Is there necessarily any necessity for Omeprazole?

[Donaloge]

Hello,

I switched from Lansoprazole to Omeprazole because the Lansoprazole was causing diarrhoea. Now I have stopped taking the Omeprazole because that too became a bit disruptive of my bowel movements, though in a different way.

The absence of the Omeprazole seems to have had no adverse effect. I wonder therefore whether any harm would be done if I continued to take neither of these medicines.

I'd be grateful for any comments on this.

John

[DorsetLady PMRGCAuk volunteer]

Many have similar issues with PPIs -so long as you take Pred with food -or good helping of yogurt you may not need one. Unless you have other health issues which make a PPI necessary -but you do need to discuss with GP

[Donaloge in reply to DorsetLady]

Thank you.

[PMRpro Ambassador]

I've never taken a PPI on a regular basis - my rheumy only insists on it if I am on a course of NSAIDs as well for a specific problem that the pred isn't sorting.

As long as stopping the PPI suddenly isn't causing rebound acid production you may be absolutely fine but another alternative is an H2 antagonist such as cimetidine or famotidine (used to be ranitidine but it was withdrawn because of a manufacturing problem). They are a different mechanism to stop acid production so different side effects.

[Donaloge in reply to PMRpro]

Thank you.

[Karendeena in reply to PMRpro]

Famotidine works fine for me

[piglette]

Why did you start taking Omeorazole in the first place? Was it because you were being prescribed steroids or for something else? I take the enteric coated version so do not need a PPI. Yogurt often works even if you are taking the uncoated ones.

[Donaloge in reply to piglette]

Thank you. It was prescribed because I am taking steroids.

John

[piglette in reply to Donaloge]

So it is quite possible you do not need them. Are your steroids the white ones or are they coloured for different doses?

[Donaloge in reply to piglette]

They are all white.

[piglette in reply to Donaloge]

I suppose the only way to find out if you need the PPI is to try it. You will need to taper the dose though unfortunately.

[Donaloge in reply to piglette]

Thank you.

[HeronNS]

Some doctors prescribe a 'prazole along with pred as the norm. Just like prescribing a bone med. I've never taken either. Have always had my uncoated pred with breakfast, or if in a middle of the night dosage pattern with plain yoghurt.

Ironically, PPIs taken longterm can contribute to the bone thinning which docs are so terrified of pred causing. 🤔🙄

[Donaloge in reply to HeronNS]

Thank you.

[Stills]

note my diagnosis is Stills Disease which for me manifests as rheumatoid Disease. I was diagnosed in 1979 aged 17 now 61 but off meds within 5 years. Steroids were prescribed but nothing for bones (maybe they didn’t know then) and as a result I’m osteoporotic.

Fast forward to now and I’m taking omeprazole for an as yet undiagnosed condition of gastric/cancer origin. There is just a locum GP giving telephone only appointments and he completely dismissed my chronic AI condition and worry about bones or any possible connection with Stills and this new episode. Gastroscopy clear, colonoscopy pending and in the meantime I’m still losing weight for no reason and as a separate issue have developed new pain in my upper arms and thighs.

Anyway the omeprazole has given me a extra constant headache, fatigue, abdominal cramps, strange orange firm stools and increased the need to go....... I’m therefore reducing by half to stave off any rebound effects.

This maybe of no use to you at all and I wish you well.

[Donaloge in reply to Stills]

Thank you for your comments. I’m really sorry to hear about the problems you are having.

John

[Nextoneplease in reply to Stills]

Really sorry to hear this Stills 😟 Sounds like you could do with better medical support. I do hope you get a diagnosis soon and that all is well 🤗 xx

[Stills in reply to Nextoneplease]

thank you for your message. My Mum thinks its all stress following the deaths of my Dad and step Dad who both died on the same day! Then my ex husband died shortly afterwards so three funerals, two grieving widows and two grieving sons to deal with. It’s Mum who causes all the stress!

As an aside, my daughter in law has been unwell for some time with suspected brain tumour or MS, diagnosis seems difficult. Last year after my son was distressed about his wife I ‘wished’ I was ill instead of her and now I am. So I’m hoping I’ve made a deal with the powers that be. Silly thought but when times are tough we do strange things.

[Nextoneplease in reply to Stills]

Oh Stills, what tough times 😟 There may be something in what your mum says, you never know…..🤷‍♀️

Like you, I have had underlying chronic conditions for much of my life. I developed PMR symptoms (undiagnosed) when distressed early in the first lockdown, and they got worse, and were eventually diagnosed as PMR and GCA in March of the 2021 lockdown. None of my family have seen me at anything like my worst. The closest they came was when garden visits were allowed (late April 2021?) and my daughter (a nurse), as soon as she saw me, said “Oh god, mum, sit down before you fall down!”. And I’d thought I was putting on a pretty good show 😵‍💫😂

And as to your pact with the powers that be, who knows? I just hope you’re both diagnosed and better soon.

