Omeprazole as we taper pred....?

[Temoral]

I started on 40mg pred 2 years ago for GCA.Now on the DSNS taper and have currently reached 3.75 going to 3.5.

Can I now start to reduce omeprazole, or replace it with taking pred with say, yogurt and a banana instead....? Thanks in advance for your thoughts and advice.

[Shandylowe]

I always make sure I eat before taking pred and have not taken omeprazole and I’ve had no issues in the last 4 years.

[Temoral in reply to Shandylowe]

That sounds good to me! When I was first diagnosed, i just did as I was told, but have since read up on this and AA. I will mention this to my GP next week. Thank you.

[Meggsy in reply to Temoral]

I have only had a banana with pred for 51/2 years.

[Temoral in reply to Meggsy]

Great system that obviously has worked well for you. Thanks.

[PMRpro Ambassador]

I have never taken omeprazole unless on a course of NSAIDs from my rheumy. The only thing that has ever upset me is taking medication as capsules - and forgetting to take lots of water and sit up after the early morning dose!

But don't forget you need to taper the omeprazole a bit like pred. First half the dose for a week or two, half again if your starting dose is quite high. Then miss odd days until the zero days join up!

[Temoral in reply to PMRpro]

Thanks...that sounds like a plan. I knew the omeprazole had to be tapered, but wasn't sure how.

[piglette]

I have always had the coated tablets so just took them with a piece of hard cheese. Are you taking the coated variety?

[Temoral in reply to piglette]

No, the uncoated ones.

[piglette in reply to Temoral]

oh well you will need to taper like PMRPro says.

[SnazzyD]

Give it a try but do taper slowly and if you do get some rebound acid, slower still. However, it is more difficult to refine the taper so you might need a bit of Gaviscon or something to help. Perhaps avoid acid neutralising basic carbonate antacids as you can more easily over do the alkalinity and you get rebound acid again without the protective reflux preventing layer. Bear in mind if you are taking Adcal, that has calcium carbonate already. I found I needed a bit of gaviscon or similar alginate formulation at bedtime.

[Temoral in reply to SnazzyD]

I only take vit D, as my calcium level from diet is good. Thanks for the information.

[Janstr]

A gp I went to at one point, said to take a daily pro biotic instead of omeprazole. She also said that bitter foods such as rocket are good. I’ve also just started having a small amount of kombucha each day

[Temoral in reply to Janstr]

I take a prebiotic, so perhaps that will suffice instead anyway. Have heard about kombucja too...thank you.

[Broseley]

I've been told I have to take omeprazole until I'm off pred entirely (now down to 2mg). I recently had a bout of diarrhoea which happened every morning at 3am. (See my recent post) I was exhausted. Imodium helped, but gives me terrible wind and cramps. Having dropped magnesium to no avail, I then looked at the PPI as a cause. I found some old 2.5mg EC pred (still in date)- this was my dose at the time - so I stopped the omeprazole and took the EC pred for approx the 1 week I had left on that dose. I didn't taper, had no gastric problems whatsoever. Wonderful.

Now I'm down to 2mg and the GP says I have to continue with the omeprazole as he can't get 1mg EC pred. (I'm waiting for a calprotectin test result then I have to see him again re the diarrhoea, which hasn't yet returned!)

[PMRpro Ambassador in reply to Broseley]

Try an H2 antagonist such as famotidine or cimetidine.

[Broseley in reply to PMRpro]

Yes I intend to ask about that when I ho back.

[Exflex in reply to PMRpro]

Are H2 antagonist better for bone health (and the brain)?

[PMRpro Ambassador in reply to Exflex]

Possibly, they say they are. But they have fewer side effects and don;t interact with other drugs as much/

[Exflex]

I’ve been on omeprazole 20mg since being prescribed prednisolone at a starting dose of 15mg. Currently taking 0.5mg tapering to 0.25mg. I also take Aspirin 75mg daily for heart plumbing.

At a recent Dr appointment I asked to taper to 10mg omeprazole and was told to ask again when I’m off steroids, but mentioned that 10mg daily might be for life because of Aspirin for life.

[Viveka]

Hi Temoral, you started a few months after me, glad to know things going ok. The tip that worked for me was to actually put the tablet in the yogurt and have a couple of spoons before and after. Never had any problems once I started doing that.

Unless you have other gastric issues I don't see any need for it under 5 (or ever really - some docs prescribe it as a matter of course because they don't know better.)

Rod Hughes prescribes coated until people get to 5 then uncoated.

[Temoral in reply to Viveka]

Hi Viveka...that's interesting...all points I can raise. Thank you.

[Stills]

I’m not on pred but prescribed omeprazole for as yet unknown issue. After 4 months on 40 I spent one month on 20 then one month 20 alternate days, all went well.

Two months later new symptoms of mysterious illness started again so back on 20 daily. I suspect thyroid issues. We plan to visit Thailand in February so hope to be off it by then as I’ve read stomach infections can be caused by it (?) the thought of travellers tummy is worrying me although I’ll be protected by relevant vaccines. Any advice welcome.

[humlies]

I've had only yoghurt with pred. for 3 1/2 years, and I am still Ok as far as I know!