Long term Prednisone and stomach ulcers

[Alebeau]

My druggist just told me I should be asking for acid protection medication to prevent stomach ulcers.

Comments welcome on this topic.

[PMRpro Ambassador]

I haven't taken any in 14 years! Lots of others haven't either. Take the pred with food and yoghurt helps.

[Alebeau in reply to PMRpro]

ThanksThat's reassuring.

I always eat something but will introduce some yogurt.

[piglette]

The assistant at the pharmacy said the same to me. In fact I was taking a coated version of the steroids. I think he may have been trying to impress me.

[Alebeau in reply to piglette]

ThanksI appreciate your input.

Will ignore his advice and do as PMRPRO suggested which is eating with the prednisone and taking a bit of yogurt.

[piglette in reply to Alebeau]

I have a bit of hard cheese!

[Hidden]

I take a PPI every morning with my pred (Lanzoprazole 15mg) although I'm not 100% convinced that I actually need it. ..🤔 I started off taking it every day back at the beginning of my PMR journey, and then decided (arbitralily) that it would be ok to take every second day, then after about 6 months I stopped taking it altogether.

Everyone is different however, and everyone's body will respond to medication in different ways, and when I was in dermatology getting a BCC removed from my leg last summer, I had stopped taking the PPI and told the surgeon when he asked about my meds, the result of that being that he scolded me and told me to get back on it unless I wanted a stomach ulcer. So I went back on it and I'm still taking it for the moment. I still can't make up my mind if I actually need it or not though.... There seems to be a lot of contrary discussion about the necessity of it..

[Bcol in reply to Hidden]

I take Omeprazole everyday, and looking at your post, just a thought, but I think you are supposed to leave at least 30 mins between taking the PPI and then anything else.

[Daffodilia]

I was given pantoprazole after about a year

[Kendrew]

Hi Alebeau,

I've reported on several occasions that I was advised to take Omeprazole when first prescribed prednisolone....as a precautionary measure!

I refused though, because I don't take any medication unless I have evidence to support it's requirement.

Four years down the line, I still haven't needed it, but I do have alternative measures in place to help protect my stomach & gut.

Should my situation change, I will obviously reconsider taking a PPI.

I feel this was the right decision for me, but you will have to make your own decision based on your own set of circumstances.

[Bcol]

Will be very mixed opinions here, I take it and have done for many years with no apparent side effects. I also take my Pred in the early morning with Yogurt.

[Missus835]

I've been taking Rabeprazole for a few years now for GERD. That was 1x per day. When they upped my Prednisone to 60 mg. due to a GCA scare in January this year and also the fact that I was having esophageal spasms, the ppi was upped to 2X per day. It has helped immensely with the spasms. Not saying you should need a ppi, but it works for me. I've been on Prednisone since Jan. 2022 for PMR. I do take it with food.

[Blossom20]

My Gp (or wanted me to take more meds with my pred, but I declined after reading about them. From what I remember Omeprazole blocks the absorption of magnesium (?) and contributes to osteoporosis amongst other things.

I did take it for a while because I did get heartburn despite eating porridge and yoghurt with my pred. Now I take gastro resistant Pred and no Omeprazole (but still get odd pains around my liver/gall bladder although I still take the meds with food)

[Alebeau in reply to Blossom20]

Thanks to you and all others who responded.

I do get heartburn occasionally but I attribute it to some types of food.

I too took some medication at the start of PMR but was advised to stop after a short time.

I never heard of the gastro resistant prednisone so I will try to remember to mention that next time I see the rheumatologist.

[PMRpro Ambassador in reply to Alebeau]

You are in Canada - doesn't exist there, a very UK "thing", PMRCanada uses gastro-resistent gelatine capsules to put her pred in.

[Alebeau in reply to PMRpro]

Thanks

[Karenjaninaz in reply to Alebeau]

I took acid reducers while in high doses of pred, Pepcid. I still had stomach pains despite food. Lowered the Pepcid dose when on lower pred doses.

[Grammy80]

Having had a history of stomach ulcers and one stomach bleed due to an overzealous orthopedic surgeon who had me on mega doses of Ibuprofen after surgery. I've taken sucralfate (Carafate) twice daily since taking pred. After three years, I have never had any stomach issues. Usually, our body is our best guide. If you have no history of stomach or digestive issues, yogurt with your pred will probably do the trick!💞

[KASHMIRI1]

I have taken Omeprazole every day for three years as advised by my excellent rheumy.