Caution for using PPI's

[Itstime 0]

Article in the Huntsville Times Tuesday May 11, 2010

Los Angeles:

The widely used family of acid-reducing drugs that includes Prilosec, Nexium and Protonix increased the risk of bone fractures by about 25 percent and can more than double the risk of contracting the troublesome bacterium Clostridium difficile, new studies released Monday confirm.

The increased risk is not thought to be caused by the drugs themselves, but by the sharply reduced levels of acid in the stomach and intestinal tract, which make the organs a more hospitable environment for infectious agents such as C. difficile and which can impair the uptake of the Calcium required for strong bones. The drugs have also been shown to increase the risk of pneumonia.

Wish they had put the author of this but I have read about this before and it is a caution for me for getting off these as soon as I can. Right now I do need them though.

[ouroborous 519]

The bone loss thing has been known for a while; this plus the reduced intake is one of the reasons why everyone post-sleeve is put on a Calcium sup.

The C. difficile thing is news to me, however.

My long-term goal is to wean off of the PPI's, but I'll take the risk if it's a choice between a possible infection and the certainty of something like esophageal erosion or Barrett's esophagus.

[Tiffykins 672]

Isn't this the main reason it's recommended that we take calcium citrate instead of carbonate?

I didn't know about the C. difficile either.

I'm really going to focus on weaning off my Prilosec as I can once I have my yearly follow up sometime next month.

[lmmore 0]

The article went on to say that these symptoms do not usually show up for about 7 years.

[lmmore 0]

Not to undermine the seriousness of this, but here is an in depth article, that talks about all the uncertainty with these studies. They were done not by tests, but by looking at medical files. They did this over a five year period not seven.

Medical News: Two Studies Highlight PPI Risks - in Gastroenterology, GERD from MedPage Today

[Itstime 0]

Another article that was posted on this forum was very informative about when you do try to wean off PPI's that you could get rebound and will have increased acid issues that you need to prepare for once you attempt it. Be ready for that with OTC acid reducers etc. I am not worried right now but this will be an issue with me before my year is out and hope I can come off PPI's.

[stcyt 15]

whats the difference between OTC acid reducers like prilosec etc. and perscription

[Tiffykins 672]

whats the difference between OTC acid reducers like prilosec etc. and perscription

Over-the-Counter Prilosec - Is Prilosec OTC exactly the same strength and composition as the previous Prilosec available as a prescription-only drug?

Over-the-Counter Prilosec

Copyright 2006 Harvard Health Publications

Question:

Is Prilosec OTC exactly the same strength and composition as the previous Prilosec available as a prescription-only drug?

Answer:

Prilosec OTC has exactly the same ingredients as the prescription version of the drug. Prilosec and the rest of the proton pump inhibitors (PPIs) work by shutting off the pumps that produce acid in the stomach. The prescription version of Prilosec was one of the most popular prescription drugs sold in the United States. It is used for a variety of stomach disorders including gastroesophageal reflux (GERD) and peptic ulcers. The dose of Prilosec used depends on the condition it is being used to treat. The prescription version is available as a 10 mg, 20 mg or 40 mg capsule. Prilosec OTC was approved for sale without a prescription in June 2003 and is only available as a 20 mg tablet.

Prilosec OTC is only used for heartburn (also known as GERD) and the directions on the container are for that condition only. The prescription version of Prilosec and Prilosec OTC are exactly the same in how they work. So, 20 mg of Prilosec OTC is the same as 20 mg of prescription Prilosec. Prescription Prilosec and the generic version (called omeprazole) are much more expensive than Prilosec OTC. A 28-day supply of Prilosec OTC 20 mg will cost about $20. A 28-day supply of omeprazole 20 mg capsules will cost about $90 and the prescription version will cost about $115. I usually advise people who pay for their prescriptions themselves to switch to the OTC product.

Can J Gastroenterol. 11(8):657-60, 1997 Nov-Dec.

The only reason I stay on the prescription version is because I get my prescriptions for free with our insurance if I fill the script on base. I figure my husband's career affords us the insurance, I'm not going to buy OTC when I can get the same thing for free. Even if I didn't get it filled on base, the generic co-pay for my scripts is $3 so I could get it filled at Walgreens, but then I wouldn't have an excuse to drive to the pharmacy on base and shop at the mini-mall that is conveniently right next door to the pharmacy.

[Oregondaisy 2,019]

The difference between a PPI and others is a PPI stops acid from forming or being produced. The others like zantac gets rid of it when you do get it.

I am going to try to get off my Protonix. I didn't take it today and my stomach hurt and I felt hungry but I took some tums. I don't think it's going to be all that easy to get off of it.

[sam30204 0]

Sometimes you have to weight the action potential and benefits of a specific med for you. You are more prone to C. Diff due to the fact that the acid reduction in your stomach and therefore you are less likely to fight it but C Diff can almost always be prevented with good old hand washing. The bone thing... well it's something we may just have to chance. I dont think I could deal with reflux daily so to think about not taking it makes my stomach burn :drool: So all we can do is educate ourselves best we can and do our best to prevent this complications.

[Itstime 0]

I meant by OTC drugs such as Gaviscon, mylanta, rolaids and tums etc which neutralize the acid from food. The PPI's reduce the amount of acid the body makes. Antacids also have precautions but not the concern of PPI's. Either way I am not looking forward to weaning off these and using tums etc.,,blaaaa. The smell of them reminds me of when I was pregnant and used them...gag.

[stcyt 15]

Acid Reflux Diet - Myths and Diet Solutions

Interesting if your trying to control acid with diet

http://ezinearticles.com/?Natural-Remedies-For-An-Acid-Stomach&id=443027

Edited May 12, 2010 by stcyt

[ichefmastersgirl 4]

I am having a big problem with acid I now take Prilosec twice a day plus I was taking some rolaids in the middle of the day. So I let Dr. Aceves know how bad it was and this is the reply Gaby sent me.....

The doctor is out of town, but I called him

he says to please do not take any Rolaids

do not take Calcium carbonate products (TUMS, Rolaids, those type products. They will help immediately but in a few hours they will create more acid than you had to start with.

He wants you to try Gaviscon.

[LAN2k 18]

Wow that is what I call dedication. I must say that it comforts me to know that your after-care is reliable. Thank you so much for passing on the instructions you received from Dr.Aceves. Please let us know if you take the Gaviscon how it works for you. Thanks.

[ichefmastersgirl 4]

Wow that is what I call dedication. I must say that it comforts me to know that your after-care is reliable. Thank you so much for passing on the instructions you received from Dr.Aceves. Please let us know if you take the Gaviscon how it works for you. Thanks.

I do take it and it helps but since I switched from Nexium to Prilosec I have not had as much of a acid problem or maybe it was because I was eating the rolaids like candy and the Dr was right and I was just causing myself to make more acid. But I have been acid free for about 4 days now.