Gastric side effect of PMR medications

[Suobe]

Hello,

I am relatively newly diagnosed with PMR, in July 2023, and just starting my tapering journey. I started on 20mg Prednisolone (now just reached 10mg), plus I take 15mg Lansoprazole and once a week 70mg Alendronic Acid. I started well, feeling great with the loss of my joint pain, but after several weeks I started to get early morning diarrhoea, and this has become my new norm. I have a review with my GP next week, but wondered if this could be down to the Lansoprazole or the AA rather than the Pred.

Anyone else have anything similar and found they could change some medication to avoid?

Thanks

(And ps finding this forum so helpful)

[SnazzyD]

Could be any of those. Pred gave me the morning trots that was worst on higher doses. I know it was that because I was not on anything else other than a bit of Gaviscon, plus the dosage being it’s absolute worst on 40-60mg. It was much better under 10mg. I was on Gaviscon because Omperazole and its relatives made my stomach issues worse and I had felt peculiar on them on other non-Pred occasions.

[PMRpro Ambassador]

Did you start all 3 at the same time?

I'd try missing the AA for a few weeks - your bones won't collapse - and see if that helps. The lansoprazole - PPIs in general - have form for it, If you have gastric problems you could ask the GP to give you an H2-inhibitor (famotidine or cimetidine) for a while instead to see if that helps. Pred - not much you can do about that!

[Suobe in reply to PMRpro]

Started with Pred and PPI, AA not long after once GP confirmed it was PMR.

[PMRpro Ambassador in reply to Suobe]

I do wish they'd do things one at a time so there is a better chance of knowing what is causing what if there are problems.

[Karendeena in reply to PMRpro]

Famotidine worked for me

[LucilleG]

Was a bone density scan done before being put on Alendronic Acid?

[Suobe in reply to LucilleG]

No

[LucilleG in reply to Suobe]

So you might not need AA after all. You should definitely ask to have a bone scan done to see if you have osteoporosis. PMRpro will let you know that after being on Prednisone for many years, she has not developed osteoporosis.

[Croft9232]

Definitely you should ask for a Dexa Scan to get a baseline for your bone health and then again 2/3 years after… You may have good scores for your age as I do , even though I have Osteoarthritis.

AA is a very potent drug and in my estimation should only be taken when needs must..

Take Care M .

[Karendeena]

Exact same thing happened to me after a few weeks. It was the Lansoprazole. Changed to Famotidine and no problems

[Suobe in reply to Karendeena]

Thanks for this Karendeena. I am stopping the AA for a few weeks to see if that is the source, but will mention Famotidine to my GP as a next step if needed.