? Omeprazole

[Harry8388]

Does everyone on Predtske daily Omeprazole for the entire time

[PMRpro Ambassador]

I have never taken it. It seems to be a rather British "thing" and my rheumy here in Italy only asks me to take it if I need NSAIDs for any reason.

[Koalajane in reply to PMRpro]

My British GP practice has never pushed it for me so never taken it.

[PMRpro Ambassador in reply to Koalajane]

Obviously depends on the doctor!

[Harry8388 in reply to PMRpro]

Hi

yes I know I was just wondering how people felt about it

It seems quite mixed opinions and Omeprazole is not without its issues the replies have been interesting

[PMRpro Ambassador in reply to Harry8388]

It is by no means the only option and not everyone needs it. My view is why take something else if you don't have a need for it.

[jayemmemm in reply to Harry8388]

I had a terrible reaction to Omeprazole and switched to Greek Yoghurt which works perfectly well and tastes very nice with a little honey. My GP approved the change.

[Kendrew]

Hi Harry8388,

I have been on prednisolone for over 5yrs now and my rheumatologist wanted to prescribe me omeprazole from day one.

I refused though, stating that I would only agree to take them if I developed symptoms that suggested that, or if other evidence came to light to support that need.

So far, I have not needed a PPI.

Obviously if the need arose, I would reconsider my decision.

[Bcol]

Morning, I was on Omeprazole right through my four and a bit years on Pred with no problems at all.

[Retallack]

Was put on it from the start as "routine" by my GP. I stopped it after 6 months because I had no gastric problems and didn't like possible side effects. I always took it with yoghurt. I managed to get down to zero pred a year ago and touch wood have not had any problems.

[Charlie1boy]

I wasn’t prescribed it at diagnosis, and never took a PPI throughout the seven years I was on prednisolone. I had no gastric issues at all.

[bluepuddy1]

Hello,

I can’t take it, because I get stomach problems, but not everybody has them. Like all these things it’s a case of trying it out. You might be fine.

[Rynn33]

I was put on it at the start but told it would be stopped once I got to 5mg ( which it was and have no issues) but probably depends on how sensitive your stomach is.

[AnnaColuthon]

I have been taking pred for 9 months with no stomach problems but recently I was prescribed a pill for a different problem and that one does upset my stomach so I was given omeprazole for that. I am thinking that it may also help avoid any future problems with pred so it covers two bases!

[sennetta]

Absolutely not- I read the patient noteswith it and didn't take any during the time I was on Pred I had no problems at all

[Koalajane]

I have been on pred for over 7 years and never been prescribed it. I take my pred with breakfast and have had no problems

[NewPMR]

I was told I had to take stomach protection, didn’t want to but was warned about potential issues, started on Omaprezole, made me so ill had to stop. Now on Famotidine, which seems to be ok but still not keen on taking it. Planning to stop if I get to lower levels of Pred 🤞🤞

[Excelsior80]

my GP wanted me to take omeprazole for stomach protection but I didnt want to unless absolutely essential. The NHS (?) online information I read said something like consider prescribing with steroids if reason to expect gastric problems but not usually needed as routine. My mother and a friend had trouble with omeprazole so im a bit anti the idea, and there are other options .

[Fatsiajaponica]

I did at the start, discovered that it was omeprazole which gave me serious diarrhea so stopped. No issues since, take it with lots of yoghurt.

[Fatsiajaponica in reply to Fatsiajaponica]

I meant that I take the pred with lots of yoghurt!

[Magictherabbit]

I’ve been taking it for 5 years now with no problems. I did ask my GP a few months ago whether I still needed to take it and she said it’s advisable while still taking prednisolone… I’m down to 7 mgs at the moment on a very slow tapering plan .

[pmrdec112014 in reply to Magictherabbit]

Unfortunately I had to stop taking Omeprazole as it affected my kidney function. I was diagnosed with Stage 3 kidney disease a few years back but the kidney function dropped even further to 42.It went back to previous level once off Omeprazole.

I now take pred ( gastric resistant coating ) with yoghurt and touch wood no gastric symptoms to date.

