Morning all,I'm on Methotrexate and Omeprazole for GCA. This week I had a message from my GP saying I can't take the Omeprazole any more and have been switched to Fanotidine because Omeprazole has been found to interact with Methotrexate in a negative way. Apparently it can cause the kidneys to retain too much Methotrexate which could in the long term cause toxicity. I've been on this combination 11 months.
Just wondering if anyone else has had the same message?
Hi,I can’t help with your question but I also have GCA the LVV version.I am also on 15mg MTX once a week and apart from folic acid nothing else.Before starting MTX I was on pred and offered omprazole which I refused as I wanted to see if pred caused GI problems.It didn’t so I decided not to take a med I did not need.Do you mind me asking what dose of MTX you are on and are you like me on that alone.
Hi I'm on 20mg Methotrexate, the same of folic acid, plus alendronic acid, ferrous fumarate, calcium plus 3mg pred. When this all started 11 months ago, I was put on all this medication and not given any choice. I just took what I was given. I'd like to have had more info about the implications of taking all this but I've been very lucky not to have had any noticeable side effects.
Thank you for your reply.I am trying to find out what the lowest dose of Methotrexate is prescribed to keep GCA under control.I also started on 20mg and after 18 months and. Positive PET scan the Rheumatologist allowed me to go down to 15mg.A lot of the side effects went away when I reduced and I’m hoping at my next consultation if I carry on improving that I can reduce again.Not sure how low you can go even if it’s a maintenance dose.All the best to you.
Thank you, and to you. I started on 15 Methotrexate and was increased to 20 after a few months. I'm not sure what the maintenance dose is, I believe it's 15. Think we are stuck with it permanently.
I think it is less of a problem when you are on rheumatology doses of MTX which are very low so the increase due to omeprazole is unlikely to be too unpleasant. The real problems will be when it used in oncology (cancer treatment) where the doses are pretty high anyway and already pretty toxic so there being higher levels would just add to misery MTX can be there.
No but I happen to take Cimetidine for something else which like Famotidine has the added benefit of being a stomach protector with no side effects so it seems a better option to me than the 'prazoles which can cause problems and as you say shouldn't be used long-term
There is also the option of putting your Pred in gastro-resistant gel capsules eg Capsuline so they don't affect your stomach capsuline.co.uk
Yes I had heard about that, but it's never been offered to ne in that form. Hoping to see the rheumatologist again soon - I feel a lot more informed thanks to this forum, so I hope I can ask some more sensible questions about medication options for the future.
We are all fortunate to have this forum for sense and support....and it makes us better patients. I'm on Actemra and had a flare...so 60mg of pred now. I'm on a med called sulcrafate which works well for me and my stomach plus Pantaprozole. Those capsules that tangocharlie suggested sound like a great solution. Never heard of them across the pond.💞
Hi I just started MTX 7.5mg 1 x a week , 2 weeks ago and my Rheumy said that’s the lowest dose. I take omeprazole as well but I guess it’s okay because I’m on a low dose
There is another reply to you here - in case you haven't seen it:
Omeprazole 
Omeprazole
methotrexate and antibiotics 
Omeprazole and Gastroscopy 
