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preparing for PPI taper


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I'm supposed to jump off Klonopin on Monday (rather scared of that, but that's another story.)  If I don't have a horrendous acute phase, I'd really like to start tapering my PPI pretty soon after I jump off.  I've only been on it for a little less than four months, but I feel like it might be causing me problems -- vitamin deficiencies, protein malabsorption leading to weight loss, etc.  I apologize for the TMI but I'm getting a lot of diarrhea with undigested veggie/fruit skins and bits of nuts when I eat those foods so I know I'm not digesting properly. 

 

I only had mild reflux when I was put on them (and it may have been caused by the benzos.)  My GI doctor thought they would help my "nervous stomach" but honestly they're not as I have more diarrhea than ever and I still get nausea (probably because of withdrawal since it's not constant or anything).  I honestly think I could do without them.

 

I don't know how to taper though.  I'm on 60 mg of Dexilant, which is probably the equivalent of 60 mg of Prevacid (the two medications are similar).  It's only one pill though and it has this weird time release formula with two releases so it lasts the full 24 hours or whatever.  In other words, I can't cut my dose of it directly.  The Dexilant does come in 30 mg strength but I'd have to wait all the way until late October when I see my GI doctor to get that, and then probably another few weeks while it clears with my insurance.

 

I'm thinking I can probably use OTC Prevacid to taper instead?  If so, how would I do it?  I was thinking cutting back to 30mg for a certain period of time (but I don't know how long that period should be), then to 15 mg for a given period (again, don't know how long), then every other day for a couple weeks substituting with Zantac, then maybe every three days for a little bit and then work on cutting back the Zantac?

 

What else should I get to help with this taper?  Probiotics, probably...is DGL good?  I've seen some people recommend it on here.  Anything else?

 

And then there's the diet problem.  What CAN I eat during this taper?  I'm already very skinny (I don't know if I'm actually losing weight, but I'm not gaining it.)  Yesterday I ate hamburgers, hot dogs, peanut butter in an attempt to put weight on (though it was all from Whole Foods, so I was at least eating the non-processed stuff) but it was like it all sat there and then went straight through me this morning.  I know that kind of food is out on a GERD diet though...anyone have any recommendations on what I can eat to keep my weight up during the PPI taper?

 

If anyone has any experience with this so I can go ahead and start buying stuff to get prepared for this taper, I'd really appreciate it.  I'm a little scared of this taper as well, but I honestly feel like this medication is doing me more harm than good in the long run.

 

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why are you trying to tapper your ppi? for the most part ppi's dont need tapering. on the rare occasion you can get rebound acid production if you quit a ppi cold turkey. but thats usually seen in people who are taking high doses for extended periods of time. youve only been on it for 4 months? if you insist on tapering. get some otc omeprazole. and do 40mg for a week then 20mg for a week. then 20mg everyother day for a week. but i think its over kill.
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I think that you are wise to taper your PPI.  Acid rebound is far from rare in people who stop using PPI's or H2 Blockers, so you would be well-advised to taper.

 

The schedule that vardenafil gave you looks pretty good  :thumbsup:  I did that when dropping from 40mgs Nexium to 20mgs.  It might be a good idea if you had some other natural acid soothers or possibley some Zantac on-hand when you begin tapering, just in case you have the odd flare here and there. 

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I think I'll probably end up using OTC Prevacid rather than omeprazole, simply because that's the "similar" drug...I'd hate for something to get out of hand because I introduced a new drug, basically.  Last thing I need!  I do have Zantac...as far as natural acid soothers what would you recommend, Bevoir?  I've heard of DGL but not much else.
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  • 2 weeks later...

Bumping this up since I've come to some conclusions about my stomach problems and what got me on PPIs on the first place.

 

I had a brief stint on Klonopin for a week in March.  I never thought much of it, but now that I have thought things through I realized that the repeated "stomach viruses" I were getting were also accompanied by other, unrelated symptoms such as dizziness and rapid heart rate.  I have now decided that all of my stomach issues were somehow caused in one way or another by benzos, and those "viruses" were actually withdrawals.  Moreover, I never had heartburn/reflux before benzos, so it really all adds up.

 

So I guess what I'm saying is I don't think I need to be on PPIs for much longer.  I honestly think they're giving me annoying side effects due to the low stomach acid -- burping after every meal on and off for hours, for instance.  I'm also afraid I won't heal or will heal much slower on them since they interfere with protein digestion and we need protein to help with the healing process. 

