PPI needed with Naproxen?

[Stills]

prescribed 250 x 3 daily until blood result's for Stills activity done. GP also prescribed Omeprazole which I was also prescribed throughout 2023 for GI and other unknown issues that were not found and have petered out for the most part. Omeprazole gave me terrible headache and it took a while to wean off so I don’t really want to start it again. Anyone taking Naproxen without using a PPI and finding it ok?

[Pops77]

hi Stills,

Yes I take 500mg Naproxen twice a day & I take Omeprazole also daily. I haven’t had headaches- other than one rare migraine, which resolved quickly & I’ve been ok since. I’ve had Lanzoprazole before when I took it previously. My knees are quite bad so hence I’m taking it again. So I’d talk to your GP ? Mine said it was advisable as I’m taking anti inflammatorories regularly. I also take sulphazalizine EC which was increasingly causing me reflux & that has been 💯 better since I’ve taken the Omeprazole. I hope this helps? All the very best 🤗

[Stills in reply to Pops77]

Thanks for your useful reply

[WilfDog]

Hi StillsI'm not a fan of PPI's given the potential side effects on the digestive system. That said, anti- inflammatories can play havoc with your stomach, so if it's going to be short term I would possibly try a stomach protector.

There are many other meds to choose from other than PPI's. I was given an alternative, called Famotidine, although to be fair I haven't used it as I decided on a natural stomach protector.

Famotidine is a H2 blocker to reduce stomach acid. I don't know whether it's any better but that's what I was prescribed as an alternative to PPI's, so maybe you could ask your doctor about these, or any others that are out there.

Hope you can find something that works for you xx

[Stills in reply to WilfDog]

Thanks for your response. May I ask what alternative you use? In 2023 I had gastric issues and took the PPI but as my Naproxen dose is low and hopefully short until results reveal something or nothing, I’m hoping yoghurt and milk will protect my tum. To be honest with myself though I could feel the burn after the first dose so maybe I’ve answered my own question,

[WilfDog]

Yes, of course. I use Zengest doTerra digestive capsules. One every morning with my supplements and other meds.

I'm not fully up on how yoghurt and milk will protect the stomach lining. I know there is the old adage "drink some milk to line the stomach, " but I'm unsure how effective that is against anti-inflammatories.

If you've felt it already after the first dose, then yes, maybe you have answered your own question. It's not worth gaining an ulcer over.

I hope you work out a strategy. It's horrible knowing after you've taken meds it's going to make you feel ill with one side effect or another.

I've tried many stomach meds over the years, especially after having an ulcer because of anti-inflammatories when I was in my 20s. I seem to have settled up to now with my alternative.

Good luck xx

[HeadInASpin]

I take omeprazole as recommended by the gp and do so without issue. If you decide against the advice I would say to make sure you take them on a full stomach, so the drug is not sitting directly on the lining of the stomach. Personally I would discuss further with the doctor as they may be able to give an alternative. It might also be worth speaking to your pharmacist, they are brilliant at giving advice on drug interactions and side effects.

[virtualreality]

When I was first developing RA I was prescribed naproxen for several months, and like you had concerns about the side effects of PPIs. They were prescribed to me but I chose not to take them (not recommending not following doctor's orders by the way!) but always took the naproxen after breakfast on a full stomach, as  HeadInASpin says above. I did talk to my GP about the reasons for my concerns, and didn't experience any problems, but it was very short-term and I wasn't dealing with any gastric issues at the time. I hope you find a good solution for your situation, I've never liked the 'taking medication for side effects of other medication' thing but sometimes it's hard to know what to do for the best.

[Stills in reply to virtualreality]

Good reply thank you. It’s good to know I’m not alone on this point about PPIs. Interestingly when Stills was diagnosed in 1979 I took about 22 tablets a day for several years and none of them were PPIs I’m sure. Of course I was young then and didn’t have a clue

[BoneyC]

When I was first diagnosed (1971) I wasn't prescribed any PPI despite taking NSAIDs. It was 37 years later (2008) when I was having my first THR that the surgeon insisted I should be taking a PPI and have done since. Rheumatology seemed to be quite relaxed that I wasn't prescribed any PPI.

[Stills in reply to BoneyC]

Much like me then BoneyC, thanks for letting me know . I think it’s a case of eating to protect the stomach unless GI issues become apparent (in my case). I’m limiting the Naproxen as much as possible.

[Monkeysmum]

I’ve been taking Naproxen with Lansaprozole for several years. I can understand your concerns with Omeprazole if you have had side effects with it previously but perhaps you could try a different PPI?

[Stills in reply to Monkeysmum]

Yes I could ask for a different one and will certainly do that if I stay on Naproxen for long, thanks Monkeysmum

[ruth_p]

I took meloxicam without it and it caused awful stomach pain, nsaids are really bad for your stomach lining so you need something to protect it. Could you ask to try lansoprazole instead? You might not get the same side effects.

[Stills in reply to ruth_p]

Good advice thanks

[Sunflower1921]

Hi I think it's safer to take short term omaprazole with naproxen,I've been put on prednisolone a Increased dose to 7.5 this week and suffered dreadful pain in my gut and indigestion so today I'm taken a 20 mg of omaprazole with a 5 mg of prednisolone and see if it works . I ve got lupus, Inflammation very high .keep plodding on thats all we can all do with these auto immune system issues.xx

[Stills in reply to Sunflower1921]

Thank you and wishing you better days

[Kati66]

I used to have naproxen but stopped it a few years back due to chronic anaemia. I’m now on lansoprazole as a recent endoscopy found my tummy is inflamed from bile reflux gastritis. I’ve not had any side effects and they seem to ease my tummy pains a bit. I hope you can find something that helps 🤞🏻🤞🏻🤞🏻

[Stills in reply to Kati66]

Thank you and wishing you better days

[oldtimer2]

There are several different Proton Pump Inhibitors: Omeprazole (Prilosec), also available over-the-counter (without a prescription), Esomeprazole (Nexium), also available over-the-counter (without a prescription), Lansoprazole (Prevacid), also available over-the-counter (without a prescription), Rabeprazole (AcipHex), Pantoprazole (Protonix), Dexlansoprazole (Dexilant), Zegerid (omeprazole with sodium bicarbonate), also available over-the-counter (without a prescription).

There are concerns about the risks of taking them long-term, have a look here if you want a summary:ncbi.nlm.nih.gov/pmc/articl...

The main risks seem to be calcium and magnesium malabsorption, vitamin B12 deficiency, Clostridium difficile infection and community-acquired pneumonia. And there is some research linking PPI use to dementia and chronic kidney disease. But short term use doesn't run the same risks and could protect your gastro-intestinal tract from suffering damage. Taking non-steroidal anti-inflammatory drugs with food might be enough but if you do get reflux pain then think again.

[cyberbarn]

It is worth remembering that everyone is different. PPIs might be a good thing for one person, but not for another. Likewise, some are fine with naproxen without PPIs, some aren't.

Once you have had stomach damage due to NSAIDs then it is more likely that taking them again will cause problems. In which case it would be a good idea to take the PPIs too. If your stomach is fine, then you might get away without the PPIs. Everyone will be different.

[bpeal1]

I didn’t get on with omeprazole so my GP prescribed Lansoprazole instead. Maybe worth asking to try that one (?)

[Chrissycl]

Therecare other PPIs you can take I tried about 4 I think before finding one that suited me

[Stills in reply to Chrissycl]

Thanks , I’ve decided to either eats lots of Greek yoghurt and/or added for an alt, script.