This is my first time here, I have had GCA for the past year. Up until now I have been very lucky health wise, only taking one colestral tablet. I now take what seems like houndreds
I get confused re what medication to take when, I have been advised by pharmacy but forgot to ask him re should I take Pred fist in the morning? Or Omeprazole. Realising there needs to be 2 hours between.
I really appreciate this link with some very knowledgeable people and would like some advice.
Also I have sean on here about yogurt and pred is there a benift in having them together?
Plus I also have 'the moon face' which goes down a little then blows up again, I started pred at 60mg now down to 10mg in others experience when should I expect it to go??? Or is that a million dollar question?
Thank you in antisupation
Pam
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Robert09
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Hi I too have been on Prednisolone since Dec and was on 60 mg down to 9mg now. My face was balloon like and has gone down quite a bit thankfully but don’t think it will go away until I am off Prednisolone
My morning routine is to take omeprasole 30-60 mins before my breakfast and after taking food have the Prednisolone as they have to be taken when you have something in your stomach. an the omeprasole I Is taken to protect your stomach.
It's usual to take both omeprazole and prednisolone early in the morning, and if the omeprazole is to protect your stomach from the steroids, then you must take it first. So omeprazole on first waking up, pred some time after breakfast. Some people split their dose of pred - half in the morning and half in the evening, but if you do get muddled, then maybe it would be best to take all the pred at once. If you can't remember, think that you have to take them in alphabetical order - O before P!
Have a chat with your doctor. If the omeprazole was prescribed when you were on very high doses of pred, maybe you could manage without it now.
By the way, thanks for writing on your profile - it makes it so much easier to respond!
My moon face started to go down gradually once I got down to about 7mg. Here's a link to a post I did about a year ago, showing before and after pics! The discussion following talks about diet too.....
Thank you for your reply. I think I should have mentioned that I also take Alendronic acid one day week, told not to take Adcal D3 at the same time plus.
Methotrexate one day week + Folic Acid both one day week
Hello Pam, right until the end I thought I was listening to a chap. The drugs are a nightmare to keep track of. Get some of those colourful daily pill boxes , some have the time of day on them too - very useful. Do them for the week ahead. Omeprazole is to protect your stomach from the corrosive effects on the digestive system of Prednisalone. I didn’t know about the stipulated 2 hour gap but I took them before my Prednisalone,which suits me,taken first thing in the morning. Due to side effects and a lower Pred dose I take Pred with live Greek Yoghurt and find this better all round.
Please question your multiple tablets to ensure that you really need them all. I have refused as many meds as I am on. If you want to list them we can explain the thinking behind them.
I found a dazzling array of pill boxes on Amazon. Good luck.
Omeprazole should be taken shortly before eating as it requires food and acid in the stomach to make it start to work - it doesn't do so immediately but builds up its effect over a week or so. So actually, since you only take it once a day, once you are on the omeprazole you could take it before any meal and take the pred as early as you like in the morning.
Omeprazole and pred weren't found to have any effect on each other in a study so I'm not sure why you were told there should be a 2 hour gap - particularly since you are best to take the pred as early in the morning as possible if you have PMR symptoms - otherwise you would spend half the day waiting for it to work!
Where there SHOULD be a 2 hour gap is between calcium supplements and pred - pred for breakfast, calcium for lunch and tea!
The "indigestion remedies" actually probably really means the sort that contain calcium carbonate - which lots do. In fact - our calcium supplements are effectively antacids, and at a similar dose.
I don't think that omeprazole would have the same effect on pred that calcium does, the presence of the calcium stops the pred being absorbed so well. Since it acts all the time reducing the production of acid I don't see how when you take omeprazole can make a difference. It isn't something that could really be classed as a remedy for indigestion - you want immediate action then and omeprazole doesn't work like that.
I take mine all together in the morning as I get up at 6.00am for work so have breakfast and meds as soon as I get up don't have time to do it any other way .
Over the last 2,.and a half years never caused any problems .
I take my prednisilone and ranitidine along with all others together. The only only one I take a couple of hours later is my calcichew and I’ve never had a problem with my stomach.
I've taken my Pred and Omeprazole together since diagnosis (4years) without problem. Your face will start to go down as you reduce, think I noticed a difference around 6/7mg when the bloated feeling disappeared, prior to that I didn't need to look in the mirror to know. You are on the right track, the first year is the worst!
There is a photo of me with a very bloated face but cannot recall the title of my post...then another photo this year where I've just got a bit of puffiness in the cheeks but the eyes have gone down loads, I'm more or less normal in that respect now and feel much better.
If you live in the UK have you tried the coated Pred. I started off on the uncoated and having to taking omeprazole, then discovered there were gastro-resistant ones (coated). I haven't had to take omeprazole since, that was 4 1/2 years ago. After all why take another medicine if it can be avoided. It appears from what I hear from various sources that it is standard practise for doctors to prescribe the uncoated ones. Which raises another question on my GCA journey - why? The coated ones cost a couple of pennies more, I know this for a fact because I had a private prescription and they cost £7.50 for 100 but if you put that against the cost of omeprazole + pred there seems to be no monetary logic to it.
I would be interested to hear others take on this.
Some years ago an edict was issued that there was no advantage in using enteric coated pred and in some cases they were not as good as they seemed not to be absorbed as well (the study was done in patients with Crohn's disease so the lower gut was compromised anyway). Added to that they were considerably more expensive - at the time it was claimed there was a 17-fold difference in price. GPs had been consulted and they agreed it was fair enough. Then patients started appearing with complaints of gastic problems - and it was also agreed that in that case enteric coated could be used. GPs had never realised the difference that enteric coated can make and many regretted the decision.
And finally the manufacturers increased the price of plain pred - so there was now only a slight difference in the prices and the need for omeprazole more than cancelled that out since not only does the PPI cost about the same as a pack of pred but there is also a second dispensing fee to pay the pharmacist, something of which many doctors are oblivious!
So as you have noticed - there is no cost advantage plus adding omeprazole adds to the polypharmacy and it has its own unpleasant set of side effects. And now it is possible to get 1mg enteric coated pills - even better!
Thanks for that PMRpro. Your explanation (so clearly said) puts that question to bed for me. I suppose as with many situations that we may face on our GCA/PMR journey it is up to us to keep informed and not just rely on what we are told by medics. For me long gone are the days when what a doctor said I took as gospel.
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First dose of pred today 
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