Famotidine as a substitute for Omeprazole?

[Heron82]

Hello friends,

Has anyone been prescribed Famotidine to replace Omeprazole? I’ve been experiencing gut issues for several months now and my gp has suggested a change in H2 antagonist to see if the frequency symptoms resolve. The list of potential side effects on the PIL don’t inspire me to make the switch.

Also has anyone else gained weight on Mtx? I’m down to 8 mg pred and been back on Mtx for 5 months during which time I’ve gained 10lb despite being careful with my diet, and am feeling quite low and withdrawn.

oh the joys of this journey.

[PMRpro Ambassador]

Famotidine is the replacement for ranitidine and loads of people used to use it before it was withdrawn over manufacturing contamination. The mass switch to PPIs was due to superior marketing by the manufacturers claiming their product was SOOOOOOO much better. It isn't that much better and since they have a different mechanism, the adverse effects are different. Always remember - no-one gets all the adverse effects that have been reported and many get none. Most fall somewhere inbetween. But there have been people for whom PPIs tied them to the proximity of a bathroom that was sorted by using an H2 antagonist!

It is unusual to gain weight on MTX but I did too - a kilo in a month! MTX caused so-called pred effects for me that I had never had before - I was ravenously hungry, craved carbs and gained weight! I'm also sure it made my a/fib worse! MTX is suposed to work by potentiating the anti-inflammatory effect but in fact it can potentiate any effect, I felt so awful I said no after a month. Took a darn sight more than a month to lose that kilo though!

[Heron82 in reply to PMRpro]

Thank you, as always just the level of info and detail I was after. I’ll give it a go and see how I get on. Hope all is going well with you.

VBW

Heron

[Motida in reply to Heron82]

I have taken Famotidine at night for a few months. The only side effect is a cough and some reflux. I take the pred in yoghurt as well. I was also warned that Famotidine might start UTi s or kidney infections, and this happened yesterday. Antibiotics for five days were prescribed over the phone thankfully, which is all there is apparently. The backache round the kidney area was bad so I took more pred today and it went away very quickly. (from 7.5 to 10) but hope to drop back down as soon as possible. The fatigue is also non stop. Fingers crossed for you though.

Best of luck.

[SnazzyD]

Omperazole upset my gut top and bottom. Famotidine was much better for about a month but I ended up with rebound acidity and since neither helped in the end I had to have coated Pred. However, I have friends who take Fam for other reasons continuously with no problems.

[Heron82 in reply to SnazzyD]

Thank you. I already take the GR film coated pred. But have been advised to take something to better protect my stomach which isn’t great.

[SnazzyD in reply to Heron82]

I guess you need to give it a try. Does brand of EC Pred make a difference?

[OPO4]

Hello, I have been on Famotidine instead of

Omeprazole for about a year now. They changed it as Omeprazole was preventing me absorbing magnesium . It was done by the Endocrinologist.

[Heron82 in reply to OPO4]

Thank you for replying. Do you take it at night as prescribed and take pred in the morning? How are you finding it?

[OPO4 in reply to Heron82]

I take it at night and have had no problems.

[Karendeena]

Yes I was switched from Lansoprazole to famotidine because of the gut issues. The PPIs really upset my digestive system.I took famotidine for almost 3 years (I am off prednisolone now) with little side effects apart from some phlegm in my throat which miraculously disappeared when I stopped taking it.

Although much improved my GI system never went back to normal and I now have IBS

[Zebedee44]

Sorry to hear you aren’t feeling so good, Heron82. My GP prescribed Famotodine to replace one of the two lansoprazole the ENT dcotor had recommended to reduce acid reflux and heartburn but I found that taking it at night made the heartburn worse.

I’m sticking with one lansoprazole in the morning with pred an hour later and haven’t had any heartburn at night since stopping the Famotodine. I’m expecting a review of my meds when I have a follow up gastroscopy after biopsies revealed atrophic gastritis. This seems to be the cause of my anaemia.

