Sorry another q. omeprazole and sulfasalazine

[Haz58]

Hi all. Sorry for another question but the more I learn and am diagnosed with the more questions I have.

I'm on omeprazole as well as many other meds. When I started sulfasalazine I asked a pharmacist what I could and could not take as the same time and one thing he said was omeprazole should be taken 2 hours before sulfasalazine as it's an antacid. So when I wake around 7am I take the omeprazole and then have to wait 2 hours to eat as I take the sulfasalazine with food (Rheumy said to take it after breakfast and tea she didn't mention a 2 hour wait).

Now I've read omeprazole is not an antacid and everywhere says there are no interactions with ppi's and sulfasalazine just antacids and you shouldn't take antacids within 2 hours of sulfasalazine.

I seem to be spending my days living my life by the clock to take meds!

Is there anyone on these 2 drugs and do you leave 2 hours between them? 🥴

I've also now got a gallbladder full of tiny gallstones and been told to consider gallbladder removal. And apparently omeprazole can upset the bile and cause gallstones do GP is changing omeprazole to famotodine? Do you take this 2 hours before sulfasalazine?

Totally confused!

[Fra22-57]

I am on these.I take the omeprazole first so it protects the stomach then after breakfast I take the rest of my meds.It is at most half an hour with mine and I don’t get side effects.hope this helps

[Haz58 in reply to Fra22-57]

It does thankyou Fra! X

[Amnesiac3637]

Not surprised you’re confused! Omeprazole is not an antacid (Gaviscon, Rennies, Peptac etc are antacids) and works differently. You might want to look up Proton Pump Inhibitors (PPIs) so you have a better idea of what you’re swallowing.

They’re usually advised to be taken before food but life often gets in the way of all this medication scheduling and they’re not going to do you any damage if you only manage a half hour between taking them and eating. Omeprazole, like any medication, can cause problems and if you’re being changed to Famotidine it’s because it works differently to a PPI, is an H2Receptor, and is sometimes more effective.

The best thing you can do is have an appointment with the rheumatology pharmacy team, sit down with them -or have a phone call - and bash out all the questions with them. They’re the experts.

I was a Practice Sister and it grieves me to hear how confusing it it for people on multiple meds who haven’t any idea how and when to take them as no-body has the time to explain. There would be a lot less frustration and wastage if that happened but sadly……..Best of luck with it all and hipe you get sorted out very soon!

[Haz58 in reply to Amnesiac3637]

Thank you Amnesiac! I didn't know you could talk to a rheumatic pharmacy team. The pharmacy at my hospital is Lloyds. In the past they've not been very helpful. The GP is changing me to Famotodine because I said I'd read 4 of the meds I'm on can cause gallstones and I've been on omeprazole for lord knows how many years! I don't think they'd have done anything if I hadn't said that. After the gallbladder diagnosis on Thursday I looked into all my meds and was amazed at what I found! It also says it can make you more prone to fractures... I had a T9 compression fracture 18 months ago and didn't have a clue how I did it and on the MRI it showed an oldish fracture on my femur which I didn't know I'd done. Coincidence.,.I have no idea 🤷

[Amnesiac3637 in reply to Haz58]

Your rheumatology team is advised by specialist pharmacists so they should be available to talk to you if you ask. If you get nowhere with that then make a double appointment with your GP for a medication review and take a list of questions with you. You do have to insist and on occasions do some polite shouting but it’s your life, your body and other people can walk away from you but you can’t!

Your fractures may or may not have been caused by medication in the past. Are you osteopaenic or have you been diagnosed with osteoporosis? You need to know. Many people, myself included, have been on drugs like Omeprazole for years (30+ in my case) but have had no problems so it’s very individual and not a given. Obviously, the longer we all take medication the more likely we are to face problems but there are other diseases which can cause issues. Good luck - let us know how you get on.

[Haz58 in reply to Amnesiac3637]

Yes I was diagnosed with osteopenia after the fracture. So I'm on CalcichewD3 as well now. Thank you Amnesiac x

[sunshineday]

Hi Haz, my hubby's on multiple meds including Levothyroxine which advises to leave 4 hours from antacids. I thought omeprazole was an antacid and spoke to pharmacist we've had for over 40years, so knows all about hubbys illnesses and meds, and he reassured me it was not. I use drugs.com to check now as well and it's really helpful (it's an american site but includes most meds used in the UK as well). There is an interactions section where you can add, delete and save meds and check out new meds etc. it also has info re drugs and trials etc.

[Haz58 in reply to sunshineday]

Thank you sunshine! Lovely name and something we need more of. The pharmacist that told me 2 hours was a very grouchy man. Anyway this morning I took the omeprazole at half 7 and ate and took my sulfasalazine 45 minutes later. So I'll do that from now on. I'd read it wasn't an antacid but you think you can trust a pharmacist don't you. It's good to hear from someone else too that they don't wait 2 hours!

I've read yesterday you should eat as soon as possible after waking as that's when cholesterol in the gallbladder is at its highest. So how I'm thinking a year of waiting 2 hours plus the 4 meds I'm on that can cause gallstones just maybe the cause of my gallbladder problem now. Who knows 🤔 x

[sunshineday in reply to Haz58]

Hi Haz, glad you have sussed suitable routine out and you could be on the right track about your bladder problem. I think with all meds it's a bit of trial and error. I'm on atorvastatin but had a nasty carbuncle under my arm. I was prescribed clarithromycin, fortunately I read the leaflet which warned great care needed if on statins. As it was Friday I decided not to risk over the weekend and contact Dr on Monday. So I did a Klinik form at 8am, the triage Dr rang at 8.30am and said I was right to leave off the statins over the weekend and could now start clarithromycin. Apparently the combination can cause a very serious reaction which can kill you so I now tend to think, if in doubt don't until I've spoken to clinician. I love the sunshine, reminds me of relaxing in the warmth so it's cheer me up. Joy

[wilbertjellyfish]

I used to take them together, never an issue.Omeprazole is a proton pump inhibitor so it stops the stomach releasing acid rather than blocking it's actions.....from my vague pharmacology lessons in the dim and distant.

[Haz58 in reply to wilbertjellyfish]

Thanks Wilbert! That's 3 people who's said this so I'm not going to clock watch in the mornings anymore. ☺️

[wilbertjellyfish in reply to Haz58]

It's so difficult to know what the right thing to do is but I try to keep it as simple as possible.

[Chockyuk]

Hello

Probably best to take a few hours apart, but I take both together, I’ve no time in the morning before going to work.

I had gallstones and had my gallbladder taken out, many years before I had RA though. Very painful, worse than giving birth gallbladder pain, and I don’t say that lightly!

I did change from Omeprazol to Lansaprozal though, from 20mg to 15mg, as it raised my liver enzymes at 20mg, as there is an interaction with Mthx, which I also take in conjunction with Sulfa.

[CallMeSunny in reply to Chockyuk]

Famotodine is an easy one to remember….on the pharmacist’s label stuck to my medication, I am told to take it last thing at night…. and I find it works as well as Omeprazole!

[Haz58 in reply to CallMeSunny]

Great thank you sunny!