Drug interaction: Does no one take Omniprazole with... - PMRGCAuk

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Drug interaction

Mimma profile image
61 Replies

Does no one take Omniprazole with their prednisolone? I also have to take tamoxifen, calcium. Omega 3 and vitamins D3 and K2.

So far I take my omniprazole and prednisolone early morning then tamoxifen two hours later followed by calcium and K2 after lunch and calcium and D3/Omega 3 after tea.

Have I left enough gaps to avoid any drug interaction? Pharmacist not too knowledgeable.

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Mimma
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61 Replies
YuliK profile image
YuliK

I was given omniprazole when I was on high doses of prednisone. Once I reached 10mg of pred I ate a yogurt before the pred instead of the omniprazole.

Much better for me.

Feel better.

YuliK

Mimma profile image
Mimma in reply to YuliK

Thanks Yulik will try that

That does look like a good spread and you seem to have at least 2 hrs between each set of pills. I do try and take calcium away from everything by 2hrs as it can reduce effectiveness of other drugs but as the combine it with d3 that's not as important.

Are your prednisolone coated or uncoated ? (Coloured or white) if they are coated then you don't need the omeprzole, unless its for another condition. If uncoated (white) get the Dr to change them to coated. They are called gastric resistant on the prescription. They pass through the tummy before they disperse rather than sitting in the tummy to disperse. They take a bit longer to kick in but if you take them in the night then that should be fine.

Mimma profile image
Mimma in reply to

Thanks so much for that. I am on the uncoated variety but will ask to change to the coated type.

1602 profile image
1602 in reply to Mimma

Hi my pharmicist told me to take my Omeprazole before my breakfast ergo before the pred. xxx

Mimma profile image
Mimma in reply to

One more question please. I am going to be having an infusion of zolandronic acid for my bone health. It’s just an annual injection. Will I still need my calcium pills?

in reply to Mimma

Have you had a dexa scan to check you need an infusion? The doctors always try and give you these things but unless you need it why bother and how will you know if it's helped without a baseline? If the scan shows you need it then that's ok but you still needed a starting point.

Re calcium I don't really know because my scan was fine. Hopefully someone will help.

Mimma profile image
Mimma in reply to

Yes I have had a scan and my bone health had deteriorated in a year. They originally wanted to put me on weekly Alendronic acid but I wasn’t keen on adding that to my medley of medication so opted for the annual injection.

in reply to Mimma

Do you know your t scores. Some people have reversed bone loss with diet and exercise.

At least you have baselines to go from. I tried AA and it didn't like me!

Mimma profile image
Mimma in reply to

T score for R Hip -2.7

T score for lumbar spine - 2.2

in reply to Mimma

Yes proper scores! I have linked you to heronNS post where she discusses her osteoporosis journey. It's worth considering especially as a lot of infusions are there for many years if not life?!

healthunlocked.com/boneheal...

HeronNS profile image
HeronNS in reply to Mimma

My OP journey is not the same as I never actually was at the OP level although AA was recommended because of several risk factors. However I do know of people who were diagnosed with OP who actually improved bone density to a level where medication is no longer recommended, but without medication, only the "natural" means. It all depends on your own particular situation, causes for the OP, and commitment to trying something the doctors tend to disapprove of!

Kaaswinkel profile image
Kaaswinkel in reply to Mimma

That is what I did too, yearly infusion. Suited me much better as well. Alida

Mimma profile image
Mimma in reply to Kaaswinkel

Glad to hear it’s worked for you.

PMRpro profile image
PMRproAmbassador

Drug interactions can happen even when you take the medications at different times - with some it helps just to separate the dose times though.

I assume you mean omeprazole, a PPI for stomach "protection"?

And yes - you still need your calcium and vit D after the infusion - bisphosphonates only work when there is adequate calcium and vit D available.

Mimma profile image
Mimma in reply to PMRpro

Thank you so much for clearing this up for me.

Mimma profile image
Mimma in reply to PMRpro

And yes for stomach protection

PMRpro profile image
PMRproAmbassador in reply to Mimma

Some people use it, lots don't and either use the enteric coated sort of pred (only available in the UK) or rely on yoghurt when taking the pred which really does work for lots of people. You have a ground for asking for the enteric coated variety of pred as omeprazole is linked strongly with loss of bone density when used over a long period and it does have other unpleasant adverse effects for some people, it can cause a lot of gut problems.

