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Acid Reflux / GERD Message Board


Acid Reflux / GERD Board Index


I have an idea that could work for a lot of people trying to wean themselves off of omeprazole.

I'm on omeprazole 20 mg/day, have been taking it for about 8 months. I can't seem to get off this stuff either – my stomach comes back like a volcano every time after 5-10 days. First 2 times I tried were “cold turkey”, then after some searching learned about "acid rebound" and the “half dose” option (plus a strict diet regimen). I too am worried about the long term side effects, especially with vitamin and nutrient absorption and their effects on joints and bone, etc., etc., etc...

As to weaning oneself off omeprazole, most people have a hard time adjusting to a dose of 20 mg tablets every other day, especially the first 2-3 weeks or so... For this drug, typically it may be too much of a shock to the system. There are other drugs that require reducing the dosage 10-25%, waiting a month or so then repeating the process until the dose is low enough to finally stop – this could take over a year. These other drugs are also sometimes replaced with a more benign drug in the meantime.

It sure would be easier on your system to taper omeprazole to 15 mg/day for the first 3-4 months and proceed from there with a 10 mg dose, then a 5 mg dose. This may seem to take a while longer but a better chance of succeeding is better than not succeeding with no results (and the pain, frustration and depression that go with it). Plus I'm still reducing the dosage right off the bat.

The problem is with omeprazole 20 mg tablets, they cannot be cut in half or quarters with a pill chopper - this would negate the effect of omeprazole as it would be destroyed by stomach acids and not absorbed in the small intestine. The tablet has a coating so it can bypass the stomach acids and be released in the small intestine.

My friend said omeprazole was available in 20 mg capsules (I searched “omeprazole delayed-release capsules 20.6 mg” and there they were). He said to just open the capsule and inside are small time-release pellets which can be mixed in applesauce and drunk with a glass of water. That way you'd be reducing to “about” 10 mg dose every day by sorting the pellets in half (or as close to half as you can get). Still, it may not be much of an improvement over taking the coated tablets as omeprazole is very slow to release into your system. But still again, skipping a whole day every other day could well have some kind of yo-yo effect on your system and many days could be “unbearable”...


Now here's where the idea/suggestion comes into play. I was still thinking I need a 15 mg dose to start (to make things easier and more “guaranteed” results). So I said if they are pellets they can be weighed! :) So I did a search on “digital scale .001 gram accuracy” (accuracy down to the milligram) - and there they were. Now I could weigh the omeprazole pellets, take that number in grams and multiply it by .75 (75% dose) for a 15 gram dose! The same applies for a 10 mg (50%) or 5 mg (25 %) dose, etc...

I wanted to be sure I got enough accuracy in milligrams with these digital scales. The ones I liked were in the $150-300 price range (which can pretty much give accurate enough readings). In the end there were 3 brands/models that I liked – I spent a bit of time sorting them all out to make sure I got the right one. These scales may be a little pricey, but to me would be a tremendous bargain if they could help get me off this drug. These scales are so sensitive they come with a plastic or glass cover so when the air-conditioning or heat come on they could affect the results! These scales don't take up much space and are convenient and pretty much easy to use.

As for weighing the omeprazole pellets, just trim a clean square piece of paper (or wax paper) to fit on the weighing tray, also fold the paper in half (for dispensing). Then you just "tare" the scale so it sets back to 0 grams for weighing. Then just put your “75% or whatever dose” on a tablespoon of applesauce and take with a glass of water! :)

Another alternative to using a digital scale is to sort the pellets on a mirror or flat surface carefully with a razor blade into halves or quarters. I'm not sure how accurate this would be if done by eye, or if the “linearity” of the digital scales would be better at low milligram measures...

I hope this helps everyone as much as I think it should help me. Another advantage is you will not need as much of those H2 blockers or antacids (which can have their own acid rebound effect) to take as a substitute – if at all... I would also watch my diet closely and NO coffee, alcohol or tobacco (the usual triggers) whatsoever. Good luck!
Well, its been 28 days on my new low fat semi low carb diet and 18 days off 40mg nexium cold turkey. I no longer have to take Zantec 150mg 2-4 times a day. I am over the jump of the acid rebound phase. I had a scope done 3 days ago and it came back clean. I didnt eat for 20 hours or take any zantec. After that I only took 1 zantec 75 since then.

I hope my story gives hope to others trying to get off PPI's. With all the acid I had over the last 2+ weeks I was sure I had damaged my espohcus but I guess not. I had some mucas and tightness in my throat yesterday and today. I am still following my diet, but it's been hard not to try something tasty to eat like dark chocolate almonds or a hamburger on the grill.

I dont know if I am going to have mucas and throat tightness for the rest of my life but at least I am not taking Nexium as I stopped helping anyway.

I will keep you all posted in another week or so.

Don't give up. But if you havent gotten a Upper GI get it to make sure nothing is damaged or if you have any other issues going on in your stomach.

