Hi all,
I've only been on the forum for a couple of weeks but am surprised to learn that some people who've been on Pred for a while, are only just beginning to take a supplement.
My GP prescribed Omeprazole, first thing in the morning, and Calcichew-D, for after my evening meal.
Is is that unusual or do most of you have these as well?
I also take omeprazole once a day and adcal twice a day. I also take Alendronic acid once a week - I seem to be ok with this though I know some people have a reaction to it....
Not unusual, I was given Adcal as soon as I started taking taking steroids 15+ years ago. I was already on Lansoprazole due to acid reflux caused by a hiatus hernia.
There are patients who are unable to take either calcium or the PPI due to other medical conditions.
I have been on Pred for three years and have never taken a supplement. Why do you need the supplements??
Calcium with D3 (and you really should get other nutrients as well but that doesn't seem to be the standard protocol) because pred can cause bone thinning. The other two are very questionable and should not be taken unless there is a proven need.
As far as I know, Omeprazole is not a supplement, it is a drug taken to prevent irritation of the stomach. Some people have a problem with this when taking prednisone. I found that I had this stomach trouble only if I tried taking NSAID pain killers (aspirin, ibuprofin, etc.)- I tried it at another time of day from when taking the pred but still got a sore tummy so I switched to Tylenol (acetaminophen).
Unless a person has another stomach problem or has reacted to prednisone, I don't think Omeprazole is given as a matter of course with prednosone.
A calcium supplement with vitamin D is normally given since, as Anhaga says, prednisone reduces the calcium in the bones.
Yes, it seems odd to me that the PPI and the bisphosphonate are prescribed so freely as they both can have serious side effects. I know there is a place for these meds if they are really needed, but they are not like candy, any more than pred is, and should not be prescribed without definite need.
I was prescribed this by the rheumatologist as I had some reflux.
I also am on methotrexate as well now and was prescribed folic acid as a supplement to that. I am now waiting to see how that all balances out. I would love not to be on so much medication and hope it is all helping - I think it is:-)
Yes, I take Adcal D3 daily and also Ranitidine (similar to Omprazole which didn't agree with me). I too have Alendronic acid but as an annual infusion to bypass the stomach. This is necessary as I have osteopenia (both my 94 yr old parents have osteoporosis) and obviously pred is not good for bones. One thing leads to another in this world of being pumped with different drugs 😞
I don't know I do need them as such. I understand the Omeprazole is given to ward off irritation of the stomach, though it's not something I'm generally prone to. The calcium supplement is to prevent osteoporosis.
Well at least folic acid is an essential nutrient, which I believe can be depleted by mtx,so that makes sense, like calcium/D3 makes sense when on pred.
I was only given pred to start with. When I mentioned vit D and calcium to my rheumie he showed surprise and blamed me for not mentioning it! I did not take Omeprazole or equivalent as I have a coated version of pred.
I wasn't given Omeprazole by my Rhemy at the start of PMR. It was only after a check up with my GP that it was highly suggested. I resisted as I haven't had any stomach issues with Pred. Even taken on an empty stomach. Her response was: once you do have problems, it's too late. Better to prevent. So, I do take Nexium.
As I have to take it separate from Pred, separate from my AM thyroid meds and separate from my noon vitamins (which also include Vit D and calcium) I often forget. 😁
I take Calcichew twice a day and Alendronic acid once a week both to counteract the effect of steroids on bone density, which apparently can make women in particular more susceptible to osteoporosis. I have taken Lansoprasole for much longer, well before the PMR came for a totally unrelated issue, and I'm not able to see any connection. Is there one? I would be very interested to know. R
Reading the discussion, I am wondering what the difference is between coated and uncoated pred? I find I do get terrible acid reflux at times and at others not. I haven't taken any notice as to whether the pills are coated or not and wonder if this may have an impact? I would rather not take the PPI but have to at times. Thanks.
Omeprazole isn't a supplement - it is a "stomach protection" measure, it prevents the production of gastric acid. I have never taken it and many people either didn't take it at all or stopped because of side effects. It is the latest generation - the older ranitidine/Zantac does the same job with fewer side effects.
Everyone should have been given calcium/vit D supplements from the start - but there are people who have never taken it whose bone density has remained fine. You should have 2 tablets a day usually - taken separately as the body only absorbes so much calcium at one time. And it shouldn't be taken within about 3 hours of the pred - it interferes with the absorption.
Pred for breakfast, calcium for lunch and dinner...
In the UK the uncoated pred is white and the enteric (coated) red.
i was given alundronic at first to protect my bones, but had side effects and my dentist was not happy. with me on on it, said he couldnt do treatment apart from fillings so told my doc and he changed me onto calceos which i was taking 1 at morn and 1 in the eveening. but now i am down to 2 mg of pred i just take 1 at morn
You.ve got it - the enteric coated ones were/are given to those who, generally speaking, already had gastric issues. It by-passes the stomach and is absorbed lower down in the gut. I couldn't take the uncoated ones at all, even with Lansoprazole.
There was a push a few years ago to get everyone on the uncoated ones (which is how I know I can't take them) on the grounds that it was a cheaper process even with having to prescribe a PPI alongside them. The world turns round though and both varieties are now roughly the same cost. The 5mg tab is red and the 2.5mg is brown. The 2.5mg is only available as a coated tab.
Enteric coated pred is only available in the UK as far as I know. "Ordinary" pred is usually white, enteric coated 5mg pred is red, 2.5mg brown.