Although I am lucky not to have gained weight during my pred years I am fed up of having to juggle everything and be wary of the side effects of new drugs which are supposed to make things better. I had hoped my PMR would gently fade away after eight years and health issues would not occupy so much of my time and energy, so far 2024 has been one thing after another and still at 3.5mg with a long slow taper ahead. So I sympathise with you feeling a bit low, and send a virtual hug, xx

[Heron82]

Thank you all so much for your very helpful responses. I’ll give it a go and hope for the best. X

[Grammy80]

Sulcrafate~~generic (Carafate) and Pantaprozole have worked like a charm for me....with a history of stomach bleeds, they have been great.💞

[Hidcote]

Hi Heron

I am sorry you are feeling low and withdrawn. I hope things improve.

Please let me know how it goes for you. I am now on coated pred because of stomach issues and have started injecting methotrexate also because of stomach issues and difficulty in reducing. Have also been advised to try Famotidine. Useful to know taking it at night is best. I would much prefer to manage things with diet but don’t know if this is possible.

I hope the presentation on the 7th is helpful.

[PMRpro Ambassador in reply to Hidcote]

When you take it depends on why you take it. It is at night if your problem is night-time reflux but mornings if you get problems during the day.

[Hidcote]

I am ok in the night and when I have tea in the morning.. It is during the day, I get bloating, pain and a bit of reflux. Do you think, Famotidine, food and pred is the right order. I had hoped coated pred would have sorted things but sadly not

Thanks as ever for your help

[PMRpro Ambassador in reply to Hidcote]

If it isn't working you need to speak to your medical team. You may need a higher dose or another drug. Or you may need further investigation.

Famotidine should be taken 30-45 mins before food and pred with or after food.

[Hidcote in reply to PMRpro]

Thanks I thought taking coated pred would make things easier but this is the same routine as with non coated. My GP has referred me to a gastroenterologist. Something is odd.

Just enjoying my early morning tea. No stomach pain or bloating until I start taking medicines. Thanks for your help.

[PMRpro Ambassador in reply to Hidcote]

Have you checked the instructions as to being taken on an empty stomach or with food? It is very important to stick to that. And have a look at the ingredients - are there colourings or something you might be intolerant of? If you can, move the timing of your morning meds to a different part of the day ONE AT A TIME. That should identify if one is causing the problem.

[Hidcote in reply to PMRpro]

The instructions depend on what it has been prescribed for. Most say evening but heart burn is twice a day but my doctor said once a day. I find it hurts my stomach when I take it and gives me a dry mouth. I might go back to Esomeprazole

[PMRpro Ambassador in reply to Hidcote]

Yes - but you said "medicines" in general. It may not be the famotidine but something else that is the problem.

[Hidcote in reply to PMRpro]

Thanks. I am getting some of the symptoms suggested in the Famotidine leaflet,, eg dry mouth , horrid taste but less bloating than when on Esomeprazole.

I now take the stomach protector in the morning and then the pred.

Everything else eg vitamin D, folic acid at lunchtime. Except when the uncoated pred really irritated my stomach lining, I don’t have problems with these, although cannot take calcium.(Have been told that as I have had infusion it is vit d that is important.)

in the past, I managed well with omeprazole and plain pred but have had problems since I had to increase to 15 for a flare.

I will check what causes problems. I think the Esomeprazole doesn’t really suit but may be easier than Famotidine.

Thanks it really helps to have someone listen as

It is all driving me potty.

[PMRpro Ambassador in reply to Hidcote]

"although cannot take calcium.(Have been told that as I have had infusion it is vit d that is important"

I have to say, I am getting concerned about the lack of knowledge about the bisphosphonate infusions. Adequate calcium is essential after being put on a bisphosphonate as that causes calcium to be laid down in the bones and that can lead to low blood levels. Normally, if the blood calcium level is low, the body leaches calcium from the bones to keep the blood level up and that is what causes osteoporosis. Low blood calcium is dangerous as it causes muscle cramps - including the heart. High calcium is also dangerous but the body normally knows to keep the blood level in a narrow range. The bisphosphonate shifts the balance so it goes from blood to bone irrespective of the amount you are taking in. You need lots of dietary calcium if you can't take supplements.

[Hidcote in reply to PMRpro]

That’s interesting . Both Rod Hughes and Joel David said it was the Vit D and not to worry about the calcium but I am eating a lot of calcium rich foods, good thing I like sardines