Weaning off a PPI tips?

Digestive health
1

Currently been taking 40mg Nexium to ''heal'' gastritis (not confirmed via endoscopy though) was originally taking 20mg Nexium from March - early May when I successfully weaned myself over a duration of 3 weeks, as I dislike taking tablets of any kind and surprise, surprise felt so much better off the tablets. 

Unfortunately, a few weeks later had a bad gastritis attack and was hospitalized on the 4th June, due to losing a significant amount of weight and not being able to eat anything over the course of a few days.

They finally performed an endoscopy no H.Polyri plus was officially diagnosed with mild gastritis. 

So I was then told that the best way to heal was to take the medication so I've been on 40mg since June 4th - although they do enable to me eat I'm on a bland diet (bananas, oatmeal, pears, honey, plain fish, chicken, eggs) for the past months. 

I decided to lower my tablets on the 4th September after 3 months of taking them and tried chocolate for the first time that week on a lower dose and felt my stomach digested for better on a lower dose of the tablet. 

I lowered the same way I did last time by cutting 10% - 15% of the tablet off each week. 

Anyway got down to half a tablet this week and since the past then 4-5 days ago out of nowhere had a really bad burning in my throat like its on fire!! I have never experienced acid reflux other than the odd time here and there over the past years but wow nothing like this! It was so painful I decided to take a full tablet this morning to ease the symptoms again. 

So my question is it was pretty easy for me to wean off 20mg of Nexium and did not experience any difficulties getting off and no reflux rebound. 

Any tips as to how to wean off the higher dose and should I keep taking a full tablets again for a few days to let my larynx etc settle down after the burn and then try again.

Also what is the best way to do it? By cutting the tablet, or reducing via 1 day taking it one day not etc or by lowering the dose to 20mg? 

Please only tips and tricks of the best way to get off PPI's as I will keep trying until I am succesfully weaned off. 

Also diet recommendations when getting off PPI's last time I was eating Peanut butter daily to gain weight after losing it (not doing that anymore learnt the hard way!) and could get off fine so was very suprised at the acid/burning this time around!

Any tips would be greatly appreciated.

Thank you 

2

I can't comment on coming off the PPI's but if you haven't already heard of it, it may be worth researching low FODMAP diet? X

3

I just would like to generally weigh in regarding 'splitting tablets'.

Only split tablets please that have a splitting line/ are scored (Nexium does, I think, but e.g. enteric coated Somac = Pantoprazole we had doesn't, Somac must never be split! Many other meds must never be split like Tramal)

Even splitting (dose) is otherwise hard, the split part is exposed to air (they are often coated for a reason: air, stomach acid) and the exposed drug might not be stable!

Nexium will be ok, but others might take other PPIs or medication and think of 'great, splitting'.

I have no idea how to wean off Nexium correctly.

Only, that it has to be done over weeks to avoid rebound acid hypersecretion.

I think you wean down the dose every week, not skipping a day.

Like 40, 20 if possible 10, 5mg  (lucky Nexium can be split!) over  a period of 8 weeks and then taking some 'milder' acid meds once the PPI is stopped for weeks before going off completely.

Do docs or pharmacists give some advice?

All the best!

4

Will do, thank you  

5

Unfortuntely so far doctor has been no help in regards to the entire situation! ​

Pharmacists where I live unfortuanetly neither they all say to stay on this medication long term (which I am against).

Anyway thank you for your tips regarding pill spiltting makes sense!

Will have look for Nexium in smaller mg doses that might be a good way to go! Thanks

6

When you are on PPI's you are on them for good. I've tried many many times to go off them but again get bleeding gastritis (erosive gastritis). I'm 24 years old... Have barrett's, GERD, GASTRITIS and other. 

You can manage your gastritis but only with longterm diet and no coffee, cigarette, alcohol and fast food for good.

7

I am no doc or pharmacist Lucy, but I always thought you couldnt split omerprazole or esomeprazole as they contain "granules" that have to be delivered to the correct part of the digestive system to be effective. i would read the enclosed leaflet in the pack thoroughly & if you don't find the answer in there, check with a pharmacist a your regular chemist. x

8

Some granules are coated itself. 

Esomeprazole (Nexium) is scored, you can split that one, the gransules are each coated

whereas Pantoprazole must not be split for sure (is in the 'never split' list in internet)

I am not sure about omeprazole, but I think it is scored as well.

Anything scored can be split, but yes, rather don't split any medication if not sure and if not splitting line is marked.

9

There's always a way. Head up

10

I'm not saying there isn't, I'm just saying that it's really hard with today's dynamics of life...