Heartburn

[Allcraft]

Hello!

Back on Prednisolone after a failed taper and accepted it better this time, but heartburn persists GP is aware and monitoring but how does everyone take their meds? I’ve just reduced to 12.5mg ( enteric coated) split into 3 doses through the day also on Lansoprazole x 2 doses, Gaviscon medicine and chewable tablets ( if needed when out) PPI shouldn’t be taken within 2 hrs of other meds etc…. how do I space them? I’ve had gastro issues prior to PMR because of ibuprofen for knee problems ( total knee replacement at 43, the joy of nursing!) but managed to get off PPI and avoided food that caused pain. Reduced carbs and following Slimming World.

[DorsetLady PMRGCAuk volunteer]

Hi,

Well it would be a lot easier if you were taking your Pred in one go, rather than 3 doses….

This link gives advice opinion timings with other meds -

healthunlocked.com/pmrgcauk...

Thus gives advice in best time to take Pred -

healthunlocked.com/pmrgcauk...

…and I’m sure you’ll be advised by PMRpro that taking a PPI as well as enteric coated Pred is not always the best idea….she’ll explain why better than I can.

[SnazzyD in reply to DorsetLady]

Wasn’t it because the low acidity of the stomach contents due to the PPI can break down the enteric coating before it has had a chance to pass through the stomach?

[DorsetLady PMRGCAuk volunteer in reply to SnazzyD]

Something along those lines - but you know who will explain it better than me!

[SnazzyD]

As DL says, one dose might be better, especially with the lag of E/C Pred absorption makes it a slow up and slow down rather than a spike within 2 hours and a relatively quicker drop in blood level.

[PMRpro Ambassador]

You shouldn't really be taking the pred 3x a day - all in one as a single dose in the morning is the recommended timing and that immediately makes it easier. And it also means you get a big hit at the inflammation soon after it started - taking small doses of e/c pred at intervals through the day means you may never get that peak in the blood that is so effective.

Since you have had problems before it isn;t surprising they are using both a PPI and e/c but they shouldn't - Snazzy gave the reason above. But are you sure the PPI is working for you? They can be a bit variable for some patients and for about a third they simply don't work.

[Allcraft in reply to PMRpro]

Thank you, was told three times a day by pharmacist and GPx 2. PPI not working hoping things ease as I taper.

[PMRpro Ambassador in reply to Allcraft]

Why don't they look at guidelines? It isn't difficult!!!

Have you tried an H2 antagonist like famotidine or cimetidine? No point taking a PPI that doesn't do anything,

[Boss302Fan]

Omeprazole 40mg 2x/d. If I wasn’t taking that for acid-reflux disease or still had heartburn I’d dissolve 1/2 tsp of sodium bicarbonate (baking soda) to 8 oz of water and drink it. Always worked, but I didn’t do it more than twice a day.