How long after omeprazole to take Prednisolone?

[tiredbutoptimistic]

I have tried to find out how long I should wait after taking omeprazole before taking the prednisolone so my stomach is protected, but nowhere can I find this information. Can anyone help? I'd be most grateful. J

[HeronNS]

I gather from your earlier post that you've been on pred for a while but only recently started omeprazole? Were you actually given proper instructions when starting pred about how to take it, because the PPIs have their own problems. First of all, although they seem to be prescribed quite happily they were never designed for longterm use. They can prevent proper absorption of some nutrients which in the the longterm can cause or add to other problems. You'll hear a lot about how pred and calcium shouldn't be taken at the same time because each interferes with the proper absorption of the other, and pred can increase chances of bone thinning which ultimately may lead to osteoporosis. But the PPIs can do the same thing over time!

So, having said that, as you are on a standard PMR dose, not the high dose people with GCA need, have you tried taking your pred in the middle of a meal, breakfast if you take it in the morning, or a small helping of plain yoghurt and/or a banana or other such food if you take it at another time (e.g. some take it in the middle of the night).

Forgive me if all this was covered in your earlier post. It's the middle of the night, I should be asleep, and I wanted to just pass on the caution about omeprazole.

[Bunchberry]

I am taking panteprezole in addition to the prednisone. Pharmacist told me to take the panteprezole first thing in the morning and then wait twenty minutes before eating breakfast. Then as soon as I’ve had breakfast, to take my prednisone.

[Hidden in reply to Bunchberry]

Hello, this is the advice I have also been given

[DorsetLady PMRGCAuk volunteer]

I think usua is around 30mins ..but check with pharmacy if it doesn’t say on their label on the box.

[Bcol]

There is a lot of information about that in this post.

healthunlocked.com/pmrgcauk...

[Lickle]

Hi, My GP put me on Omeprazole from the first day of taking Prednisalone and that has continued. However, I was referred to Gastroenterology separately for anaemia and had been on the waiting list for endoscopy, colonoscopy & CT Scan for 9 months and was recently called for those. The results of those showed Diverticulitis, which had not caused me any particular problems, but the Specialist has advised long term continued prescription of Omeprazole.

I am now down to 5mg per day on Pred with good signs to taper further so hoping that I'll be done with the Pred before the Omeprazole.

Have been so grateful to the NHS for all the investigations and treatment over the last few months, whatever people say, I am so glad we have them compared to my friends in the USA who have to check with their insurers about every detail before getting processed.

[PMRpro Ambassador]

It doesn't magically coat the inside of your stomach - what it does is prevent the production of stomach acid and once you have been taking it for a while the effect persists over 24 hours. The reason it must be taken earlier is that it is absorbed best on an empty stomach so it works better. If you take it as you get out of bed, you are likely to have a good 30 to 45 mins before eating breakfast and taking your pred afterwards and that is ideal.

[suzy1959]

I am on omeprazole because of a hiatus hernia but because I also take thyroxine in the morning which also needs a gap before taking anything else, it is more convenient to take it at night and that is working very well for me, so also an option?

[PMRpro Ambassador in reply to suzy1959]

DO you mean taking the thyroxine or the PPI at night? Since thyroxine at night has been found to improve management.

[suzy1959 in reply to PMRpro]

Has it? I was unaware of that. Maybe I should swap them over?

[PMRpro Ambassador in reply to suzy1959]

I have discussed it on the forum before when things clashed

jamanetwork.com/journals/ja...

drugs.com/medical-answers/y...

[suzy1959 in reply to PMRpro]

Thank you!

[Hidden in reply to suzy1959]

Hello, I am also on long term thyroxine (over 30 years now) my body clock wakes me at 5 am so I take the thyroxine then, well out of the way of anything else, then go back to sleep 🙂

[AtopicGuy]

According to the link below:

"Omeprazole takes around 1 hour to block the production of stomach acid, and its maximal effect occurs around 2 hours after taking the pill. The action of omeprazole can continue for about 3 days."

medicalnewstoday.com/articl...

For those taking steroids first thing in the morning with breakfast, this means you are best taking omeprazole at bedtime, so the maximum effect has kicked in by the time you wake up in the morning. Each pill continues working for three days, so (after a few daily doses) the drug builds up to ensure some benefit continues all day, whenever you take it.

[tiredbutoptimistic]

As ever, I remain eternally grateful to the community here for their endless kindness and support and good information!

A quick update – I saw my GP again today to discuss what next after my flare and he is fully supportive of my staying at 10 mg for about six weeks to let things settle, and then starting to taper again MUCH more slowly both in terms of much smaller reductions and longer periods between reductions. He explained I was the first case of PMR the practice had had in years (they are predominantly a university practice) and I will probably end up more expert than them! He is very keen for me to have omeprazole and given he has been so understanding (and that I’ve been having digestive side-effects from the steroids even when having with food) I’m happy to stay on it for the moment reckoning that as and when I’m lucky enough to get the steroid dose much lower I can revisit this decision.

To answer the various questions colleagues asked above, no I was not given any guidance on when and how to take Omeprazole (or pretty much any of my many other drugs) so when my PMR drugs arrived I sat down with a large piece of paper to work out which to take when based on the leaflets in the packets and which could not be taken with what. Having read all of your information and advice here I am going to start my day with Omeprazole and then after 45 minutes or so (I know two hours is optimal but then again I have one every day so I will have some benefit from previous pills) eat and have the steroids, and then have lunch with the calcium and finally everything else including thyroxine last thing at night. Sometimes I think I’m going to rattle!

[Hidden in reply to tiredbutoptimistic]

It's a juggling act isn't it?

[PMRpro Ambassador in reply to tiredbutoptimistic]

That is a GP to hang on to!