Mimma profile image
Mimma in reply to PMRpro

Thanks will take that on board. Certainly have a very bloated feeling!

PMRpro profile image
PMRproAmbassador in reply to Mimma

That is certainly one of the common effects. Maybe you could try ranitidine instead? It is the older version, sold as Zantac. Pressure marketing of PPIs persuaded GPs that they were wonderful and SO much more effective than old-fashioned H2-inhibitors. In fact the difference is not that great and they have more and different side effects so trying Zantac is always an option.

Highlandtiger profile image
Highlandtiger in reply to Mimma

Omeprazole made me feel dreadful in a number of different ways. My GP swapped me to Ranitidine and I've had absolutely no side effects with it so as PMRpro says it’s worth a try.

Mimma profile image
Mimma in reply to Highlandtiger

Thanks for that - will discuss with GP

darkred profile image
darkred in reply to PMRpro

Great advice about the yogurt. I read the ingredients because not all yogurt is the same or is beneficial. Some have fillers and not enough probiotics. Some Greek yogurts are especially beneficial but I still read the ingredients. Recently, I read that kefir is good for acid reflux. It goes down easy and I don't think it interferes when taken with prednisone. Correct me if I'm wrong. Kefir has helped me since my appetite has been poor lately.

Telian profile image
Telian in reply to Mimma

I took Omeprazole for 5 years with no side effects - then I started to get a regular tummy ache for no reason and decided to switch to Ranitidine - tummy ache went! You can get it on ‘script in the UK.

Mimma profile image
Mimma

Thank you - I will discuss these options with my GP

Jemsea profile image
Jemsea

On my last pred prescription I asked my GP for the gastric resistant ones because I was getting heartburn. Believe it or not, I received a telephone call the next day from the pharmacist who is employed to work within the surgery. Never knew they had one. He said that my GP wanted him to explain why I should take Omeprazole. I said I didn't want to take any more tablets. However, he managed to persuade me to try them, and when I collected my prescription my GP had give me the uncoated pred because she wants me to take Omeprazole, saying it is better that the coated pred. As yet I haven't taken any Omeprazole, and not sure that I will.

This pharmacist, it turns out, has a weekly clinic for patients he would like to talk to. He has invited me to his clinic to discuss PMR, medications, blood pressure and all things related. He admitted his knowledge of PMR was limited, because of the lack of research.

He even suggested we could look at at what could be the cause of my PMR. if in fact I have PMR. Very much looking forward to this appointment.

in reply to Jemsea

I wonder how much cash was given to the Dr to push them. Coated pred is fine. And to push another drug that may contribute to osteoporosis is damn negligent in my view. I was lucky, having been on lanzaprozole for 15years I got away with at least bone density issues by being a big girl. My pharmacist suggested enteric coated aspirin years ago to get lanzaprozole off my prescription but Dr said no I needed it. I didn't have the info I have now....dropped it within months of PMR. Try and really get pharmacy onside or complain to the practice.

Jemsea profile image
Jemsea in reply to

I agree poopadoop. It's bad enough with pred and its side effects, without taking another drug to counteract the side effects of pred, which in turn there will more than likely be another drug to counter the side effect of the drug taken to counter the side effects of pred. and so it goes on, more and more drugs to counter side effects of other drugs.

in reply to Jemsea

Exactly...I have dumped a few meds this year. Don't feel much better so far 🤣🤣🤣

HeronNS profile image
HeronNS in reply to Jemsea

I remember when I was given naproxen for migraine. I considered it a miracle drug. Then it turned out I needed another drug to protect my stomach, and at a certain point I said enough is enough and returned to overdosing on aspirin instead, which never hurt my stomach like naproxen (now otc as aleve) although it is claimed it is less hard on the stomach than aspirin. But I've used aspirin all my life and understand it and it has so far been fine. Touch wood.

Jancorb profile image
Jancorb in reply to HeronNS

Thank you for reminding me, I would take 2 aspirin every morning to relieve the stiffness, but had to stop as interacted with methotrexate. As I've now decided no more methotrexate I can go back to aspirin, it always worked well. Yipee

PMRpro profile image
PMRproAmbassador in reply to Jemsea

Cause of PMR? Well, that will be one very clever pharmacist if he can work THAT one out!!

