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canon007
09-24-2011, 08:20 PM
Is it possible to take proton pump inhibitors on an as needed basis, say a few days at a time, stop until symptoms return or every other day?

janewhite1
09-24-2011, 10:56 PM
It works for me! And if you don't have severe symptoms all the time, it's probably better in the long run than taking it every single day.

solofelix
09-25-2011, 08:36 AM
My GI Dr told me it is fine to take them as and when I needed them.
Your own symptoms will let you know how/when.
I have just been on them for three weeks and am in the process of weening myself of them as my condition has improved.
I would suggest not to leave them of (cold turkey).
From 40mg per day I reduced to 20mg per day for a week and then 10mg per day for a week. This has worked well for me.
Solofelix.

canon007
09-25-2011, 12:19 PM
Thanks for the reply. But do you find that you have rebound acid when you go off the meds for a bit?

janewhite1
09-25-2011, 01:22 PM
If I've been on for a few weeks, yes, If just a few days, no, I don't, and I seem to develop tolerance faster than most people.

canon007
09-25-2011, 02:56 PM
I found some old posts where someone had said that these drugs are not to be used as needed as they take 2 weeks to be effectual. I do find them immediately effectual but I could see being on them for longer if you need healing. By the way why are people on these drugs for months and years on end when I believe the drug companies themselves say not to be on longer than 2weeks, some just 4-6 weeks.

janewhite1
09-25-2011, 03:02 PM
The 2 weeks is the over-the-counter version: If your symptoms last more than 2 weeks, you are supposed to see a doctor rather than continuing to self-treat. It's a pretty normal warning for OTC drugs. Some people with severe reflux do take them for years, and for them it's worth it, although I believe you should at least TRY lifestyle measures first.

It takes about a day for Prilosec to start working for me when I go on it.

sjzrifdsa
09-28-2011, 06:27 AM
i don't know!Thank you!

JohnnyL
09-28-2011, 07:33 AM
not the most ideal as it takes a few days to get a steady state . I know some people that take them as such but they are not desinged to work like that. I also know some people that once they build up a concentration in there blood they may take them every 2-3 days but going off for 3 days seems the most anyone can do! I ran into the problem of feeling good and stopped and had to restart for a week or 2 but now I swear as long as I live I will not stop! UGH!

JanaJ
09-28-2011, 08:07 AM
The reason people carry on taking them is that there isn't anything else, oh apart from surgery of course!

Well, I've had the surgery but still need medication.

JanaJ
09-28-2011, 08:08 AM
I develop a tolerance as well. How do you cope with it?

janewhite1
09-28-2011, 07:17 PM
I have the weird ability to develop tolerance to the PPIs in just a few weeks of use. Quitting was a month of torture, but I got through it, and I feel no worse now than I did while taking them.

Now I take domperidone, which actually changes the way the muscles in my digestive tract work. Baclofen might do the same thing for some people.

JanaJ
09-29-2011, 01:43 AM
I quickly develop a tolerance and Domperidone don't seem to do a lot for me. I'm at my wits end as to what to do. I've had surgery, but still need medication.

tammykinz
10-02-2011, 11:02 AM
MY doctor told me I could take them on as needed basis also. However, if you look in the drug book for this medication it does not say that you can for this medication. It says to take daily and to not skip doses. Funny thing is, my doc said I could and then I asked for a prescription refill and he wrote it for me to take daily. He wouldn't write "as needed" on the prescription, yet he told me I could. So wonder if he was covering his butt.

I think the best person to ask would be a pharmacist. I am going to ask next time.

solofelix
10-02-2011, 11:16 AM
MY doctor told me I could take them on as needed basis also. However, if you look in the drug book for this medication it does not say that you can for this medication. It says to take daily and to not skip doses. Funny thing is, my doc said I could and then I asked for a prescription refill and he wrote it for me to take daily. He wouldn't write "as needed" on the prescription, yet he told me I could. So wonder if he was covering his butt.

I think the best person to ask would be a pharmacist. I am going to ask next time.


Hi,
If you go to page (1) of this thread you will see how I take my PPIs.. on a As Needed method and I have no problem.
NOTE... What suits one may not suit another!!.. Solofelix.

tammykinz
10-02-2011, 11:22 AM
Hi,
If you go to page (1) of this thread you will see how I take my PPIs.. on a As Needed method and I have no problem.
NOTE... What suits one may not suit another!!.. Solofelix.

I understand what you are saying. BUT just because we feel better taking them the way we do doesn't mean it is healthy for us. I take them as needed and they help me that way also and I don't feel like I am having problems doing it this way either. To me it didn't make sense taking them every day because I can manage taking it every 3 days. BUT do we know the long-term effects of what this could potentially be doing to us. That is what concerns me. Would it be better to take 10mg daily verses 40mg every 3 days ??

I just found it odd that my doctor said yes sure, I can take it this way..but then he writes up the prescription differently.

janewhite1
10-02-2011, 02:39 PM
I personally believe that intermittent dosing may reduce tolerance and help keep the medicine working.

Unfortunately, many doctors don't believe PPI tolerance exists, so to them, preventing tolerance is crazy. This despite several placebo-controlled studies that confirm PPI rebound can produce GI symptoms in previously healthy people. There's acres of lab evidence that regular PPI use raises the levels of gastrin in the bloodstream, which means the body is overproducing acid to compensate. Finally, we have decades of patient experiences. But if a doctor or researcher sets as the cornerstone of his thinking that PPIs can't cause tolerance, dependency or rebound, how do you touch that?

(It's also tough to have a discussion about solar power with someone who doesn't believe the sun exists...)

Now, uncontrolled severe acid reflux can be dangerous. It can cause damage to the esophagus, larynx, even, in rare cases, the lungs, and it does contribute to the risk of cancer. Still, I think that PPIs should be taken at the lowest effective dose for the shortest effective time.

solofelix
10-03-2011, 01:25 AM
Thanks for putting that so well Janewhite.
I have read that older people in particular often have lower Acid than too much and as you pointed out the body then compensates by producing more when taking PPIs constantly.
I agree that taking the lowest effective dose/shortest effective time is efficient.
Solofelix.

Leo255
10-03-2011, 12:46 PM
A couple questions for you guys...

1. When you say that you reduce the dose (i.e. 40, 20, 10, etc.) are you cutting your pills? I'm sure it's not a huge deal, but it would seem to effect the time release design of them.

2. Do you know if the H2 acid blockers (like Pepcid AC) can cause rebound acid? That is what I'm currently on, because it has somewhat been working for me, and I'm a little concern about PPI dependency.

3. How exactly are the PPI's technically supposed to help you end your acid reflux? I've heard from my doctor that they help your esophagus heal. So does that mean we have reflux in the first place because our esophagus and/or sphincter is/are inflamed or damaged by acid?

senior41
10-24-2011, 12:28 PM
canon007

Try stopping PPIs and see what happens. I was on a generic PPI for 3 years and they seemed to releive my symptoms. What happened though, was that I developed Osteopenia which is early stage Osteoporosis so I switched to Zantac and was fine for about 6 months until I developed nausea which is a side effect for that class of drugs
- H2 Inhibitors.

Good Luck!!

senior41
10/24/2011