PPI's: Those of us on 40 mg and higher, or even... - PMRGCAuk

PMRGCAuk
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PPI's

Staplehurst
Staplehurst

Those of us on 40 mg and higher, or even lower Pred. What mg are you taking for the Proton Pump Inhibitors (PPI's) I take 20 mg of Omeprozale by once a day. Wondering if I should take (one am) and (one pm)

37 Replies
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Poopadoopy
PoopadoopyModerator

The best thing really is to ask for coated pred and then you don't have to take a ppi for it. 😊

I ask pharmacist this question when last at the private hospital...he said un-coated were best to take. I think being on steroids whether coated or not will could still potentially upset our stomach's.

I've just Googled it and it says un-coated absorbs better than coated

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

Better probably means it last longer and us a little more available. I would always choose an extra mg of pred to 40 or 80mg of ppi. But i was on ppi for almost 18 yrs as it was standard prescription for diabetes. I suspect only my excess weight stopped potential bone thinning.

I take both coated and uncoated.. 5mg coated on a night so it starts to work for morning and 2.5mg uncoated in the morning.

Of course you are on higher dose so might want to just keep tapering if you are happy and 🤞 it's not GCA.

Wish I knew if it was or wasn't....no way of knowing now. Hope second blood test is back in the morning to enable me to tell rheumy when he calls me at 11 am Will be interesting to see what he tells me when to start tapering. I told him that I'd joined the Forum, he was impressed. However, I can't say to him that I'm taking advice from members and not him, but I will ha ha !!

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

We have all been there. 😂🤣😂

Of course

Just checked out prices of coated and un-coated Pred...so cheap ! I had to pay £10.30 for a box of 28 tabs.

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

Did you have to get private prescription? Yes they cost pennies

Yeah, I had to as been seeing Rheumy privately since last Dec. Now I get my GP to prescribe. They're very cheap that's why nothing has been made that's better for us all...can't think of the word instead of made...what is it ??

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

Yes. I know what you mean. Pennies Vs pounds, hence little or no action.

PMRpro
PMRproModerator
in reply to Staplehurst

It was based on a study done in patients with a GI condition, Crohns I think, where it would almost certainly affect how it was absorbed lower down the GU tract. It doesn't really matter how much is absorbed for us as we are titrating the dose to find the ideal dose for us personally. People absorb anything between 50 and 90% of the oral dose anyway so titration in something like PMR/GCA is essential to make sure that each patient has the correct dose.

Do you feel you actually need it? I certainly wouldn’t just in case because of the potential side effects which includes bone thinning. As Poopa’ says, try asking for coated Pred. That’s what I did because PPI’s made me feel peculiar and caused intestinal upset. When the doc said it was more expensive I pointed out that the lack of PPI prescription meant it wasn’t and occasional bit of nightly Gaviscon I needed I bought myself.

bnf.nice.org.uk/drug/omepra...

Staplehurst
Staplehurst
in reply to SnazzyD

Hard to know what to do then. I was told to take them but X 2 daily...I've only been taking one. Every drug we take has to go through our livers, so possible liver damage too over time. Even BP med cause some people side affects that are not nice. Still trying to decide whether to take the Alendronic Acid.....do wish I'd been able to have the Dexa scan...blasted Virus !!

SnazzyD
SnazzyD
in reply to Staplehurst

Is the one effective?

Staplehurst
Staplehurst
in reply to SnazzyD

No idea, never suffered from Reflux so never needed to take them. It was rheumy that told me to as steroids can give us ulcers. They can only go by other patients after taking steroids of they experience problems.

SnazzyD
SnazzyD
in reply to Staplehurst

Some people on this forum find taking them with food or some yoghurt is all they need. I found Pred like boiling lava so had to go to enteric coated. There is another type of med called am H2 blocker which is a bit more benign. It went out of fashion when the PPI wonder kid came on the scene.

Staplehurst
Staplehurst
in reply to SnazzyD

My friend has studied all these drugs and PPI's are dreadful things to have to take. Not sure what to do now. One thing I have found is after taking my Calcium/D3 my voice goes funny, people have commented I sound croaky

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

I hate to tell you GCA can effect the voice. A few people have lost their singing voices too. You could try yoghurt what size pred they? 10, 20 etc??

40 mg...only seems after taking the Calcium though. I'll google that too I think...things we can learn on here. If we're taking different drugs, eg Alendronic, Calcium, Steroids and Calcium how would we know which one is affecting us. If we told our rheumys and GP's about this we'd get laughed at and told not to read about it them.

Poopadoopy
PoopadoopyModerator
in reply to Staplehurst

I know. Put this drug into you but never look at what it is!

SnazzyD
SnazzyD
in reply to Staplehurst

Croaky voice can be GCA but it can also be due to acid reflux. I had both of these. Calcium made my stomach acid worse too and have me cystitis. I halved the dose and only took it with a substantial meal.

PMRpro
PMRproModerator
in reply to Staplehurst

In the absence of ranitidine after the recall, you could try famotidine, same group of drugs.

Staplehurst
Staplehurst
in reply to PMRpro

Aren't they all much of a much ness...all the same ingredient ??

PMRpro
PMRproModerator
in reply to Staplehurst

No. They would have the same name if they were the same ingredient. They differ in the same way ibuprofen is different from aspirin.

Ranitidine is available again.

PMRpro
PMRproModerator
in reply to Highlandtiger

I think it was available in some places all the time - depended on who the supplier was.

I had lots of side effects while taking a PPI. They caused more stomach problems than the Prednisone. I switched to Pepcid AC and it made all the difference in the world. Usually just need twenty mgs at noon but take another 20mg at night if needed. It’s expensive just like PPIs but my Doctor writes a prescription for the generic famotidine and it’s much cheaper. It’s helped so much I can go days without taking it.

Are you in the US ?

Yes. On Cape Cod, MA.

Thought so. I have family in the US

I just asked the DR and I am taking 15mg pred for a flare up and PPI Lanzoprosol 30mg She said take one more Lanzoprosol for a week as I am having an acid stomach too. Never have had before but I been very busy and stressed. Taking advantage now of lockdown and doing nothing for two weeks.

I have been taking Omeprazole 20mg since last April. I took famotidine for 2 years before that, but it stopped working. Coated prednisone is not available in the US, for reasons I can’t understand. I hate being on omeprazole, as it affects my lower GI tract. I have developed diverticulitis (3 episodes since May) since I started it. If I had the choice I would be taking coated tablets.

Staplehurst
Staplehurst
in reply to Ciar

I was told by private hospital pharmacist that the un-coated Pred absorb better then the coated ones. I just think they want us to take them just to protect our stomachs, like Alendronic Acid to protect our bones.....whether we end up taking any of these drugs is entirely up to us I guess. Still contemplating whether to take the Alendronic, really don't want to. To be told by my rheumy that if I had a fracture it could kill me does cause for concern.

Everyone has to decide what works best for themselves. For me, I would do whatever I could to avoid omeprazole, but I can’t. I don’t have any bone thinning (I’ve had the test) so I don’t need AA, thankfully. Fortunately I only have PMR, but I can’t get my prednisone dose down enough to avoid side effects. All these drugs have risks and benefits, and everyone is different, so it’s definitely individual.

Absolutely Ciar. I've now decided to take one 20 mg of Omeprazole every other day. Still undecided about the Alendronic Acid and will make up my mind on Monday morning. Hate the word Acid attached to this drug, that puts me off.

PMRpro
PMRproModerator
in reply to Staplehurst

Does it make it feel different if it is called alendronate? The acid is a chemical designation - vit C is ascorbic acid, you still happily take that.

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