Omeprazole/Lansoprazole: Hi, can anyone give me... - PMRGCAuk


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Hi, can anyone give me some advice please? I had been taking 30mg Lansoprazole since January, but it was causing terrible diarrhoea 3 or 4 times a day. This was automatically prescribed along with Predisolone, although I have absolutely no problems with my stomach or indigestion. I spoke with my GP yesterday and he has now prescribed 10mg Omeprazole and after reading the side effects , it kind of defeats the object as it can increase the risk of fractures and Predisolone can increase the risk of Osteoporasis. I am on 5mg Predisolone a day for PMR. I also take 2 x Adcal D3 a day. My question is, is there anything else I can take instead of Omeprazole and do I have to take anything to protect my stomach? I would be grateful for some advice please.

48 Replies

This comes up fairly often. Some do not get on with the -zoles at all, me included. In the end I had to have enteric coated Pred , but you don’t feel you have a problem. Some just take yoghurt or a good meal.

Here is a past post with a similar question.

Yealink in reply to SnazzyD

Thank you so much SnazzyD

omaid in reply to Yealink

well as far as omeprazole is consider it has no side effect of diarrhoea or is ver very rare but if you stop it for a week and see how it can improve your diarrhoea,as it has no harm in stopping for a week.

Yealink in reply to omaid

Thank you for the advice Omaid

PMRproAmbassador in reply to omaid

It causes many people GI tract problems:

"Omeprazole may help your stomach symptoms related to acid, but you could still have serious stomach problems. This medication may increase your risk of severe diarrhea. This diarrhea may be caused by an infection (Clostridium difficile) in your intestines."

Yealink in reply to SnazzyD

My Preds are not coated, should I maybe ask for them?

SnazzyD in reply to Yealink

Windy lose stool was one side effect I had.

You could ask. Coated Pred is more expensive so some GP’s will try to refuse. However, I told mine that uncalled Pred plus Omeprazole was about the same as coated Pred. I bought my own Gaviscon for nighttime use.

It is not a good idea to stop Omperazole suddenly because you can get rebound acidity. Tail it off slowly. I stopped it abruptly to start a different type of stomach protector, an H2 antagonist type eg Famotidine, thinking it would be ok. I had two weeks of boiling lava. I guess because it worked differently, the effects weren’t counteracted in the right way by the new drug.

Yealink in reply to SnazzyD

I’m going to try yoghurt with cereal before taking my Pred. I’m lucky that I’ve never had any gastric problems, until this episode! I have a telephone appointment at the end of March and will ask if I really need to take Omeperazole after the effect Lansoprazole had. Thanks for all your great advice.

My GP refused coated pred even though my bone scan showed osteopenia, so at 5mg I stopped omeprazole and have since taken pred just after breakfast (porridge with blueberries) and never had any gastric issues. I didn’t get rebound acid when I stopped but I know some people do. X

I was prescribed ranitidine although I had no stomach problems but was told that it would act as a preventative. This was in the early days when I just did as I was told. The drug was withdrawn due to suspected ill-effects and I've never taken anything to replace it. I've been fine for over two years 🤞🏼. I take my Pred with porridge or plain yoghurt.

If you have no stomach issues with Pred you may wish to consider whether stomach protection is really necessary.

Yealink in reply to 123-go

Great advice 123-go thank you so much. I reckon it was a check list, Pred, AA (which I refused) and Lansoprazole and of course Adcal D3, which I do take. Like you I did as I was told, but having found this amazing forum, you do learn so much.

123-go in reply to Yealink

See how you go without. 🙂

Why not ask for enteric coated and say it is cheaper to just have the one drug than have two drugs.

Yealink in reply to piglette

I will ask the question, it must be cheaper to have one rather than costing the NHS for two drugs!

I've been on pred for almost 2years now and refused to start taking omeprazole, etc unless I needed to....because of yet more additional side effects they may cause. I have gastro resistant tabs but still take them after I've eaten a good breakfast. So far I've had no issues and pleased I didn't take the omeprazole. I appreciate I may just have been lucky, so wouldn't in any way recommend that everyone else follows that course of action. Just showing that it is possible to manage without them in some circumstances.

Yealink in reply to Kendrew

Do you know what the symptoms are with not taking omeprazole? I know I feel so much better not taking Lansoprazole, I’m not bloated and dashing to the loo has definitely stopped and no gurgling tummy!!

PMRproAmbassador in reply to Yealink

Some people say it feels like a small rodent nibbling at their insides ;) But most people are fine providing they take pred with food.

