Your responses to my first question were so helpful and now I have one more to ask! Last week, I had the second appointment with a dr in the rheumatology department and he prescribed Omeprazole to be taken once a day to line my stomach. Apparently, I would be at risk of stomach ulcers and stomach bleeds otherwise. I am currently on 10mg pred a day (down from 15 in the first two weeks). I have slight niggles on this dose around the hips but nothing that interferes with my life. I am supposed to be going down to 9mg next week for a month, then tapering down by 1mg a month but can obviously review this with my GP. She is also prescribing Vitamin D and Calcium for me.
My question is this: do I really need to take Omeprazole as I have had no stomach problems so far and I hate the idea of taking more pills to counter the effect of another. The leaflet inside reads like a horror story of side effects! Would it be possible to take a couple of spoonfuls of natural, live yoghurt instead?
Thank you for any advice you can give.
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Uke1
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I came to the same conclusion as you and always took my Pred with natural, organic, Greek style, yoghurt. I seemed to experience fewer symptoms than when I originally took the Omeprazole. That is not to say damage has not been done. I do, 4 years on, experience digestive, sensitivities. I am currently taking Entric Coated Prednisalone that seems to be best of all, so far.
Bizarre to find those side effects in a medication designed to protect the stomach.
Firstly, we’re all different including response to Pred but bear in mind that gastric problems can be insidious especially reflux into the oesophagus which can cause serious problems if it becomes chronic. Pred is a known irritant but some are fine taking it with just yoghurt to line the stomach, some a decent decent meal and some need medication. Omperazole (Proton pump inhibitors type) don't “line the stomach” as such, they stop the production of acid and give a consistent less acidic stomach contents. Not everyone gets on with it, I didn’t, and they might go for an antihistamine type like Famotidine. Stomach liners such as Gaviscon are enough for some. In the end I had to go for enteric coated Pred plus Gaviscon at night but I was on high doses of Pred and by 3mg and below I was able to use uncoated Pred.
I had GCA and never took a stomach protection. Another patient told me. Yoghurt, probiotic, with a teaspoonful of Manuka Hone (UMF and highest you can afford) every morning first, before I ate my breakfast and never had a problem.
If you do need a stomach protection. skip Omna and look at the other ones.
I have never taken omeprazole in 11 years on pred. I was on enteric coated for a while so didn't need it then but most of the time have been on tablets that release in the stomach. No problems I've noticed.
OTOH, my husband was given a PPI while in hospital and it was absolutely disastrous! Took weeks to get over too.
Be careful with Omniprazole!!! I have A cute Kidney Injury Stage 3 caused by Omniprazole. My kidney function was not monitored I had a rare reaction and now have a kidney function of 30 instead of 70-90. Have g tapered off steroids after 1 year (PMR) I am back on massive doses. So ask and insist on a kidney function test to monitor what's happening. I have inflammation of the tubes and needed a biopsy to confirm, been in hospital twice not ideal with co I'd. Currently shielding a d really fed up.
Omeprazole dos seem to get a very bad press on this forum and it undoubtedly does cause some problems for some people. We are all different and there are other PPI's to try if Omeprazole doesn't suit. However, I have taken it daily for 18 months now, while tapering Pred from 15mg to 4 mg, and have not had a single bad reaction. My OH recently had it added to his prescriptions because he is now on a blood thinner and a heart med, and he also has had no adverse reaction. We are both in our 70's and neither has had any past history of acid indigestion, stomach ulcers, stomach bleeds or reflux problems, but we still feel that the Omeprazole is a wise precaution so long as it does not cause side-effects. I plan to taper off it once I have finally tapered off the Pred - if you do start taking it, it is wise not to stop suddenly as you can get a rebound effect of excess stomach acid.
Hi Uke1, I started taking Omeprazole as soon as I started steroids and then stopped after a couple of weeks as my rheumatologist told me that he no longer prescribes it routinely and my GP confirmed that I can stop and start again if I needed to.
Because I was on it for a short time initially I was able to stop overnight without any problems. When I started experiencing acid reflux in the mid-morning and gastric pain at night (just over 4 months later), I started taking it again. I am not sure why we are not all given coated prednisolone (is it less effective?) which would be better than being on additional medication. In any case, I can report no side effects so far (I have been on it for the last 2 months), but I will ask about the coated Pred at my next appointment.
They think coated is more expensive and there was a study that claimed it was no better and possibly less effective. But the study was done in patients with GI disorders - who would tend to absorb it less effectively. At the time the edict was issued not to use it there WAS a big price difference - but shortly after the suppliers increased the price of plain pred and once you add in the cost of stomach protect the difference is pence. Which isn't much to pay for removing a layer of potential adverse effects - many of which you won't notice day to day but it is as bad at leading to osteoporosis as pred ...
Had bad side effects on Omeprazole , also causes bone loss, and stops one absorbing properly. I saw a Medical Herbalist and that was the first thing she suggested I stopped so now take Slippery Elm. Taken that now for well over a year and no issues.
So pleased you raised this issue Uke1. I was about to ask the same question. I’ve been on Pred since December 2019. The GP also prescribed Omeprazole but, having looked at the list of possible side effects - and, like you, my reluctance to take yet another drug (Pred plus anticoagulant for AFib and now Alendronic Acid for osteoporosis!) - I decided not to take it. I have a big breakfast of fruit followed by a large bowl of yogurt before I take the Pred. I’m hoping this will be enough to protect the lining of my stomach. I also try to eat foods that are more alkalising and cut down on foods that are acidifying- easier said than done!
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