Omeprazole what if anything do I do?

[Bcol]

Hi all. I know this has appeared in posts many times, generally with no positive comments for Omeprazole. Background

I have been on Omeprazole on and off with more on than off since the 1990's. At early stage OA in conjunction with Naproxen and Co-Codamol probably for 10/15 years + pretty much continually and then at various times since. Now of course prescribed with my PMR Pred. As far as I can tell it, nor any of the other medication, has ever had any problematic side effects. Not on been on Naproxen for quite a while apart from a very short spell last year.

So my questions/dilemma

Q.1 Do I, should I, talk to Doc about stopping it? I take my Pred with a Banana and Yogurt early in the morning.

Q.2 Given my past history is it too late to worry about it and carry on regardless?

Q.3 If I do carry on if I take with my evening meal will that still be OK for taking care of any problems with the Pred, or do I need to take it later?

[Devoid]

It should be taken first thing , ideally half/1 hour before food

[Rache]

I have been taking Lansoprazole for around 6 years and after reading so many negative comments I have tried to come off it several times without success. It was initially prescribed by my GP when I was losing weight, food tasted bad and I had a dry cough. I was very worried it was something serious but the Lansoprazole completely got rid of my symptoms. A camera down the throat later found I had a sliding hiatus hernia and lax stomach valve. My GP had been on the ball with his diagnosis! This was long before PMR.

I have tried to come off it very gradually, substituting Ranitidine (equivalent now available - Famotidine) and using other things such as Gaviscon, propping bed head, using more pillows - none have worked. I use enteric coated Prednisilone, which should protect the stomach, at my request, but still need the PPI. You may have better luck than I have as everyone’s circumstances are different. I have resigned myself to taking a PPI as I am concerned about damage to my oesophagus leading to Barretts which can cause cancer. For me it is the lesser of two evils, especially while I have to take prednisilone. I envy those for whom a dollop of yoghurt is all they need but they may not have ‘structural’ issues such as mine. You may find you can stop it or change to Famotidine but you need to do it very gradually to avoid severe acid rebound. By the way, I take my PPI 30 min to an hour before my evening meal. All the best!

[Estellemac in reply to Rache]

I take a PPI have done for over 20 years. No side effects I can relate to? I started taking it with Naproxen for OA. I used to have terrible acid when I ate or drank before OA. I got awful burning stomach pain when I had meat or anything like oranges lemons wine beer spirits and processed food. I lived with n eggs porridge and yoghurt. I think that’s why I’m fat now I can eat anything. If I stopped taking it (which I have done to see what might happen) I get burning acid and pains in my stomach just like I did years ago. Same for Alendronic Acid no problems I can think of but I have stronger bones now according to my last Dexa scan and have come off it.

[giraffegal in reply to Rache]

Same scenario here. 20 plus years due to hiatal hernia. Dexa scan improved when I added 10,000 units of D, very low carb food plan.Two years on prednisone and A1C is 5.7 and all labs are good. Best of luck to you.

[SheffieldJane]

I think a lot of people just quietly get on with medication that receives a bad press on here. I don’t think now is the time to wrestle with the issue if it’s not problematic for you and your gut is under more stress. It’s tricky to manage withdrawal without a resurgence of the original symptom. Perhaps it could be a goal when you are almost done with Pred?

[PMRpro Ambassador]

PPIs are usually taken on an empty stomach 30-60 mins before a meal.

If you are going to try to stop you MUST taper the dose - stopping cold turkey can result in rebound production of acid and it can be severe. Rache covers most of the points I think.

Have you had a dexascan to see the state of your bone density?

[Bcol in reply to PMRpro]

I've got a DEXA in a couple of weeks. If I'm honest I don't feel worried about taking them if the Doc thinks I need them, but they get such bad press everywhere I wonder if I should be making the effort to have the conversation about stopping them with her. I understand about the tapering.

[PMRpro Ambassador in reply to Bcol]

If you need them you need them - but if you DON'T need them, why take them? The bad press does tend to be for the new starters because they DO lead to low bone density in some people, although it is rarely mentioned, and they can cause gut problems. Lots of people assume it is the pred but then it turns out to be the PPI. It infuriates me when the doctors start a patient on several medications at the same time. Start with the most essential and add the others one at a time - then you can work out what is what.

[Poshcards]

been on omeprazole for over 15 years now, put it this way, if I don't take it, then I suffer badly with burning reflux xx

[Harrywogan]

Hi Bcol was prescribed Omeprazole when I started on pred but after a year or so on it stopped taking it because I wasn't having any stomach problems,take my pills will a natural yougart and that seem to line the stomach mayb different it you are bothered with heartburn or wind, sometimes I go back to it for a week because it protects your stomach from acid. But dont really need it and haven't renewed prescription and Gp never asked why.