Hugs xx

[Iamfedup]

Given automatically with Steroids, but I stopped taking them when I got down to 5mg

[Donaloge in reply to Iamfedup]

Thank you. That’s helpful.

[Exflex in reply to Iamfedup]

Interesting.

I’m tapering from 1.25 to 1mg and still taking omeprazole. Maybe I should wean off omeprazole as it’s 3 1/2 years and as reported above by @HeronNS omeprazole can contribute to bone thinning.

How would I go about weaning off, I’ve heard sudden stopping can cause rebound?

[PMRpro Ambassador in reply to Exflex]

Usually it is suggested you halve the dose first - what dose are you on? The OTC doses are usually lower. After a week or two you can start missing days of the dose - much like tapering pred and using no PPI as the new dose.

[Exflex in reply to PMRpro]

Thank you. I’m on 20mg in capsule form. Perhaps I should ask for a lower dose, say 10mg, then 5mg, or in tablet form so that I can split.

[PMRpro Ambassador in reply to Exflex]

I think 10mg is the lowest available and it is sometimes possible to open the capsule and remove some of the contents to lower the dose or to mix with yoghurt/apple sauce to make them easier to take - though you should ask the doctor about it really and it doesn't apply for medications that are time released.

[Exflex in reply to PMRpro]

Thank you again, I do value your input.

[Iamfedup in reply to Exflex]

We are at the same stage I am on one and a quarter after three and a half years. I tapered my PPI by dropping a couple a week then dropping three the next week, then four etc etc. No problems to report

[Donaloge in reply to Iamfedup]

Thank you. That’s helpful.

[ImC_]

One of the doctors at my GP practice once prescribed Omeprazole alongside another medicine (not Pred) without even telling me during the consultation, and as a matter of course. It didn't agree with me at all, and I'm not generally sensitive, have a strong stomach.

But for Pred my regular doctor said it as fine to just take with food. I take Pred very early morning with a couple of spoons of thick plain yoghurt or, if I've run out of that, a couple of big bites of banana. Been doing since August 2020, not experienced any issues.

I've had to take various powerful meds in the course of my life, and been grateful for them, but not keen of taking anything unnecessarily.

[Orange_2022]

My GP prescribed with my Pred (as per the rheumatologist's letter) but after taking them for a month or so I read the leaflet properly (!) and saw the potential side effects including the bone thinning. I stopped taking them as I always take the Pred after breakfast which usually includes Greek yoghurt.

There must be some people who need them but I think many of us don't?

[Donaloge in reply to Orange_2022]

Thank you.

[Karendeena]

Hi John, I had the same problems as you. GI issues with all the PPIs that ended in 'ole'. My GP says I need stomach protection and even more important as I am on an anticoagulant for afib and cannot risk a bleed or stomach ulcers. I have been switched to Famotidine which works in a different way and I have no problems now

[Donaloge in reply to Karendeena]

Thank you.

[Alchemy8]

Thank you all for this interesting discussion. I ended up in A&E last night for the 3rd time in about three years (5 hours - got home at 2am!) with suspected heart problems. And for the third time deemed absolutely normal. I had bloods taken, 3 ECGs and two chest X-Rrays, Yet again though no-one said it this time I think it was a gastric issue, that was exacerbated by over three hours weeding on the allotment and some stresses and worries during the week plus a new (and strenuous yoga class the night before. I had a sense of a lump and pressure/constriction at the level of the lower sternum, and a sense of sadness/depression but breathing was fine. I have been urged to take Omeprazole and its relations in the past by doctors and indeed the doctor overseeing my case last night firmly recommended a PPI for steroidal use. They don't agree with me either nor do I like the look of their side effects. I have been taking Slippery Elm bark/Marshmallow root recently but haven't experienced heart burn, just discomfort. I also take Betadine as a mouthwash if I am having any gum infection which I have also noticed recently. I think they are related.

Possibly time for an endoscopy!?

[DorsetLady PMRGCAuk volunteer in reply to Alchemy8]

Think it certainly needs further investigation - if only to stop trips to A&E.

Take care -and maybe ease up a bit on weeding and yoga

[PMRpro Ambassador in reply to Alchemy8]

Try famotidone or cimetidine instead of a PPI - different mechanism, different adverse effects. And less bending ...