[Angelsmummy]

morning Harry8388,I was prescribed Omeprazole right from the start of GCA,left hospital clutching a carrier bag of drugs!After reading lots of info on Omeprazole ,I decided to “ knock them on the head” a little while back.I reduced to one capsule daily for a couple of weeks,then only took it every third day or so for a week or so,then finally stopped it.I take my pred with a yoghourt drink at 2 am,and have no problems at all without taking Omeprazole.Obvs,if somebody has gastric issues or similar that would be a different story but I won’t take anything unless I have to medically.All the best.x🌼😜

[Ridge]

GPs love it! I was prescribed it before Pred while I was on vaste quantities of NSAIDs for a mysterious head pain and jaw claudication !!! Once I was properly diagnosed and under the care of a Rheumatologist I was told to take it if and when I thought I needed it which is what I do.

[Almostaweed]

The strange and annoying thing is I just feel better on Omeprazole, it seems to soften the raw impact of Pred on how I feel. However I am scared of the side effects so might go down to alternate days.

[PMRpro Ambassador in reply to Almostaweed]

Which side effects?

[Almostaweed in reply to PMRpro]

Hi PMRpro the side effects I am scared of are osteoporosis and damage to kidneys. But I could be wrong about them.

[DorsetLady PMRGCAuk volunteer in reply to Almostaweed]

I was on Omeprazole before and during GCA -no issues with either things you mention.. then or now 8 years later.

[Almostaweed in reply to DorsetLady]

Well that's good news. Perhaps I should be less scared of it.

[PMRpro Ambassador in reply to Almostaweed]

PS - I forgot to say that both paracetamol and ibuprofen are associated with possible cardiac and kidney damage but it doesn't stop most people taking them!!

[PMRpro Ambassador in reply to Almostaweed]

There is small risk of osteoporosis due to PPIs but it IS small. Pred is greater!

This recent publication discusses the kidney damage concerns

karger.com/ajn/article/55/4...

and conclude that there is insufficient evidence to link them.

There are many factors that may be involved and sometimes you have to look at why the patient is needing the drug under consideration. For example, the risk of jaw necrosis associated with bisphosphonate drugs which appears to loom large - but in fact, the risk is mostly in patients who are on it as part of cancer treatment. Not only is their dose much higher (12 to 17 times more in a year) but there is also the underlying disease that means they need it.

And there are many reasons that people need PPIs and not all PPIs are created equal. For example, pantoprazole-induced acute kidney injury was first reported in 2004 and there have been no more than 100 publicly reported cases since then - it is very rare.

[Harry8388 in reply to PMRpro]

Thank you for your reply

I find it all a bit of a minefield to be honest

[DorsetLady PMRGCAuk volunteer in reply to Harry8388]

It certainly can be… and everybody probably has a difficult view of most medications depending on how they fared on them - and their own personal circumstances of course.

[Almostaweed in reply to PMRpro]

Dear PMRpro many thanks. So I can worry less. Because I am at quite high risk of osteoporosis I am keen to get off Pred (and Omeprazole) as soon as I can. I am one of those people aiming at zero asap - hope I won't regret it!

[PMRpro Ambassador in reply to Almostaweed]

You will if you ignore the fact that you have gone to too low a dose to manage the inflammation as you will end up back where you were at the start. Everyone wants to get off pred asap - but PMR holds the cards and as long as it is active you will need some pred to manage the inflammation. You can't cheat it and there are no ways of speeding up the demise of the autoimmune part underlying the inflammation. Ironically, if you rush at tapering and try to force a dose reduction when you are not ready, you will end up needing pred for longer as you cause a flare, need more pred to manage it and then have to taper again. Do that too often and it becomes increasingly difficult to get things under control and taper. And bear in mind that immobility due to PMR pain and stiffness is also a high risk factor for osteoporosis.

[Almostaweed in reply to PMRpro]

Thanks for the timely reminder PMRpro. I may come back another day to try and clarify whether I am going too fast or not. But I will start asking myself the question!

[PMRpro Ambassador in reply to Almostaweed]

It isn't too fast if you are coping with the changes in dose - but as soon as you notice any niggles of PMR appearing it is a warning you are skating on thin ice. DON'T be in denial!!!

[Leafsong66]

I can vouch for taking Pred with a good dollop of full fat yoghurt. I found the Omeprazole caused my stomach to burn!

[Karenjaninaz]

No. It gave me wind from hell. I used Pepcid a different class acid reducer. I noticed, whenever I take anything related to antihistamine, either for stomach or allergy, I’m not as sharp in the head and get palpitations. If I need to use any of these drugs it’s short term.

I’m taking my prednisone with whole fat yogurt.