# Getting ready to stop Prilosec...ADVICE PLEASE!



## h8ibs

Hello everyone,I've experienced acid reflux for many years. About 9 months ago, I began taking 20 mg Omeprazole (generic Prilosec) daily. Whenever I try to stop, the reflux begins after a day or two. I've heard of acid reflux rebound from stopping PPI's, which is probably what I'm experiencing.I have a few questions I'm hoping you can answer:1.) Should I gradually wean myself off?2.) Can I cut these pills in 1/2 so I'm taking 10mg/day instead of 20? (If not, I can try every-other-day with the 20mg.)3.) Can I take an H2 blocker (Zantac or Pepcid AC) while I'm trying to stop the PPI?What other advice would you have regarding stopping PPI's? Also, just an fyi:I'm a mid 30's male, not overweight, but get acid reflux very easily if I gain any weight at all. Even just a few pounds. My plan is to re-evaluate my diet and exercise plan and lose the 5-8 pounds that might be causing this acid reflux.Thanks in advance for your responses!


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## Kathleen M.

I usually just go to every other day and have an antacid (tums or something with calcium if you tend to diarrhea and something like maalox with magnesium if you tend to constipation) on hand for if I need it.You might also want to sleep with your upper torso at a slant (either a wedge pillow or put a brick under the legs at the head of the bed).You could also use zantac or H2 blocker, but I usually do a wean off those when I go off of them, so I usually just go to the antacid for any bounce back symptoms.


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## h8ibs

Thanks Kathleen. I'll try to wean off by reducing to every other day for a few weeks. As for the antacids....I tend to "D", but my D gets worse when I take tums. Maybe I'll try something else.Thanks again for your input!


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## BQ

Some TUMS have sorbitol in them so that may be why your D gets worse when you take them. I wish they wouldn't put sorbitol in OTC stuff... sigh...


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## Reds

I just quit Prilosec about two weeks because I was having some tests run, and my doctor said I had to get off Prilosec or any antacids to receive accurate results. Anyway.....its been strange. I have had horrible bouts of heartburn but it was worst when I first started, presumably because of the rebound. At this point, I have some very bad bouts but with less frequency. My stomach burned like crazy as well, bu that seems to have subsided. What I've been doing to deal with it:- I have drinking TONS of water, always having it with me. It seems to help.- I use antacids, usually when I can't tolerate the heartburn.- Apple Cider Vinegar does seem to help, though I can't tell how much.- Aloe Vera Juice also seems to help, but I've heard it can cause diarrhea, which is doubly bad for IBSers. I got George's Aloe Vera Juice, which says they take out the substance that irritates the GI tract. But I just can't tell if it upset me or not. - Finally, you really will have to watch what you eat, but that is probably a good thing in the long run. Carrots, apples, potatoes, grapes, fish, chicken breast, etc. are actually pretty good for GERD. Basically, anything that's is bland will be better. However, more than spicy food, I would avoid foods high in fat or fried foods (which you should be avoiding anyway).But this is why I came on here to post after lurking. I was diagnosed with GERD about 6 years agoa and developed IBS. I tried numerous times to quite PPIs (mainly Prilosec and Nexium) but the pain was too bad (I never heard of a rebound until two weeks ago). I have pretty loose stools and developed stomach gurgling, spasms, and tons of gas over the years.Well... basically that has all stopped for the most part. My stools still aren't "normal", but they are better and the fact that I don't have gas or abdominal pain has been wonderful. I think its that the food is being properly broken down now that I have some acid to do its job. That's pure speculation on my part though. It may very well not last, but right now its been great. Now, the problem is that I have heartburn and will have to make a decision on how I want to deal with GERD. However, I'm happy I quit Prilosec at the moment and won't be going back on it ever. Maybe I'll try another medication later down the road. Hope this helps you, and those who might have IBS and GERD.


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## h8ibs

Stopped PPI's on Feb 1. First week, I cut back to every-other day. Then stopped. Acid rebound effect has been HORRIBLE. Worse reflux than when I started taking the PPI.Tums and other antacids don't work for the bounce-back. So know I'm using Pepcid AC H2 Blocker (20 mg 1x/day) to deal with the bounce back reflux. Any ideas on how long this Acid Rebound can last? I suspect that this is going to be a slow and gradual process. I'm afraid that the H2 Blocker will just keep the rebound effect going on and on. This is horrible!


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## Kathleen M.

The bounce back should only be for a few days.However, if you still have a weak sphincter or a hiatal hernia you may always have reflux as the meds AFAIK don't heal that.If you are doing badly for more than a week or two after stopping I would call the doctor. You may need to be on something for the long term.


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## h8ibs

So I decided to a little digging...actually, a LOT of digging on this "Acid Rebound" issue. I've looked at FDA reports, findings of studies, etc and was shocked to learn that Acid Rebound is a well known phenomenon when PPI's are discontinued. In fact, it is documented that this rebound effect can commonly last from 1 to 3 months. Funny how the doctors who prescribe PPI therapy aren't making a concerted effort to inform their patients about this. "SIGH"


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## annie7

oh dear..rebound for one to three months... so now i'm wondering this: i've been taking prilosec for a week and then i went off it and switched to cimetidine 200 mg once a day to see how i'm doing and still have really miserable reflux symptoms--acidy mouth, pain, lots of nausea..even with a totally bland diet. mylanta etc does not help at all. previously cimetidine worked well for me with this regimen.how do i know if it's still the actual reflux still going on or whether i'm experiencing rebound?? i'd been going by what kathleen said in the previous post about if it last for more than a few days ( or a week or more) it's still reflux. how do you know what's really going on--the original reflux or rebound??


