Side effects of PPI's...what to do?

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Flyerfan

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I have taken Aciphex, 20 mg 1x/day for a good 8 years with no problems. When I think back the only side effects I had were more than normal headaches (nothing I couldn't live with) and eczema (which I believe is due to the low acid...not necessarily a side effect).

Without going into a long story, for the past six months I've been on and off the pill. I want to get off it for good and I have an appt. with a Naturopathic Doctor next month which I'm hoping will help me. Recently I've had a Barium Swallow (no stricture, no other findings), blood test and biopsy for H Pylori (negative) and an EGD which showed "completely normal", as GI doc put it.

My problem is every time I try to go back to the Aciphex I seem to get gas pains and other abdominal pains. I need to do something at least for the next two weeks as I'm going on vacation next week and don't want to suffer. When I don't take anything and use some natural alternatives I have a lot of post nasal drainage and feel like someone is squeezing my throat along with the burning (which I must say is managable).

I'm not sure if I should stick it out for the next 6 days and hope the pains subside as I get back to my regimen or go without. Am I not giving my body time to adjust to these pills as I'm constantly on & off them? Thoughts, anyone?
 
SounRAB like after 8 years of using Aciphex you've grown a tolerance to them and the drug is no longer performing the way it should. I would stop use of them and when you get a chance to see your doctor, ask about switching to a new PPI if you can't live without them. In the meantime for your vacation (and even daily use), I recommend taking a couple of bottles of Gaviscon to relieve any reflux syptoms you may encounter. Also, don't let your mind wrap around acid relfux (easier said then done) it will just make your symptoms worse. I hope this is helpful - good luck!

~Don
 
Hi Flyerfan:

In my opinion, vacation is not the time to try to get off your PPI. Otherwise, why bother going on vacation if you are going to feel miserable and not be able to eat. I would stay on the medication until you have had the opportunity to meet with the naturopathic doctor and he/she gives you a game plan on how to go about quitting the PPI for good. Rebound is a terrible thing. I went on spring break almost two months after I stopped taking Aciphex and I was still experiencing fairly severe problems and daily episodes of heartburn. I did not get back on the Aciphex because I was determined and had already been off for two months, but I would not have gone off the medication right before vacation.

Rebound can last a long time. It is best for you not to get off the Aciphex again until you are ready to do so on a permanent basis and have a long term plan as far as how to deal with the rebound symptoms. Otherwise, you are putting yourself through misery for no reason. If you go through two weeks of rebound, for example, and then get back on the Aciphex, you have then gone through two weeks of misery for nothing basically.

I think it is better to get off the PPI when one is going to be home to be able to deal with the rebound and have lots of remedies available. It is hard to travel with a bottle of apple cider vinegar or aloe vera juice, for example.

Best to you,

Rose
 
Sorry Flyerfan I gave you some bad advice earlier. Rosebloom is absolutely right. Coming straight off of a PPI will lead to rebounding from the drug and the symptoms would be worse then what you are trying to relieve in the first place. And you don't want that going on while on vacation.

I still do think you should wean off the PPI when it will affect you the least.

Thanks for the correction Rose and nice to see you back on the boarRAB!
 
Thanks for the replies. Right now I'm taking (1) 20 mg every 36 hours and I'm fine with that. I believe I'll be OK for vacation in a few days while on this regimen (I am taking the DGL and Gaviscon with me just in case). I'll just stay on that until I see the ND in a month. When I take it every 24 hrs I have more side effects and they are more annoying than anything.
 
I used to be able to get by on 10 mg of Aciphex (used to cut the pill in half with one of those tiny gilloutines you can buy at the pharmacy(sp?).

Have a great vacation! No need to ruin it by trying to go off your medicine while away from home.

Rose
 
I don't think your advise was bad at all. I don't think PPI's are intended to be used long term and we (at least I) did not ever get that information from my doctor while I was on Aciphex for two years. It so happened that I discovered I had developed calcium loss and decided to get off the Aciphex on my own. I did that in January and by the middle of March (spring break) I was still experiencing fairly severe acid rebound symtpoms. That whole experience took me by surprise. I always thought rebound would last two, three, four weeks max but never three months! I was miserable while on spring break and not able to have with me liquid gaviscon and other medications and remedies that were available to me while I am at home. I woudl hate for someone to spend their money on a good vacation and be miserable like I was. However, I had been off Aciphex for nearly two months at that time and was not about to go back and start that crazy cycle all over again.

I think PPI's may be lifesavers for some people. I just wish doctors who prescribe them provided us with more detailed information so we can make better choices.

I just wanted to say that I agreed with everything in your post.

Rose
 
I started 40mg Zegerid (PPI) daily in February this year.

I knew I was going to be on it until at least July so I contacted a pharmD for advice.

I posted this advice here and again this is what he told me to do to avoid a rebound:

"Start by cutting the tablets (Prilosec) in half and take half of a tablet every day for 2 weeks, then try half of a tablet every other day for at least 2 weeks. Also take famotidine (Pepcid) or ranitidine (Zantac) if needed on "off" days. You can also take Tums or RolaiRAB on an as needed basis throughout and after the tapering process. Tapering should take no less than 4 weeks and preferably 6 weeks." (Zegerid is a capsule and that's the reason he said to use Prilosec.)

I went to my GI doc July 2. He told me I could get off the PPI. He also told me to take Pepcid Complete 40 mg in the AM and 20 mg at night to try and prevent my stomach and esophagus from getting into the shape it was in in February. I had stomach ulcers.

My husband has a terrible memory and all he could remeraber the doctor telling him following my second gastric scope and esophagus dilation on July 6 was "Everything looks good and stay on the Pepcid Complete." Then the next day he remerabered doc saying I had "tiny polyps" in the esophagus. I have to wait until my follow up appointment to find out what my condition really is.

I'm waiting until I finish the Prilosec system before starting the Pepcid Complete (in the AM).

I just wanted to say that the pharmD system seems to be working for me. I take the 20 mg Pepcid Complete at night. So far the reflux hasn't been too bad. I do take Mylanta in between. I think I will be able to stay off the PPI. I know it will take some determination and prayers.

When I finish the Prilosec system, I will take the Pepcid Complete in the AM and at night.

Wishing all of you the best.

Blessings, Annie
 
SounRAB about right. For the past week I've been taking them and I just can't stand the side effects. Last night, my whole right arm hurt, kind of like fibromyalgia and I've been getting tiny muscle spasms all over. I think I'm going to have to brave it without for the trip. I am taking Zantac, Gaviscon, Tums, DGL with me...and in case of emergency I do have 40mg Omeprazole which I've taken before when I had to switch (due to insurance reasons). I just can't understand why all these years I never had effects like this from Aciphex and now (after a 6 week hiatus from it earlier this year) I have them. I've been on and off the Aciphex for the past 5 months trying to figure out what to do and every time I go off, the problems stop.

And yes, it's REALLY hard not to think about this. It's on my mind every day, all day it seems.
 
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