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Old 09-08-2009, 07:27 AM   #1
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Switching Reflux meds

I know alot of you have tried different reflux meds and I'm just wondering, what would be a good protocol for starting a new reflux med? If after 2 months of Nexium I decide to switch to Aciphex or Zegerid, etc. What would be a good strategy? For example:

a.) If I were to stop Nexium on Sept. 11th, when would be a good time to start the next drug?

b.) How may days should I use the new drug before I decide a) If it's working? b) If it's okay, but not as good as Nexium? 1 week, 2 weeks? How long with the new drug to see if it's worth it?

Thank You for reading and I appreciate your opinion.

 
Old 09-08-2009, 08:34 PM   #2
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Re: Switching Reflux meds

I know that the decision to take PPI's isn't one to make lightly. When the homeopathic solutions didn't work for me, I found that I needed to seriously consider them though. I've taken all of the PPI's on the market currently. Last year when my reflux was flaring bad, I tried one after another trying to find one that worked best. My Gastroenterologist didn't have me wait any days between ending one and beginning on the next. I just started taking the new one as prescribed. He had me stay on each one for one month before making a final determination as to how well it was working. It really is an individual thing on how long it takes, but I found that after a week, I could pretty much tell how my body was responding. The month time frame also allowed my doctor to help me in getting insurance approval for some non-formulary medications as well since they had to prove I'd tried the others. My GI doc was pretty good about giving me month long samples though.

My regimine of PPI's over time: Prilosec years ago, then Protonix once a day for a couple years, Prevacid solutabs twice/day for several years (those were good years), then last year I tried Nexium, Aciphex, Zegrid, Kapidex. My GI doc finally told me I could just take my pick for my maintainence med.

After years of keeping things under control, none of them fully worked for me any more. Having tried the homeopathic stuff for years prior and having testing verify my reflux had gotten extremely severe, I opted for surgery. While it was life-saving for me (literally since my reflux was severely affecting my breathing), I'm still on the twice per day PPI's which is pretty rare post-surgery. I'm currently on Kapidex because the manufacturer has a coupon that lets me purchase a prescription for $5 for a year. Then I'm back to the Prevacid Solutabs which are cheaper. Hopefully OTC by next spring.

Things I learned personally:
-most of the PPI's seemed pretty interchangable. I really couldn't tell much difference.
-I needed the twice a day dosages to see any change at all. (The exception to this is with Kapidex which is dual delayed time release.) While officially diagnosed with GERD, my symptoms really fell in the LPR arena.
-Nexium really tore up my gut. I could tell within a day, but I stayed on it longer per my GI doc. I now have permenant IBS.
-The solutab version of Prevacid seemed to help me better than the capsule. Not sure why that would be, but if it helped...
-Coming off of the PPI's wasn't a problem with regards to any "rebound" effect, but I really did notice how much they had been helping when I was on them. I went off a couple times in preparation for reflux testing.
-Supplementing with other OTC meds in addition to the PPI helped when things were at their worst. Gaviscon seemed to work best for me.
-Watching my diet is very important.

Last edited by MountainReader; 09-08-2009 at 09:09 PM.

 
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Old 09-09-2009, 03:15 AM   #3
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Re: Switching Reflux meds

Quote:
a.) If I were to stop Nexium on Sept. 11th, when would be a good time to start the next drug?

b.) How may days should I use the new drug before I decide a) If it's working? b) If it's okay, but not as good as Nexium? 1 week, 2 weeks? How long with the new drug to see if it's worth it?
If you're switching PPIs there's really no reason to wait to start the next drug. Just stop one and start the new one as prescribed the next day.

As far as how long you should wait to decide if it's working the question is how will you know if it's working? If you're going to decide that based on whether it controls acid effectively (or has fewer side effects), you should know within a week or two whether you see an improvement in your reflux symptoms, but if you're looking for long-term improvement from reflux damage it can take 12 weeks to notice an improvement.

 
Old 09-10-2009, 11:54 AM   #4
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Re: Switching Reflux meds

Hello,

Thank you for your replies. I actually plan on weaning myself completely off the meds, but I just felt like asking these questions just in case for future reference.

 
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