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## Kathleen M.

I don't know if there is a good way to tell. I've never had rebound problems for that long after any drug, and I'm not sure what the limit is.The problem is with a chronic condition you don't expect to have zero symptoms when you stop medicating it. Reflux tends to be a chronic issue. I have a small hiatal hernia so will always have some level of reflux issues. Just sometimes it settles down enough I can be off the meds for awhile. But if I ever need to take a week of NSAIDs for an injury everything flares right back up.I don't think a couple of days of a med will lead to months of rebound. Usually you do need to have taken something for awhile before you start seeing issues.When they study the rebound effect people are on the med for 8 weeks not a few days.http://www.ncbi.nlm.nih.gov/pubmed/1936255...mp;ordinalpos=1They did a 5 day studyhttp://www.ncbi.nlm.nih.gov/pubmed/1150060...mp;ordinalpos=3And that was not long enough to induce rebound.


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## annie7

thanks so much for your input and info kathleen--very helpful!!h8ibs--you're right about the prescribing docs. i went to my doc with with questions about how long could i safely take prilosec otc since the instructions that come with it say to only take it for fourteen days and to allow for at least four months to pass before taking it again--to check with your doc if you need treatment before the four months have passed. he assured me i could disregard those instructions and could take it for as long as i needed it, whenever i needed it. never mentioned rebound or the fact that ppi's can interfere with calcium absorption, which is a concern for me since i'm post menopausal.


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## Kathleen M.

One thing to remember about limitations on over the counter drugs is that if something is going on for months on end rather than for a week or two you should see your doctor.I think almost all of the "don't take more than" X days is because they don't want the liability if people use their product to avoid seeing the doctor.Chronic conditions need chronic treatment (as taking meds for a couple of weeks each year has its own risks as many conditions when completely untreated have serious complications). They also need you to have a doctor checking on them (because many chronic conditions do have long term complications). So if your doctor says it is OK to take something regularly that means you saw the doctor and you are not self-medicating and are likely to get any tests and screenings someone with your chronic disease needs.An acute problem that would resolve in a week or two whether you take medication or not is something that is fine to take OTC meds for a week or two without a doctor giving the OK. But if you need treatment regularly you should not be self-medicating without ever seeing the doctor.The makers of prilosec do not want to be sued when someone gets esophageal cancer because the OTC meds helped just enough that the person could avoid the doctor.


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## annie7

thanks kathleen. yes, that's essentially what my doc said---that those instructions were worded that way by the attorneys to avoid lawsuits...which also reminds me of my brother-in-law who thought he had heartburn (didn't see a dr) and started taking prilosec and then four weeks later had a heart attack and a triple bypass.


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## h8ibs

For the most part, doctors aren't much help (in my experience) when it comes to reflux. Probably because there's not much that can be done. They put a lot of faith in what their drug reps say. I just wish they'd be a little more open about what the side effects of PPI's are. For me, I'm managing the rebound w/ Pepcid AC 20 mg 1 x day.


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## annie7

good luck! hope pepcid works for you and the rebound doesn't last too long.


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## pghmember

overitnow said:


> I have handled both of those problems with a flavonoid supplement for over 10 years, after suffering from these problems for a prior 10 years. No anti-ds, no PPIs, not even any Tums. There are alternatives.Mark


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## pghmember

Just found this site while searching for advice on how to wean myself off Prilosec successfully. *I would love to know what flavonoid supplement you are taking.* I am seeing a naturopath and taking enzymes, which help a great deal. I admit to being "bad" about what I consume occasionally and then I pay for it horrendously! I know I need to become more rigid in adhering to the list of foods I can and shouldn't eat. Thanks.


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## lealouise

I have taken Prilosec for over 4 years. I began having stomach problems on and off over the years...come and go.. the thought occured to me that mayabe I should cut down on the Prilsec, to half a pill each day. When the burning got worse I went back to the full pill. OTC.Stomach got worse and my husband said " honey, I think you need to get off prilosec all together". I did, about 2 weeks ago. I was worried about the heart burn etc, how would I handle it. When it got to the point of needing help I took atums for relief. I was suprised to see I could do this!!! After doing research on the web I found that enzymes might help the problem thatprilsec was causing. I got some super digestive enzymes to help break down the protien and, even after 2 weeks, there is a differnce.I can't say more than that at this time, but for me, I will continue on this trail for a while and see what happens. I certainly do not wantto go back on prilosec after I read, and personally can attest to, the harm it can do to the body. I have wondered why so many millions of people suffer from stomach disorders. Research tells me that the processed foods we eat are devoid ofthe natural nutrients we need. We cook/process the enzymes out of our food which are needed to break down the protiens we consume. DAHWhat is the industry doing to us? Well now I'm sounding political so...I'll be on my quest to better health and better choices and more education. Thanks for listening, hope this may help you.


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## jpsimons

I'm also getting ready to get off Prilosec, I guess because of the long term calcium absorption thing, and because I read somewhere that proton pump inhibitors cause depression. I've taken one every day for like six years (I have a minor hiatal hernia). One thing I've noticed though -- one time I had a "herpangina" infection, it's a painful postule on your tonsils, makes it hard to eat. I hardly ate for 3 days and didn't need the Prilosec at all. I'm thinking the only way to do it is pretty severe dietary intake restriction. Wouldn't be so bad since I've got 5 pounds to lose. Still though, it's not going to be easy.


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