lansoprazole withdrawal discomfort

[Gettingbetter1]

I’m down to 3.5 mg of pred having tapered down from 40mg 2.5 years ago with the usual ups and downs. Visited Rheumy a few weeks ago who said it was ok to come of lansoprazole (30mg per day) which I’d been on since the start. However now suffering discomfort and feeling slightly unwell which seems to get better when I take the capsules again. I’ve tried tapering ( probably to quickly!) without success and tried Gaviscone which also helps. Has anyone else experienced these withdrawal symptoms?

[PMRpro Ambassador]

When stopping a PPI you must taper it over a few weeks at least - withdrawing it can result in a rebound production of acid which is worse than before using it. Either get some H2 antagonist (Pepcid or Tagamet) to use alongside the PPI while tapering - it is easier to taper off the H2 antagonist or reduce the PPI slowly much like pred, first halving the dose for a few weeks and then missing odd doses now and again, always getting lower.

Gaviscon is also useful but the PPI dose must be reduced SLOWLY

[Gettingbetter1 in reply to PMRpro]

thanks PMR pro, I will follow that advice. You’d think the Rheumy would have been able to advise the same…..

[PMRpro Ambassador in reply to Gettingbetter1]

He should - but it isn't his field so may not know. 2-4 weeks is a minimum - I know of some who took even longer.

[Stills in reply to PMRpro]

does this apply after short term use of 4 months at 40mgm per day?

[HeronNS in reply to Stills]

Just read that after 4 weeks one is liable to encounter rebound. At least you don't have to taper as slowly as with pred!

[Stills in reply to HeronNS]

thanks, my plan is 40 mgms per day down to 20 for two weeks then 20 alternate days for two weeks then 10 alternate days for two weeks then as needed unless rebound occurs . I can’t wait to be free of the dreadful headache it gives me.

[musicality in reply to Stills]

Once you get to 10mgs Pred, it's usual for most people to decrease more slowly, i.e. the DSNS system - DEAD SLOW, NEARLY STOP. say by half a mg every 2 or 3 months, to prevent a flare. Everyone is different, find what suits you. Even reducing Pred or stopping it altogether can bring the symptoms back, but often if one waits a few days or so, it can right itself. Good luck for the future!

[Stills in reply to musicality]

sorry I wasn’t clear, I’m weaning from omeprazole not Pred.

[musicality in reply to Stills]

Sorry my mistake.

[PMRpro Ambassador in reply to Stills]

As HeronNS says - depends on the person. Some people are fine however long, others struggle quite soon.

[SnazzyD]

You mean stomach discomfort? The Rheumy should know that you can’t just stop these proton pump inhibitors because rebound increased acidity occurs. You have to tail them off slowly. How slowly depends on the person but I’ve seen 2-4 weeks recommended.

[Gettingbetter1 in reply to SnazzyD]

thanks Snazzy 2-4 weeks will now be what I work to

[Joseph14612 in reply to SnazzyD]

How do you wean from Lansoprazole when it is a capsule with granules?

[Stills in reply to Joseph14612]

I am weaning from omeprazole capsules by opening then and mixing half with warm water to drink. I have checked with the Pharmacist that this is ok. We’re all different in our meds and conditions so do check with your GP and pharmacist.

[Joseph14612 in reply to Stills]

Thank you

[PMRpro Ambassador in reply to Joseph14612]

What dose is it? You start by a lower dose if there is one and then you can use the DSNS approach by using no dose as new dose and current dose as old dose so you have first the odd day without and then very slowly increase the no dose days but getting them closer together.

[Joseph14612 in reply to PMRpro]

30 mg....thank you

[PMRpro Ambassador in reply to Joseph14612]

There is a 15mg dose so you start with using that for a couple of weeks.

[Thirkelly]

Such useful info. Always something to learn here.