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Old 01-08-2010, 01:52 AM   #1
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if taking ppi when to take calcium and other supplements

if taking ppi when to take calcium and other supplements? should it be early morning when there is more acid and then after 4 hrs. take ppi?

 
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Old 01-08-2010, 08:14 PM   #2
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Re: if taking ppi when to take calcium and other supplements

Yes, I'd love an answer to this question, too, because I did recently read that this is a side effect of PPI therapy (the inability to digest mineral supplements due to low acid). I'm going to ask my GI when I see him next month. Until then, I'm not taking calcium supplements but am trying to eat calcium-rich foods (which I presume are easier to digest than the supplements). I do take an antioxidant supplement, usually midday and with food, but that's just vitamins A,C, and E.

 
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Old 01-09-2010, 08:28 AM   #3
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Re: if taking ppi when to take calcium and other supplements

my doctor told me calcium should be taken 1 hour before ppi. research shows calcium citrate does not need acid to be absorbed, so we shall be better of with calcium citrate because calcium carbonate needs acid. also, if you are taking ppi and would like to stop, you can prevent acid rebound by weaning yourself from ppi (i.e., using a step-down approach; decrease the dosage and decrease the # of times you take it in a week).

 
Old 01-09-2010, 05:05 PM   #4
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Re: if taking ppi when to take calcium and other supplements

This is what I read, too (to do a step-down dosage for awhile). I'm starting to do that with my omeprazole, sometimes skipping my evening dose and taking an H2 blocker instead. So far, so good...

 
Old 01-10-2010, 03:54 AM   #5
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Smile Re: if taking ppi when to take calcium and other supplements

good! just remember h2 blockers can also cause acid rebound.:

 
Old 01-31-2010, 09:17 PM   #6
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Re: if taking ppi when to take calcium and other supplements

Hello everyone:

I don't mean to hijack the thread but I am new to the forum and not sure how to start a new thread. I have decided to wean myself off PPI's after discovering that I have osteopenia on both hips. I had a Dexa scan two years ago about two months after starting on PPI's (Aciphex) and all my numbers were normal. I had another Dexa scan in late December 2009 which showed I am a few points from developing osteoporosis in my left hip and have osteopenia in my right hip. Needless to say, I was totally shocked. My OBGY's immediate advise was to start Actonel and handed me a prescription. After doing some research on this drug as well as the PPI's, I realized that the bone loss is likely related to the Aciphex and decided, rather than start on the Actonel (which sounds like a bad, bad drug) to switch to a different type of acid blocker.

I spoke to my regular internist who suggested I switch to calcium citrate, increase my vitamin D3 intake and try an H2 blocker as a way to get off the PPI. Surprisingly, she did not push the Actonel or told me to stay on the Aciphex. She suggested I try Pepcid or Zantac. The Pepcid did not help much and the Zantac has only helped a little bit more so far.

I started to cut back on the Aciphex since late December and started on the H2 blocker (Zantac 150 mg twice per day)about a week ago. I am going through a very difficult time with this, experiencing quite a bit of nausea, heartburn, and even some pain.

I feel I need to continue this plan but doubt myself every day and wonder if I should go back to the Aciphex after a bout of heartburn. I am eating light and healthy, no coffee, no alcohol, small meals, I am not overweight, eat dinner early, have never smoked, etc.

Natural cures like vinegar or mint tea do not work for me, but simply give me more heartburn. I tried chewing on ginger and that gave me more heartburn. I have DGL and chew on it but that provides relief for about ten minutes. Gaviscon helps a bit more.

Does anyone here who has tried weaning off PPI's succeeded long term? How long does one feel sick before the H2 blocker begins to work more effectively?This is the beginning of my second week and in my moments of desperation, I feel it will not get better than this.

I fear that if I go back on the Aciphex, I will feel better again (I had about 99 percent relief while on the medication) but then fear I will trade that relief for a broken hip in five to ten years. However, I can't imagine feeling like I have felt this past week forever and I don't know what to do.

If I call my doctor, I know she'll just refill my Aciphex prescription and insist on the Actonel. Actonel produces more heartburn which in turn will lead to a higher dose of the PPI, etc. I feel that is creating an unhealthy vicious cycle.

About me:

I am a woman in my mid fifties. I had one bout of heartburn in my thirties which went away in about six weeks with Zantac (prescription) and a change from a very stressful job. The heartburn returned with a vengeance about two years ago and after an endoscopy, I was diagnosed with reflux and put on Aciphex. I was told I could take it as long as needed and my internist happily refilled it any time I needed more.

I am now at a crossroads not knowning what to do. I want to stick to my guns, stay on the Zantac and off the PPI's. But, is there hope ahead after having these lousy days of stomach aches, nausea and heartburn. Is this the rebound? or am I always going to feel this way.

What makes me mad is that none of my doctors ever discussed with me potential side effects such as the calcium malabsorption or acid rebound effect. I had no idea. I was so happy for two years when I could continue to drink coffee, drink an occasional alcoholic drink and whatever other goodie I wanted. I thought Aciphex was a miracle drug only to find out it has kept my bones from getting the calcium they need.

Sorry for the long post, but does anyone have personal experience getting off the PPI's? Any other suggestion as to what I can do or add to what I am doing to succeed.

Thank you all for your replies.

 
Old 04-17-2010, 08:34 AM   #7
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Re: if taking ppi when to take calcium and other supplements

Quote:
Originally Posted by llysa View Post
if taking ppi when to take calcium and other supplements? should it be early morning when there is more acid and then after 4 hrs. take ppi?
Saw this from another thread. Just be aware that calcium is "binding" and can cause constipation. Some Calcium supplements have Magnesium added, which is a mild laxative, to counteract that effect.

Tums are calcium based, Mylanta uses magnesium and aluminum hydroxides. So adding supplements and taking antacids can have side effects you should watch out for.

 
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