I will continue to take my align every night and my Wholezymes with meals for atleast 2 more months.
[QUOTE=gpinzone;4308610]Well, its been 28 days on my new low fat semi low carb diet and 18 days off 40mg nexium cold turkey. I no longer have to take Zantec 150mg 2-4 times a day. I am over the jump of the acid rebound phase. I had a scope done 3 days ago and it came back clean. I didnt eat for 20 hours or take any zantec. After that I only took 1 zantec 75 since then.

I hope my story gives hope to others trying to get off PPI's. With all the acid I had over the last 2+ weeks I was sure I had damaged my espohcus but I guess not. I had some mucas and tightness in my throat yesterday and today. I am still following my diet, but it's been hard not to try something tasty to eat like dark chocolate almonds or a hamburger on the grill.

I dont know if I am going to have mucas and throat tightness for the rest of my life but at least I am not taking Nexium as I stopped helping anyway.

I will keep you all posted in another week or so.

My rebound lasted well into three months. After that, it has been up and down as I have tried to adjust my diet to foods that do not give me reflux. I think I am following a diet similar to yours and using similar supplements. I can have decent days now. For me, giving up on offending foods has been hard but I am happy to do so if that is what it takes to stay symptom free or keep them manageable without medication.

I think there is hope to be PPI free but probably not completely symptom free even with a disciplined diet and the use of natural remedies like DGL.

Rose

Don't give up. But if you havent gotten a Upper GI get it to make sure nothing is damaged or if you have any other issues going on in your stomach.

I will continue to take my align every night and my Wholezymes with meals for atleast 2 more months.[/QUOTE]
To Rosebloom - Thank you so much for posting your experience. I quit Prilosec cold turkey 8 weeks ago and still suffering although I never suffered before the doc put me on Prilosec 2 years ago. Your posts have kept me going through the rebound and give me hope. Otherwise, I probably would have started back on the Prilosec. I won't give up though and will try the Apple Cider Vinegar. I already have Aloe Vera juice but doesn't seem to help. Again, thanks for all the information and encouragement.
[QUOTE=Marylebone;4310476]To Rosebloom - Thank you so much for posting your experience. I quit Prilosec cold turkey 8 weeks ago and still suffering although I never suffered before the doc put me on Prilosec 2 years ago. Your posts have kept me going through the rebound and give me hope. Otherwise, I probably would have started back on the Prilosec. I won't give up though and will try the Apple Cider Vinegar. I already have Aloe Vera juice but doesn't seem to help. Again, thanks for all the information and encouragement.[/QUOTE]

Hi Mary:

I think GERD is a chronic condition, but a liveable/manageable condition. Your system is likely still out of wack from the PPI. I think my rebound lasted about three months, but there isn't a definitive cut off. Maybe the symptoms got better after the three months, but who really knows if it was still rebound. I have now been PPI-free since January and whatever I experience now is probably GERD and not rebound.

I can now experience several days of nearly heartburn free or such mild heartburn that I can drink a glass of water or chew gum and have it go away. There are days, however, when I'll experience what I call an "attack" and it still burns and bothers me considerably. Sometimes I know there are triggers I can identify and sometimes not.

I think the low carb diet is helping along with the supplements. I no longer do the ACV daily, but only on the "bad" days and for a couple of days. Vinegar, even diluted in water, does not taste very good and it is hard for me to drink it all the time when I am feeling good. The aloe vera will not cure the heartburn but will keep your tissues from being irritated or soothe those that are already irritated by acid. I have found a chocolate flavored DGL at the healthfood store and pop a few of those during the day. That is easy to do and it does not taste bad. The regular/unflavored DGL does, unfortunately.

I would have gone back on the Aciphex too after a few weeks had I not done some research and found so much information here. Sadly, my family doctor never told me about rebound and I did not get much support there. At eight weeks, it is likely you are still on the rebound phase.

One other thing that has helped me is to stay upright (I mean standing, not sitting) after meals for a while. I usually go out to water my potted plants after dinner, and that keeps me from plopping down to watch television in the evenings for a while.

Try to keep a food diary to see what is irritating to your stomach. I found out I cannot have bananas and green tea, at least for now. These are two wonderful foods with great nutrients and health benefits, but both give me heartburn every time I eat a banana or drink green tea. I can fortunately eat a lot of other things, but it seems like my current diet consists of protein (lean meats), vegetables, nuts, and a little fruit. I can live with that for a while if I can stay off the darn PPI for good. I love bread, pasta and potatoes, but there isn't much of that in my diet right now with the exception of when I occasionally grab a bite from my husband if he is consuming any of those types of foods.

Keep posting here and letting us know how it is going for you. Others' posts helped me. My post has helped you and hopefully your posts will help others who struggle with this phenomenon in the future.

