Time interval between Omeprazole and 40mg Pred - seeking advice.

[Exflex]

This is a respiratory issue, but since I’m a recent user of Pred for PMR and I know the ladies know their stuff. I finished Pred for PMR in January 2024, but 4 months ago caught a chest infection that persisted as a dry cough. Fast forward I was hospitalised and diagnosed with pneumonia, Covid positive and Pulmonary Fibrosis. Today my GP prescribed a 7 day course of 40mg of Pred per day, plus Omeprazole. (The dry cough can be a symptom of Pulmonary Fibrosis, by the way.)

The question, as per title really, what time interval should I allow between taking Omeprazole and the Pred? 1/2 hour?

PS The GP said there should be need to taper off after the 7 day course.

[Sharitone]

Yes, according to my pharmacist: half an hour.

[Exflex in reply to Sharitone]

Thank you!

[PMRpro Ambassador]

PPI half an hour before breakfast, pred after breakfast.

[Exflex in reply to PMRpro]

Thank you! What do you think about not tapering, ie 40mg to zero?

[PMRpro Ambassador in reply to Exflex]

After a short course you don't need to taper. As DL says, 1 or 2 weeks of high dose pred is commonly used without taper. You just drop back to your previous baseline.

[Exflex in reply to PMRpro]

Thanks PMRpro 🙏

[DorsetLady PMRGCAuk volunteer]

After only 7 days on Pred, there shouldn’t be any need to taper. Short courses of Pred are used on many occasions like this.

As you have been a long time user of Pred I can understand your question - but that’s a different scenerio.

[Exflex in reply to DorsetLady]

Thank you DorsetLady. Indeed it was my long term use of steroids and gradual tapering led me to question.

BTW, yesterday I took my first dose of 40mg at about 1:45 in the afternoon and had a bad nights sleep. I’ve taken it earlier today when I woke at 9:30, half an hour after Omeprazole.

[DorsetLady PMRGCAuk volunteer in reply to Exflex]

That’s a problem with higher doses-but at least it’s only a week. Hope it sorts things for you.

[Exflex]

BTW, the steroids prescribed are soluble, dissolve quickly and then drink. I guess the benefit is that you’re not getting ‘hot spots’ in the stomach from individual tablets, maybe helps absorption too.

[PMRpro Ambassador in reply to Exflex]

There is increasing evidence that it is not actually only the physical/mechanical effect of pred and other antiinflammatory medications that causes the gastric problems but their systemic inhibitory effect on prostaglandins in pain perception. That is why they are so reticent about all these medications nowadays.

[Exflex in reply to PMRpro]

One more question ‘Pro, I’m taking Omeprazole for the duration of the short course of Prednisolone. Can I stop the Omeprazole as soon as I’ve completed the 7 days, or do I need to taper?

[PMRpro Ambassador in reply to Exflex]

No - if that was only 7 days, you should be able to just stop.