Lansoprazole

[lesley2015]

HI All

Just a quick question, do most of you take the Lansoprazole when on long term Preds, just don't want to be taking unnecessary tablets etc??

Thanks as always

[piglette]

It depends if people are taking coated or uncoated pred. Some people take yogurt with the uncoated tablets rather than something like Lansoprazole. The coated tablets tend not to be absorbed into the body until they get to the gut, so do not cause the same stomach problems. I can understand you not wanting to take extra tablets with extra side effects! Some people take the older drug Zantac (Ranitidine) rather than the newer PPIs like Lansoprazole which seems to be gentler.

[lesley2015 in reply to piglette]

Hi Piglette

I take a mixture 5mg, 2.5mg and1mg so some are coated some are not I believe. Is yoghurt enough ? often have plain natural yog and fruit for breakfast.

[piglette in reply to lesley2015]

You may be OK taking yogurt at the same time as the pred particularly if you have the coated type as well as uncoated ones. I think some people are just given Lansoprazole and do not question it. I know someone who no longer has PMR who only took uncoated ones, but no tablets to protect her stomach with no problem. She reckons it was because she had a concrete stomach!

[Celtic PMRGCAuk volunteer]

Lesley, I was unable to tolerate any of the PPIs, including Lansoprazole and Omeprazole - nasty tummy problems from both. I upped my usual intake of 'live' yoghurt, taking a small pot daily with my breakfast (muesli or porridge) and before the steroids. It worked a treat for me and I never had any further stomach problems in spite of a steroid starting dose of 40mgs.

[HeronNS]

I do not take any stomach medications. I just make sure to eat breakfast before I take my pred, and drink a whole glass of water with it. No problems (after nine months so not terribly long term so far). I think the presence of food in the stomach is more important than the kind of food. Yoghurt is a favourite because a lot of people take it the moment they wake up and it is so easy to have ready. Or in some cases in the wee small hours. I just aim for 8 am and so far that's working for me.

[Skodadet]

I stopped taking Lansoprazole, always took prednisolone on a full stomach, added ibuprofen once a day for a short while and ended up with severe gastritis which took several months to heal. Never again! No ibuprofen for me and back on a PPI.

[Annodomini]

I have a pre-existing reflux condition for which I was prescribed Omeprazole and Ranitidine. Last week I wondered what it would be like if I knocked off the Omeprazole and had excruciating indigestion which I haven't had in years. So I'm back on the Omeprazole. Better the devil you know.... But we are all different, as these responses prove.

[PMRpro Ambassador in reply to Annodomini]

If you stop omeprazole suddenly after taking it for a long time it causes something called rebound - you produce even more acid than you did before and that is what happened to you. PPIs should be tapered off, just like pred, and then it is less likely to happen.

[Annodomini in reply to PMRpro]

Ah! That figures!

[Caro12line in reply to PMRpro]

Thanks PMRPro... How do you taper Omeprazole (sorry if that sounds a silly question). Currently on 20mg daily. Should I ask for 10mg? Or take 20mg alternate days, then maybe every 3rd day? I'm stabilising at 7mg Pred then going for 6 (using dead slow) so with 5 coated and 1 uncoated I don't think I need the Omeprazole ....just rely on the yoghurt

[PMRpro Ambassador in reply to Caro12line]

Not a silly question at all - I seem to remember they're a bit small, I wouldn't like to cut them! You certainly do it by going to a lower dose in between as you'd expect. This study

medscape.com/viewarticle/54...

did it by 1 week at 20mg, 1 week at 10mg per day and one week alternating 10mg and zero which seemed to work successfully.

They were aiming to taper patients off PPIs, most of whom were taking PPIs for GORD although some were using them as "stomach protection". It mentions at some point in the text that some patients subsequently used ranitidine as required - i.e. not continuously (continuous longterm use of PPIs has implications for various problems hence the desire to get the patients off them). Using ranitidine (Zantac) also helps with acid - with lesser side effects it is felt so maybe it could have a role in tapering too.

[PMRpro Ambassador]

I've been on pred for over 6 years but for about 3 years it has been either enteric coated or another coated form. I don't even bother with yoghurt and have a cast iron stomach really anyway!

But mixing in ibuprofen with pred is not a good idea and certainly not without some form of stomach protection. Each can irritate the stomach and together the risk is even higher.

Another way of dealing with pred if you don't want to wake and take it very early (when you need something) is to eat half your breakfast, take the pred, and then eat the other half.

[Sheilamac]

I refused it because I didn't want more side effects. I do take Ranitidine as and when I have the symptoms. It is a much safer medication.

[bowler]

I have been on Pred for 16 years. My GP stopped the coated Pred, several years ago saying they were too expensive, and then prescribed a PPI. so where's the saving??? [as PMRpro said in one of her recent posting re costs of these tablets ] however I never took the PPI, because it disagreed with me, and take my Pred with porridge. However I have recently been having gastro problems, and just had a gastroscopy and endoscopy, and waiting for results. I'm now wondering if the changing of the coated to non coated 5 years ago has damaged my stomach ? so with hindsight perhaps I should have taken something to protect my stomach but wasn't offered an alternative.

[Celtic PMRGCAuk volunteer in reply to bowler]

bowler, in view of your gastro problems, I would have thought that was at least a good enough reason for your GP to agree to switch you back to enteric coated, especially if you are still on a high dose. Like you, the PPIs really disagreed with me, but discarding them and sticking to enteric coated plus 'live' yoghurt did the trick for me. Good luck with the results of your recent exploratory investigations. You haven't had a change of BP meds have you? Some of those can also cause stomach problems.

[bowler in reply to Celtic]

Hello Celtic, sorry in delay in getting back, I had to go to A/E [ advised to go by my surgery as I have GCA ] re a really bad behind the eye painful haemorrhage and also what looked like white ulcer's in the eye Cut a story, they said it wasn't an ulcer's but swelling, and the haemorrhage/bleeding would disappear, which I know it will as I have them frequently, they didn't seem too concerned, and said any problems to go back, my eye looks awful, Whatever next ?

I haven't had any change of B/pressure meds,

I am having a Hydrogen breath test next Tues. then the following day have an appt, with the Gastro. Dr. for results of that and the endoscopy/gastroscopy, I am going to ask him, when he writes to my GP with the outcome of my results to ask my GP to put me back on the coated Pred.

regards bowler

[Celtic PMRGCAuk volunteer in reply to bowler]

Oh, sorry to hear about another potentially worrying experience, bowler, but so pleased it turned out to be nothing but the dreaded burst blood vessel side effect seemingly quite common whilst on steroids. I had so many of them with the worst experience being when vessels burst in both eyes at the same time.....unfortunately it wasn't Halloween! They do disappear once off steroids. Good luck with those tests/results.

[Coralmary]

Although I have weaned off prednisone I am still taking Methrotexate which I started to take as every time I lowered dose of Preds the symptoms returned. Like you I don't want to take unnecessary tablets and asked my GP if I could discontinue Omoprasole . She advised me to continue as I am also taking other medications and as I have always had digestive problems it would not be wise . So I carry on taking the tablets!

[lesley2015 in reply to Coralmary]

Thank you- I think Iwill continue and speak to GP.