Regards,

Rose
Thanks for the info. I had an endoscope 2 years ago due to burning in my chest and there was a raw spot. I drank some Carafate? and took ppi's to get rid of it but then everytime I stopped the ppi, I got bad burning in my throat (which had never had before the ppi). When I learned that ppi's can lead to osteoporosis, I quit cold turkey. That was 10 weeks ago and I know the "rebound" can last 3 months or so. The past 10 days have been better as I am really watching what I eat, sleeping on a wedge pillow, and taking Gaviscon before bed. I have a colonoscopy in November so will talk to my gastro doctor then.
Rather than stopping a PPI cold turkey, I would suggest the following

1. Reduce your PPI to 20mg per day of Prilosec, nexium, or the equivalent of the other PPI's. Stay on 20mg for 2 weeks if you have been on a higher dose.

2. Stop the PPI, and start taking Zantac 150mg twice a day. Take this for 2 weeks. Keep some Gaviscon or Tums in your pocket for breakthrough symptoms.

3. Reduce the Zantac to 75mg twice a day. Take this for 2 weeks. Again, have Gaviscon or Tums avaliable.

4. Stop the Zantac, but always carry some Gaviscon (best) or Tums or Mylanta in your pocket, and take a dose as soon as you feel any symptoms starting.
[QUOTE=jonnstar;4730840]Rather than stopping a PPI cold turkey, I would suggest the following

1. Reduce your PPI to 20mg per day of Prilosec, nexium, or the equivalent of the other PPI's. Stay on 20mg for 2 weeks if you have been on a higher dose.

2. Stop the PPI, and start taking Zantac 150mg twice a day. Take this for 2 weeks. Keep some Gaviscon or Tums in your pocket for breakthrough symptoms.

3. Reduce the Zantac to 75mg twice a day. Take this for 2 weeks. Again, have Gaviscon or Tums avaliable.

4. Stop the Zantac, but always carry some Gaviscon (best) or Tums or Mylanta in your pocket, and take a dose as soon as you feel any symptoms starting.[/QUOTE]

I think this is a very sound step down approach to PPI withdrawal. I stopped the Aciphex cold turkey because I was so freaked out by the DEXA scan results that showed I had gone from normal bone density to advanced osteopenia on both hips. It would not have hurt me to gradually decrease the Aciphex to wean myself off more gradually. I did use Zantac generously during the withdrawal phase, but Zantac only took the edge off the horrible heartburn and multiple other symptoms I experienced.

I now realize my worst withdrawal symptoms lasted about three months, but my stomach did not return to normal for approximately six or so. "Normal" for me is baseline symptoms, not being cured. I still experience heartburn several times per week, but not daily anymore. I can manage it with Zantac and over the counter and other natural remedies, and have to be careful with what I eat and how much I eat. Same advice you read from many others here.

Otherwise, GERD without PPI's is manageable for me. But it is not symptom free as I wish it were.

But if I had to do it all over again, I think John's method is much saner than the way I went about it. I did not know better back a year ago, and had little to no help from my family doctor (whom, by the way, I have since changed).

Rose
Hello!
I'm having the EXACT SAME PROBLEM WITH REFLUX! I was on prilosec for 8 months (you can look at my posting to know a little more about my situation) and stopped it cold turkey because I was beginning to have side effects like blurred vision and vertigo, which was really scary. My family doc actually wanted to INCREASE the dosage, but that was a no no. I've been on 20 mg of pepcid a day, and it's been one month. Since I think the drastic reduction from ppi to h2 blocker (had to do all my own research on the subject) was harsh on my bowels, I'm increasing my dosage to 40 mg of pepcid a day tomorrow. Did you completely stop your ppi and just substitute with an h2 blocker as well? Please let me know Im so desperate at this point I just want to eat and drink whatever the hell I want again! All I had was a little heartburn and I didn't ask for this! Thanks,
Serena
[QUOTE=BlueSky17;4772200]Hello!
I'm having the EXACT SAME PROBLEM WITH REFLUX! I was on prilosec for 8 months (you can look at my posting to know a little more about my situation) and stopped it cold turkey because I was beginning to have side effects like blurred vision and vertigo, which was really scary. My family doc actually wanted to INCREASE the dosage, but that was a no no. I've been on 20 mg of pepcid a day, and it's been one month. Since I think the drastic reduction from ppi to h2 blocker (had to do all my own research on the subject) was harsh on my bowels, I'm increasing my dosage to 40 mg of pepcid a day tomorrow. Did you completely stop your ppi and just substitute with an h2 blocker as well? Please let me know Im so desperate at this point I just want to eat and drink whatever the hell I want again! All I had was a little heartburn and I didn't ask for this! Thanks,
Serena[/QUOTE]

Hi Serena:

If you have a chance to read over the entire thread you will see that this was a lengthy process of trial and error that took me many, many months. My rebound lasted for months. I did switch from the PPI to Zantac nearly cold turkey which is a regret I now have. Others have written here about how they went about weaning off from one to the other. I also tried many natural remediies such as DGL, Apple Cider Vinegar and others. Please take some time to look through the thread to get a sense of what to do.

Note of warning. You may never be able to eat and drink all you want again. My diet has been greatly altered in order to be able to live off the PPI. Not what you want to hear, I am sure.

Wishing you the best and a speedy recovery.

Rosebloom





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