Others are unlucky enough to struggle even with a PPI - some even need a PPI and enteric coated pred.

Kendrew in reply to Yealink

Like PMRpro probably would be a gnawing kind of of my friends had issues with her tablets and resisted taking PPIs and described it as a burning pain that feels like it's gnawing away inside. She eventually decided to take omeprazole as nothing else she was trying was working for her.

Yealink in reply to Kendrew

I'll watch out for the systems, this morning I have had the thick natural Greek yoghurt and cereal, then the pred. Since stopping Lansoprazole and not even starting Omeprazole all toilet issues have stopped!! 👍

Kendrew in reply to Yealink

I know sometimes meds are given preventatively but if it's a situation where blood tests or other warning signs can alert you first, I'd personally rather not add to the already long list!

Pleased you're feeling better.


I've never taken anything and I've been fine for 11 years. You are on a low dose and if you take the pred with food you should be fine. Lots of people use plain, non-flavoured yoghurt.

It is so strnge that the GP automatically hand out medications that are associated with poor bone density when they make such a fuss about pred! And PPIs are reckoned to do nothing for a third of patients and cause intolerable adverse effects for another third! I suppose 1 out of 3 isn't bad ...

An alternative is famotidine - an H2-antgonist - does the same, different mechanism. But it wasn't marketed quite as well as the PPIs!

Yealink in reply to PMRpro

I wasn’t asked any questions about anything, just handed a huge bag with all the meds!

123-go in reply to PMRpro


PMRproAmbassador in reply to 123-go

H2 antagonists are old fashioned - and the new PPI was SOOOOOOO much better they claimed. They are a bit better - not that much though.

As for handing over medications without asking questions - makes my hair stand on end. Older patients and polypharmacy - there's a recipe for disaster ...

123-go in reply to PMRpro

Makes your hair stand on end!

Ibeen taking omprezole 20mg in morning for about a year now and peptac up to 4x a day when needed but last few day my gp put me up to 20mg at night as well. Before omprezole I was taking randadine I think that is was called twice daily and didnt get on with that diarrhoea sickness stomoch cramps

I probably mentioned on the other thread that I gave up Omeprazole for similar reasons. I managed very well with thick Greek natural yoghurt, then I moved to gastric resistant Prednisalone and have had no issues with this. Some people gently rinse off the red dye on the 5 mgs tablets due to sensitivity.

I ended up having gastritis after 3.5 years on pred with no PPI though the pred may not have been the only factor. I would go for enteric coated pred if possible. Otherwise make sure you take the pred with yogurt.

Been taking omeprozola for 10 years 20mg each day and had caused no side effects, last bone scan showed no effect, only effect was a met due to prostate cancer.

I changed omeprazole for pantoprazole - seems ok


I had diarrhoea with Omeprazole which carried on for weeks. My GP said it was famous for that side effect. Changed to Lanzoprazole. No problems now.

Sorry to confuse the matter for you!

Like many, I was prescribed a PPI with 15mg Pred but stopped taking it after a few days and felt no different to when I was taking it. Reduced the pred down to zero after 2 ½ years with no further PPI and no obvious stomach problems. I always took Pred in the morning with a bowl of cereal and whole milk.

Seems very strange to dish out the Lansoprazole when you’re not even having issues!! Also, what a silly dose!! I’ve been on it for years @15mg, pre PMR, and had to double dose to 30mg because of issues with the Pred. Why on earth they’d start someone on 30mg just makes no sense and would have me checking all other medication decisions from that doctor!!

Yealink in reply to Loopy65

Made no sense to me either, but I wasn't asked any questions and just did as I was told, until I found this fab forum! And I've had so much advice and lots of tips how to manage PMR

I suffer from gastritis and diverticulosis and practically anything can start it off even though I take probiotics. Being on prednisolone has made the situation worse. However, about a week ago I started taking sips of goat's kefir three times a day (breakfast, lunch and before I go to bed) along with my probiotic, and my digestive system has really improved. Might be worth a try.

Yes I have exactly the same side effects from any of the 'azoles' , always starts within about a week of taking ! I used to take Ranitidine but of course that's off the list now so far not found any alternatives!

