famotidine

[Renlim]

Dear All, advice please! I’ve got GCA and am on 5mg pred a day. Recently the medics have raised the issue of CKD but after a scan and blood test have decided it’s only mild (thank goodness}. However, they ‘suggest swapping omeprazole for famotidine as PPIs can rarely cause kidney problems.’

I’ve looked up the side effects of famotidine and see constipation and dizziness listed. I’ve got both of these already and definitely don’t want them to get worse!

Does anyone have any experience with famotidine? I’m even considering the daring option of dumping both omeprazole and famotidine. Thoughts?

[SnazzyD]

The side effect of Omperazole doesn’t make good reading either. It’s down to the person. I couldn’t tolerate PPI’s one bit and changed to Famotidine that was a breeze by comparison, for me. I did find while on 60/40mg I ended up with rebound acid again after a few weeks, but a friend of mine (has lupus) is on them all the time with no bad effects having also had to stop PPI’s for your reason.

[PMRpro Ambassador]

If you are stopping the PPI - you must taper off it slowly over a few weeks, much as with pred. or you risk rebound acid production.

Have you ever been without the PPI? Or was it and automatic addition to the list "just in case"?

[Renlim in reply to PMRpro]

Crikey! But can I just swap omeprazole for famotidine, following their instructions? I started on omeprazole right at the start of my GCA diagnosis and pred medication in September 2023 and have never stopped taking it.

[PMRpro Ambassador in reply to Renlim]

You should be able to - unless you have severe acid production and then Gaviscon might do the trick in the interim. Or you could reduce the PPI a day or two per week at a time and take the famotidine on those days until you have got to all famotidine.

I had a warm discussion (wasn't really heated) with my daughter who is an endoscopy nurse and has just done a prescribing course about the merits of one against the other. She comes down firmly on the PPI side on the grounds they are far more efficient - I have seen suggestions that the difference isn't as marked as claimed but I have no doubt she has read more than me in this context! There probably is no doubt that PPIs are more efficient but kidneys really don't like them!

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

makes some very pertinent comments about their introduction

"But as time passed, PPIs started to be indiscriminately administered to individuals for purposes that weren't intended, for a more significant duration than was advised, and by people who were taking their medication "

And that is when the nastier adverse effects of anything become obvious.

[Renlim in reply to PMRpro]

'You could reduce the PPI a day or two per week at a time and take the famotidine on those days until you have got to all famotidine'.

Thank you very much. I'll try that.

[NewPMR]

I couldn’t tolerate a omeprazole it made me really ill for weeks. I have been on Famotidine for sometime now with absolutely no problems whatsoever. All the best.

[Renlim in reply to NewPMR]

Let's hope it's the same with me! Thank you for your support

[MrsPractical]

hi I was put on Famotodine by the hospital as it was thought long term Lanzoprozole had caused low sodium. I started on a higher dose and then reduced it. I don’t think it is quite as efficient as a ppi but I have found that staying on the low dose has been possible by including gaviscon tablets occasionally. I also find chewing sugar free gum helps keep acid down too. I don’t believe I have suffered any side effects at all.

[Renlim in reply to MrsPractical]

Thank you so much! Had my first Famotodine last night!

[AncientAunt]

I’m on Famotidine and love it. Having said that, I’m comparing it to Omperazole and Lansoprazole which both gave me diarrhoea, wind and stomach cramps. So for me, a little bit of dizziness is preferable to sitting on the loo all night!

It might be worth trying.

[PMRpro Ambassador in reply to AncientAunt]

"a little bit of dizziness is preferable to sitting on the loo all night!"

I can't imagine why you think that - NOT!

[Renlim]

I'll see how I get on and report back in a week. Thanks tons for your support

[Pollyanna16]

Hi, My GP offered me Famotodine after I said I was concerned about the effect on my bone density after 12 years or so on either Lansaprazole or more recently Omeprazole. I firstly tried to do without either for about 3 weeks coming off slowly but found the acid reflux very troublesome and my esophagus was getting sore! So tried Famotodine and all was resolved very quickly. As someone said it doesnt always have the life span the others have so very occassionaly I take some Gaviscon, late in the day. No dizzy spells and I am prone to get verytigo but no episodes so far. Tummy no better or worse! Constipation has not been an issue but I do eat a fairly high fibre diet. All the best.

[Renlim in reply to Pollyanna16]

Thanks! Doing ok so far, fingers crossed!