omeprazole

[Excelsior80]

hi, i started on prednisalone in June at 15mg, currently dropping 1mg every 6 weeks which is going Ok so far, on 8mg now. No pmr pain since I started but the 8mg is only for the last 2 days so I'm waiting to see how it goes. My GP would like me to take omeprazole to prevent stomach problems, but I would prefer not to, seems another set of possible side effects and I haven't had any stomach problems so far. Would it be reasonable to wait and to start taking it only if I get problems or could I be making things worse? I also take thyroxine and a calcium/vitamin d supplement and I am feeling well at the moment. I can discuss with GP when I see her but that won't be for a while and Id like some advice/experiences of others if possible.

[Bcol]

I was on it for over four years with my Pred and it caused me no problems at all. I also used to take the Pred around 02:00 ish with yogurt and often a banana,

[DorsetLady PMRGCAuk volunteer]

If you aren’t taking it, and don’t appear to have any issues and also take your Pred with/ after food then it’s your choice.

Like Bcol I took it without issues, but was on much higher doses of Pred [GCA].

[Angelsmummy]

Morning.I was told to take Omeprazole when I first got GCA because of high doses of pred etc.I decided after a lot of reading etc that once I got to a lower dose of pred I would go down to 20 mg of Omeprazole and now I am slowly reducing that!On advice of Forum,I take my Pred at 2 am with yoghurt drink and have absolutely no issues with Pred and gastric issues.Personal choice of course,but I hate taking pills etc and will only take them if absolutely necessary.Best Wishes to you,xx🌼😜

[Grammy80]

I'm a GCAer and still on high dose pred. I took Omeprozole initially, and now take Pantaprozole and sulcrafate. I had no issue with either one...and don't recall when the omeprozole was dropped or why. Sometimes we don't like taking the extra med, but I found them harmless to my system. Good luck💞

[Excelsior80]

thank you all! reassuring .... i think its a combination of hating any medication and a vague memory of my mother having trouble with omeprazole . . also nhs guidance seems to say at low doses of pred, only recommended if higher risk person, but im not an expert ...what is the gastric problem that steroid could cause?

[DorsetLady PMRGCAuk volunteer in reply to Excelsior80]

Steroids may increase your risk of developing ulcers or gastrointestinal bleeding…

[Excelsior80 in reply to DorsetLady]

thank you 🙂

[marionofnorwich]

But also it might be a good idea to reduce by half milligrams once you get down to 6 or 7 mg and take it slowly at lower doses

[Excelsior80 in reply to marionofnorwich]

thank you! yes Im bearing that in mind....9 to 8 is still not far off 10% but lower doses worse ... ill have to talk to GP as at the moment shes prescribing exacly what i need for 6 weeks, and checking im ok after changes by text...not a repeat prescription under my control ....

[PMRpro Ambassador]

I have only ever taken stomach protection when there has been an additional need to do so - there isn't the same drive to keep the makers of omeprazole in business here in Italy! Whena PPI is used, then it is pantoprazole so I imagine they have something against omeprazole which was actually the first PPI launched in the late 1980s.

And when I looked it up - indeed, pantoprazole is preferable for us for all sorts of reasons!!

"Notably, pantoprazole is associated with lower incidences of drug interactions than older PPIs (omeprazole), resulting in lower affinity for specific CYP isoenzymes [34,36]. This is an important consideration, especially among patients with comorbidities who are affected by polypharmacy, which increases their risk of drug-drug interactions [36]. Moreover, most of the elderly have concomitant illnesses and receive other drugs, but this does not adversely affect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of the patient’s age [15]. In essence, pantoprazole may be a preferred long-term treatment choice with fewer drug-drug interactions in the elderly or patients with comorbidities with fewer drug-drug interactions as compared to other PPIs"

ncbi.nlm.nih.gov/pmc/articl....

[Sofarbrnun in reply to PMRpro]

I'm now PMR free but must take a PPI for Barretts esophagus. ( not sure if this was caused from NOT taking a ppi while on pred for 6 years BTW). My doctor just renewed my omeprazole script, but after reading this article, I called the office to have them change it to pantoprazole. Thanks for the info PMR pro!

[Griggser]

Hi, I’ve been taking steroids for ten years and only now at 8mg, the lowest I’ve managed to get to. I always make sure I take my steroid after breakfast if some sort but Greek live culture yoghurt is best. I did take omeprazole at some point but like you I didn’t want to take more drugs than I needed. I haven’t suffered any stomach problems but of course we are all different.

[AtopicGuy]

I've never yet taken a PPI despite about 3 years on and off prednisolone (up to 30mg/day). I spot which things make my stomach sore and avoid them. I'm on calcium and vitamin D, too.