids people use when on Methotrexate? Dr Google says no to omeprazole, it’s just for mild heartburn. Thankyou
antacids : good morning. Can I ask what antacids people... - NRAS
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AR50cyclist
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I rely on Rennies. I used to take Ranatidine but it was then withdrawn. My GP has prescribed Omeprazole but it doesn't seem to work well for me...
Rosie-NRASPartnerNRAS
Hi AR50cyclist, sorry to hear of your heartburn issues, this is something we encourage you to discuss with your local pharmacist or GP to find a medication suitable for you.
With the caveat that I’m not medically qualified and advice should be sought from a professional aware of your history. My understanding is that when used at high doses, such as when used as chemotherapy for cancer patients, methotrexate elimination from the body can be delayed by taking any proton pump inhibitor such as omeprazole, leading to potential problems and worsened side effects. However, at the doses used in arthritis, it’s not considered an issue. I was taking omeprazole concomitantly the whole time I was on mtx due to an underlying hernia and resultant reflux. There’s probably a fair few people on the boards here that take both mtx and a PPI of some description. However, I’d strongly suggest speaking to a pharmacist or your GP. If the issue is only occasional acid, before reflux became a major issue, I used to get on quite well with gaviscon liquid.
LondonLinda• in reply to
I concur, Gaviscon Advanced is a good product. I too suffer with very active reflux. I used to take Omeprazole twice a day but was then instructed by RA Consultant to take my 40mg x 2 dose at night plus the Gaviscon Advanced. I was amazed at the speedy result. I’m also on 25mg MTX
I've been on omeprazole as long as I’ve been on MTX, since 2009, so no issues for me. I'm on 10 mg twice a day & 17.5 mg subcut MTX. The aren't prescribed for heartburn though, rather to protect my tum from the tablets I take.
This is one reason we don't recommend Dr Google. Can I ask, did you specify low dose MTX in your search? I think generally it's high dose MTX where it applies, as used in cancer treatment (like 15 g for 5 days not 15 mg once a week for example). If you're still concerned you can ask your GP or pharmacy where you have your scripts filled.
Thanks! No I didn’t specify low dose, it just said it slowed down the metabolism of MTX. Good to know!
You're welcome. If you check again it relates to high dose (grams) rather than low dose (milligrams or one thousandth of a gram).
Omeprazole didn't work well for me, pantoprazol is much better 20 mgs morning and evening.
Hi. I am prescribed Nexium. Mostly it is good. Only have issues if eat chilli type spicy food. I have been on nexium for years when I first started methotrexate 15 years ago. Hope all is good.
I switched to methotrexate injections.
I’ve been on mtx for over 15 years, 15mg a week now. I started getting acid reflux after about 10 years and I was put on Lansoprazole, a proton pump inhibitor. After reading comments on here, I’m thinking I may need to change meds. I have a prescription review in December and will ask for advice from the pharmacist.
peppermint capsules or peppermint tea helped me and being very mindful of trigger foods to avoid that exacerbate this issue.
I’m on 15mg of Lansaprozal, it seems to work ok, I have GERD and a hiatus hernia.
I was on 40mg of Pantoprazole, but the higher dose didn’t agree with Methotrexate and raised my liver function tests to over 100, so I had to lower the dose, my GP suggested changing to 15mg Lansaprozal.
Talk to your Consultant and GP and see what they say.
👍
I am on 25mgs mxt by injection so have been prescribed folic acid and Omeprazole daily from day one, have no problems with indigestion although used to suffer before ra diagnosis. Hope this helps.
I use omeprazole with no ill effect. I take one tablet with my morning meds. I am on 25mg Mtx (and 2000mg Sulfasalazine daily). It’s a stomach protector.
Interesting because omeprazole has been prescribed and I'm on methotrexate and steroids.
apparently it’s only the high doses of methotrexate that it’s an issue with, low doses used in RA are ok!
I take Gaviscon when needed. Mainly controlled it by losing weight and reduction in carbohydrates. (GP kept giving me PPIs in gelatin capsules - I don't eat meat - despite my protests - as the disolvable ones were more expensive. I also didn't like the long-term effects of PPIs respoted).
But discuss it with your GP and do your own research. Peristent relux of acid into the oesphagus is not a good idea and can cause damage, so you need to do something to control it.
I have always understood that antacids of any kind were not allowed with Mtx. I use soda water when needed. It has a very similar affect
Yep I’m in the same boat but things like mylanta and gaviscon are ok.
Good morning l take famotadine which replaced ranitidine. And Omeprazole
I'm on 20 mg methotrexate weekly , 5 mg folic acid on the day before MTX and 3 g Sulfasalazine od ( 3 x 500mg am and pm ) . I was started off on Omeprazole initially but suffered from acid reflux . Changed to Lansoprazole 30mg od , which has worked fine for years . Very occasional acid reflux dealt with by Gaviscon Advance .
my specialist prescribed Omeprazole
don't rely on Google, ask GP or Rheumy. I take both and my metho is highest dose and I am fine x