Omeprazole and an extra layer of adverse effects is better than coated pred? It never ceases to amaze me that they protest about pred causing osteoporosis. Omeprazole does too - but it never gets a mention.

Jemsea profile image
Jemsea in reply to PMRpro

It mentions in the bumph inside the box that osteoporosis is a possible side effect, also dizziness, also fatigue and for these reasons I shall endeavour to keep away from it. As for finding the cause of my PMR, yeah, well, we know it's virtually impossible, but I'm willing for him to have a go, with my help of course!!

HeronNS profile image
HeronNS in reply to Jemsea

Do report back and tell us how that conversation goes. I'm smiling as I write this!

Jemsea profile image
Jemsea in reply to HeronNS

Will do. My appointment is in two weeks time. I'm just happy that someone out there is willing to sit down and talk/listen for half an hour instead of the usual 10 minutes with GP. He sounded genuinely interested. I also asked him about Hawthorn Berry (crataegus) for high blood pressure and A.F. which I have just started to take. It certainly lowers the blood pressure and gives one a feeling of well being. I want to kick the beta blockers if I can. I've been meaning to ask if anyone on the forum has ever tried crataegus for HBP and A.F. but don't have much time to write on here, although I read most of the posts each day. 😊

Conundrum profile image
Conundrum in reply to Jemsea

Sorry, what is A.F?

Jemsea profile image
Jemsea in reply to Conundrum

Atrial Fibrilation - rapid heartbeat in my case.

Conundrum profile image
Conundrum in reply to Jemsea

Ah, thank you. I too have higher blood pressure while taking Pred. and am interested in the Hawthorn Berry.

Jemsea profile image
Jemsea in reply to Conundrum

I have been using Hawthorn Berry Tincture, but only half the recommended dose, since I am still on blood pressure tablets. If you are on blood pressure meds. you must keep an eye on your blood pressure in case it goes too low. Best to discuss this with your GP if you have any doubts about it. I buy mine from Baldwins.

Conundrum profile image
Conundrum in reply to Jemsea

👍

Mimma profile image
Mimma in reply to Conundrum

My blood pressure has escalated too

PMRpro profile image
PMRproAmbassador in reply to Jemsea

Is your AF a new issue? Or did it start soon before your PMR? The cardio is sure mine is due to the a/i part of PMR.

Jemsea profile image
Jemsea in reply to PMRpro

I had an A.F. in hospital after my lung op. The surgeon happened to be doing his rounds at the time and I said I wasn't feeling so good. He felt my pulse and shouted for the nurse to put a canula in and inject magnesium. He said I was in 'stroke country'. He put me on a low dose of beta blockers, but on subsequent follow ups with him he said he thought I had always had A.F. but it had never been picked up. Since being on beta blockers my pulse is often as low as 58. Too low for me. This is why I want to use the hawthorn berry in place of, since it is supposed to be good for regulating the heartbeat and good for the circulation.

I would love to chat more, but I have to rush out now to the other end of town to play bridge. Playing bridge often makes my B.P rise!!!

PMRpro profile image
PMRproAmbassador in reply to Jemsea

Never mind the betablockers - you are on an anticoagulant aren't you? And the dose of the betablocker can be adjusted. Now I have a pacemaker my pulse is generally 60 and that is fine for me. As long as it doesn't go lower - I was having 7 second asytoles (pauses) after the tachycardic episodes!

Jemsea profile image
Jemsea in reply to PMRpro

No PMRPro I am not on any coagulant. My beta blocker dose is very low - 1.25mg. Yes, I think I read in another post that you were having 7 second pauses. That sounds a very long time. Occasionally I have a missed heartbeat, at least I think that's what it is. just one second missing. I have stopped taking the diuretics because the Hawthorn is also a diuretic. As yet I haven't read of any contraindications for Hawthorn and there is no doubt about the 'feel good' factor.

I took 10 drops in water this morning before going to bridge, 15 drops is the recommended dose twice or three times a day. Felt great all morning.

Had lunch when I came back then went for a walk. Began to feel tired on the walk, possibly needed some more Hawthorn - it seems to give me more energy.

