Using ppi

[Zofitmogelijk]

Goodmorning everybody, may I ask a second question? Since it is like living in a parallel world, being diagnosed with pmr and you all know what I means. My question is about Omeprazol. I am now on 15 Mg prednison daily, and my gp wants me to take the Ppi as Well. I am 72 and never had problems with my stomach and never use nsaid . Ppi gives me the idea of swallowing a paraffine candle, causing troubles in stomach and further on, cramps a.o. Read in some posts people use yoghurt instead. Gp warns me, a bleeding in the stomach is very nasty. How can I make a wise decision? Thank you in advance for responding.

[SheffieldJane]

I also balked at the idea of Omeprazol because the side effects seemed worse than the thing it was supposed to help. I take Prednisalone with porridge in the mornings and have no significant problems. I suppose there is always the risk of a price to pay further down the track, but honestly day to day life is hard enough. Good luck with your gamble, am also rejected the Osteoporosis drug because my bone scan was average and that is also a horrendous drug. I guess I might repent at leisure.

[DorsetLady PMRGCAuk volunteer]

Hi,

There are many discussions on here regarding the use of PPIs. Many do believe it is not necessary and that eating natural yoghurt does as much good. Others are happy to take it- it's really a personal decision.

Long term use of Pred can cause stomach problems for some. It's like any drug, different side effects, affect different people, and if you are susceptible to that particular side effect then you need to take something to counteract it. Trouble is, nobody can say at the outset what side effects you will get - the doctors are just trying to reduce the possibilities of the more severe I guess.

I've taken Omeprazole for the last 4 yrs - no problems.

Sorry, not been a lot of help. But it's your decision, just make it as informed as you can.

[PMRpro Ambassador]

I have never taken a PPI and have had no gastric problems at all in over 7 years of taking pred. It isn't unusual for omeprazole to give people an upset stomach, for some people they dare not be far from a toilet. Omeprazole also contributes to loss of bone density.

For many of us, taking our tablets always with a meal (preferably in the middle of eating it) or with yoghurt has been enough. From my experiences in the last 7 years of the forums, my opinion would be that your doctor is exaggerating the risks, particularly if you don't take NSAIDs at all. It is strange I think - doctors will hand out NSAIDs without insisting on a PPI but are terrified of pred.

But as DL says - it is a personal decision. Everyone is different.

[piglette]

My new rheumie insisted I should be on a PPI even though I have special coated pred. I declined, which upset her. Do you have the coated pred or the ordinary run of the mill type?

[Zofitmogelijk in reply to piglette]

Thank you for asking piglette In Holland the uncoated pred is the cheapest adequatsolution, so That is wat you get. Been searching the internet but for example Lodotra costs 1 euro 5 gr. So I do not know since iT is a lot of money.

[piglette in reply to Zofitmogelijk]

I had an enteric coated version which is different from Lodotra, it is availabe in 5mg and 2.5mg versions and in UK is not that much different in cost to the uncoated version. Lodotra is more expensive in UK than Holland, current cost is one pound thirty three pence for one tablet irrespective of size. Well over one euro.

[PMRpro Ambassador in reply to Zofitmogelijk]

I don't know if enteric coated is available in Holland - but in the UK the cost of non-coated pred plus a PPI is considerably higher than giving just the enteric coated formulation. There is a double medication cost plus a double dispensing fee - and the PPI costs the same as the enteric coated pred. Don't know figures for Holland though. Discuss it with a pharmacist.

[PMRpro Ambassador in reply to piglette]

What an eejit - what does she think the enteric coating is for? Just to make it a prettier colour?

[piglette in reply to PMRpro]

I seem to attract eejits! Perhaps it is birds of a feather.

[PMRpro Ambassador in reply to piglette]

On the contrary - you recognise them, as do I!!

[paddyfields]

What is PPI? Although normally my stomach is easily upset I never had any problem with pred.doses of 20/15 mg max,

[PMRpro Ambassador in reply to paddyfields]

A PPI is a type of ant-acid medication - a proton pump inhibitor, it stops the mechanism that produces stomach acid. Omeprazole is probably the most commonly used. Ranitidine, better known as Zantac, does the same thing but acts on a different part of the process.

[Zofitmogelijk]

Dear fellow travellers through this pmr/ gca disease, Thank you for all the advice. I'll need Some more time before knoei ng what to do. Lost Piglette and Pmrpro somewhere on the road, perhaps a reply came not in my mailbox? And Paddyfields Ppi means proton pump inhibitor, a medicin to protect your stomach from bleeding since pred is rather agressive. And in case anyone is interested, uncoated pred is very cheap in Holland, 7 euro for 30, and the Omeprazol is sold over the counter for 5 euro a packet.

[IdasMum]

I don't eat before midday, don't take PPI and take my uncoated Pred with a small amount of milk. So far not problems...

[SusanEleven in reply to IdasMum]

I'm similar to you. I take my uncoated pred when I wake up (4-6am). I don't eat until maybe 10am. I take the pred with half-and-half and no problems to date (10 months).