My doc said the problem with taking PPIs is that it leaves you vulnerable to any stomach bugs ! For me personally I try to take a good probiotic and a prebiotic to up the good gut flora, Manuka honey too and take the PPIs in shorter courses, it's a bit of a juggling act ! Good luck

From my experience I've been taking omeprazole a lot longer than pred. I have been taking 20 mg of omeprazole for over 18 years and 7mg pred for15 years. I have all the test yearly and as yet I dont suffer any side effects, no fractures, no Osteoporasis. I'm 71 and quite active. To be honest without omeprazole and pred, I would be in a bit of a mess!!!

Hope this helps

Hi there! I have been taking Prednisolone for PMR since June 2020. Initially I took the prescribed Omeprazole as I required 22mgs of Pred daily to get on top of the inflammation.

Once down to 15mgs of Pred I stopped the Omeprazole as I too found it gave me diarrhoea and it doesn't help with calcium absorption and therefore can worsen the risk of Osteoporosis.

I take my Pred between 2 and 4 in the morning as this regime has definitely helped catch the inflammation as it kicks off. I take yogurt in a cool bag to help line my stomach and also drink a glass of water beforehand to reduce the acidity in my stomach.

It may not work for everyone and some have more sensitive stomach linings so you still need to be aware and watch out for signs the pred is causing problems.

Any upper abdominal pain should be taken as a warning and although unpleasant watch your bowel actions are normal in colour.........dark or black poo is a really bad sign and could mean there is blood present .

A friend of mine recently took some Anadin which helped her pain until I asked her to check what was in it.............Aspirin apparently which is very gastro unfriendly and a recipe for disaster if taken with a steroid so watch out for medications that may make things worse.

Talk to your GP and let him know if you are going to stop taking Omeprazole and I am sure he will be very glad provided you watch out for any problems.

Yealink in reply to larkthebark

Thank you very much for the tips, I'll watch out for any symptoms. I have had great advice from people here and no advice from my GP at all - you're all marvellous, thanks again, and we're all in the same boat!

Hi Yealink,iam suppose to take Lansoprazole but dont bother as I dont and never had problems with stomach. Sometimes if iam very windy I take it for a week but then I stop,hate taking them if not needed. Take Care

Yealink in reply to Harrywogan

Thank you, I think if something isn’t broken then don’t fix it! You too take care

It is my wife who has GCA but as I have been on 30 mg Lansoprazole for twenty years + with no ill effects for a different condition, I thought I would mention it. I'm now 74. A lot of people take it very safely so I was surprised to hear of your issues. It is of course to control acid in the stomach.

I too keep a dollop of thick natural yoghurt in a tub in a cool bag by my bed, eat it at 6am with my Pred then go back to sleep.

It works for me, but I do have an iron stomach.

I am on Prednisolone.

I had been taking 15mg Lanzaprazole a day as a preventative, and I never got what I would have considered stomach problems.

However I developed problems with swallowing, and after a load of tests, MRI etc I was told it was reflux, and I was put on 30mg Lanzaprazole a day, which sorted the swallowing problems, and I went back to 15mg a day.

However some months down the line, I developed an intermittent hoarse voice and sore throat, which my GP thinks is also probably reflux again. She has put me on 60mg a day!!!!! 30mg before breakfast, and 30mg before my evening meal.

I have got to stay on this for a few months, and if my symptoms don't improve I will have to have further investigations.

Oh happy days 😂

Meantime, I am stuck on 4mg Prednisolone with intermittent aches and pains, presently right arm plus neck. Trying to ride with it as I don't want to increase the dose again 😪

ETA: I have also been prescribed Gaviscon, to take after meals and at bedtime.

PMRproAmbassador in reply to Thezillionthsue

Hasn't occured to them to 1) try an H2 antagonist like famotidine 2) give you enteric coated pred?

PPIs can stop working. And I'm darned if I'd take that sort of dose without her being SURE what it is.

Yealink in reply to PMRpro

The GP, not the original GP who prescribed all the meds along with the diagnosis of PMR, changed the medication from Lansaprazole 30mg to Omeprazole, said it was a very high dose, but owing to me taking Pred, he said they were needed. To be honest I really didn’t have a clue as to what this medication was only that she said we had to protect my stomach!

PMRproAmbassador in reply to Yealink

Well I've been on pred for over 11 years and in that time have taken about 8 tablets! That was purely because I was having a week of infusions of high dose NSAIDs, nothing to do with the pred itself, just that taking them together is risky. I get the occasional twinge if I have eaten the wrong thing/way but pred hasn't caused any problem I can identify. And I am not alone.

Yealink in reply to PMRpro

I was just pleased that the fourth GP knew the symptoms I had was PMR and took anything she gave me to alleviate the pain!

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