PMRpro profile image
PMRproAmbassador in reply to Jemsea

If you have proven AF you need to be on an anticoagulant to reduce the risk of stroke and other cardiovascular events, Once mine was identified I wasn't allowed out of hospital until I was on warfarin at a therpeutic level! My husband was found to have it during an egometer test on his birthday - the only reason he got home was because he was already on warfarin for something else! The UK does seem very dilatory about it.

uptodate.com/contents/atria...

Jemsea profile image
Jemsea in reply to PMRpro

There's a lot of information there PMRPro. Thank you. Haven't read all, but some. There was discussion whilst in hospital whether I should have an anti-coagulant and it was decided not. Several weeks out of hospital a different GP (not my usual one) called me to the to discuss anticoagulants because of what happened when in hospital. I told him surgeon decided not to prescribe them, so he said he was going to write to the surgeon to find out if I should be on this medication. I have never heard anything further, so don't know what the outcome was. However, now you have given me all that information, I will ask the surgery pharmacist about it when I see him in a couple of weeks.

AndrewT profile image
AndrewT

Dear Minna,

Based on the drugs, that I take- including Omeprazole and Prednisolone, I would say....Yes, you are, leaving enough time between them. Another 'Point', to consider, how are your Blood Results? If they are, generally speaking, ''Good'' then you are definitely 'Doing' this right.

Personally, my Timings, tend to be based- at least in part anyway- by how I 'Feel', in myself. I'm, pretty sure, that you do the same yourself. I hope that this has 'Reassured' you, a little anyway, Minna. Kindest Wishes

AndrewT

Mimma profile image
Mimma in reply to AndrewT

Thank you Andrew

Hellyowl profile image
Hellyowl

I have been taking Omeprazole 3 years and i don't think I have had any side effects, I was given 40 mg when I was on 60mg. Pred. it has never been reviewed and when I worked my way down to 20 mg. Pred I reduced my Omeprazole to 20mg and have never had any stomach problems. I am down to 3mg so at my next Rhuemy appointment I am going to ask if I can stop it.

Mimma profile image
Mimma in reply to Hellyowl

Hope they agree with you!

Waterfeature profile image
Waterfeature

Hi Mimma, to be honest I hadn’t given it a thought because on my doctors instructions it read take daily so didn’t think it would matter when I took them. I will now inquire

Mellow-Yellow profile image
Mellow-Yellow

I had side effects from omeprazole and for the past year I have taken my drugs with a large glass of full fat milk.

Mimma profile image
Mimma in reply to Mellow-Yellow

Great idea - thanks

Nancysanti profile image
Nancysanti

I just got off steroids in March after 2 years....

I take tamoxefin and the other supplements

You take.i just learned my liver enzymes are climbing above normal....I read it could be tamoxefin

anutycrixp profile image
anutycrixp

ommeprazole?taken for years no problem.Advised to continue as now on prednisolone.I also take other drugs for various conditions.Everone is different and has a unique biological/medical history so working with your gp is the way to go.All drug info leaflets list every possible issue [for legal reasons rather than patient info I suspect!],

Mimma profile image
Mimma in reply to anutycrixp

Yes, I agree - not the same reaction for everyone. Trial and error I guess

York54 profile image
York54

I took lanzoperazole for a few years before PMR as I have acid reflux. Still taking now 15 mg. have tried ranitidine, but it doesn't touch me, so Im continuing with lanzoperazole. I take it an hour before breakfast then I have my pred.

in reply to York54

I did the transition. Lanzaprozole and other ppi's require a slow taper otherwise you can get a major case of rebound acid reflux. I made the mistake of stopping it after 15yrs and using zantac. Never had such bad reflux. Then I tried a slow taper swapping a lanzaprozole for a zantac starting at 1 day a week. Then 2, the 3 etc. If I got reflux i stopped. Changed back to.previous split then tried again. Zantac/Ranitidine which I thought wouldnt work, works great now and I take as required. The main thing to do for reflux is to ensure the head of your bed is propped up. I have had a couple of old books propping it up.

YuliK profile image
YuliK

rxlist.com/consumer_omepraz...

👆

This article may give a few answers regarding side effects.

YuliK. Age 76

Mimma profile image
Mimma in reply to YuliK

Thank you it’s really interesting. I’m going to try the gastro resistant variety for a month without Omniprazole and see if there is a difference

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