GCA meds

[tgca]

Having followed a recent link to the Patient info site, I read that they seem all in favour of aspirin and adding omeprazole to counteract the side effects of the pred and aspirin combination. Some months ago, I read on this site that aspirin is not necessarily necessary and therefore, neither is omeprazole... I would be very grateful if someone could shed more light on this subject. I am currently taking 9 mgs pred, Adcal D and Amlodipine and loads of yoghurt on my morning muesli !

[DorsetLady PMRGCAuk volunteer]

Hi tgca,

Many people don't take omeprazole, they find yogurt sufficiently protects their stomach.

Not sure how common it is to prescribe aspirin in UK nowadays, but I guess if you have 2 separate medications that can affect stomach it's wise to take a protector. However, if you don't need it, then don't take it. It's your choice at the end of the day.

As I was already on small dose of aspirin for other reasons before I started Pred, I was put on omeprazole, didn't bother me, but it does affect some. Although I am now off Pred, but still on aspirin, have continued with omeprazole, albeit at a lower dose. I did raise the need for it with GP, but he "suggested" it might be wise to continue with it.

[SnazzyD]

Hello, I'm interested to know about aspirin because my UK Rheum Reg I saw said I should have 75mg for GCA, "just in case" but couldn't tell give me any figures on outcomes if people do or don't.

[PMRpro Ambassador]

In the 2010 BSR Recommendations for the management of GCA they suggested using aspirin on the grounds it was of benefit to the vascular side of the illness. In the soon to be published new international recommendations I gather it is now being said aspirin is no longer recommended as there is no evidence that the benefits outweigh the considerable risk of gastric irritation, especially alongside pred. I gathered this from a presentation Prof Dasgupta gave at the Glasgow PMR meeting last September (Recommendation 9, slide 67/71 of his powerpoint presentation);

pmrandgca.org.uk/research-a... under Conferenece: 30 Sept)

Omeprazole is said to reduce the risks of the pred-associated gastric irritation. Ranitidine works as well with different side effects and a lot of us have managed well without either - many using yoghurt (which has no side effects). Some people have had considerable gut problems due to omeprazole plus it doesn't work for about 1 in 3 patients. Not to mention its major role in leading to osteoporosis due to interfering with the absorption of calcium.

[tgca]

Thank you so much for your suggestions and ref to research.. that puts my mind at rest as I gave up aspirin and omeprazole a few months ago and substituted them with yoghurt ... seems to be working well. I had a dexa scan last week and will be really interested to see the results compared with those of Sept 2015 ! Wish me luck.