 

I'm a little scared to start the tapering process with the PPI as acid rebound sounds very scary and I've read some sites where people say it can last for months.  However I really don't think that staying on this drug long-term is the best thing for me at all! 

 

Bevoir, I know you mentioned cutting your Nexium in half -- how did that go for you?  Did you have any acid rebound and if so how did you manage it?

 

I'm also a little scared of introducing the Zantac later on since it's another drug my body isn't used to and it might flare me up.

 

I know I've seen several people around this board who have come off PPIs successfully -- if you're around and you see this, I would appreciate your advice! 

 

Plan right now is to go from 60mg Dexilant to 30mg Prevacid, down to 15 mg Prevacid, then maybe every other day from there?  Don't know how long to take with each reduction, if that's a good plan, what to do after the every other day...how much I'll have to restrict my diet (I've already cut out spicy foods, most dairy (yogurt I seem to be fine with), most tomato-based products (I hope this won't be permanent -- I'm part Italian and miss my pizza and pasta dishes now and then!), and although I've been able to tolerate red meat fine right now I'll probably have to go off it for a time to do this...)  I've added in probiotics to hopefully help this process, but that's about as far as I've gotten.

 

I appreciate anyone's help in advance -- I'm supposed to see my GI doctor in about 3 weeks but I have a feeling he may just tell me I can stop cold turkey.

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I've been tapering from Pepcid AC (an H2 blocker)for about 4 months. I began at 40 mg in early July and will be finishing my taper this Friday. Right now, I'm at 2.5 mg. I have had very little return of acid reflux, only a little in the last few days. And, I think that may be due to not making sure I drink enough water to get my vitamins down.  ;) My stomach has felt tons better since beginning to taper. I was having lots of stomach pain in July, and, I have basically none now. So, I think that the medication was actually hurting me (a lot) and not helping me. You've made a good choice in getting off the PPI's.  :)

 

Nicole

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  • 3 weeks later...
I still haven't started this taper :(  I have no idea how to do it and of course the doctor was no help.  I feel bad a lot now and I'm stuck in a catch-22: I'm afraid tapering now might make me worse, but I'm also afraid the PPIs are making me worse too.
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Does anyone know if there's anything out there about how to get off PPIs without getting really sick and losing a lot of weight (that I don't have to lose)?  I tried to join another forum about it and I've been scouring the Internet for weeks now and nothing.  No one is able to help me.

 

I'm so sick and scared.

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Hello Aj,

 

I was thinking that a GI doctor would know. I met with my Gastro doctor during my benzo taper and he was very helpful when I was getting colon cramps. Maybe that specialty of doctor could help.

 

What do you think?

 

Love,

Summer :smitten:

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I have a GI doctor -- I met with him Thursday and he just told me to take it every other day for a couple weeks and then stop.

 

They can be as clueless when it comes to withdrawing from these drugs as regular doctors are about benzos.

 

:(

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And the people on these other forums are pretty much useless -- they don't tell you anything to help you at all.

 

I am literally about to break down in tears over this and how messed up my stomach is.

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What are you taking ?  Have you thought about dropping 1 dose per week....see how you feel....then eliminate 2 doses per week. 

I was able to get off prilosec..and can't remember how slow I went, but it took me about 6 weeks.  I replaced it with zantac toward the end.  You are correct....it can be difficult to get off of....when you have taken it for a while.

 

Vertigo....was tapering off of a PPI...not that long ago.  Maybe you could find out through the search box, how he tapered.

I got off prilosec first, because it was causing some of the bad side effects, that you read about.  I wish I had never taken any PPI's.  I have been off for 2 years....so you can do this. :thumbsup:

 

Sunny girl

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Sunny girl,

 

I remember from a previous post you'd come off a PPI, in fact I was just trying to find out if you had a blog or something so I could ask you about this!  Thank you so much for responding!

 

Here's the problem.  I'm taking a high dose (60 mg) of something called Dexilant.  It's similar to Prevacid, except it's formulated so that you only have to take it once per day but it releases the medication twice or something funny like that.  I think I need to come down on the dosage first before I start skipping days.  I was going to ask how high of a dose you were on.

 

I've read Vertigo's thread several times.  The only problem is that he was on the lowest dose possible of the Prilosec so he just started skipping days and using Zantac right away.  I'm also scared that the Zantac might flare up benzo withdrawal symptoms.  He also used several natural remedies if I remember correctly.

 

I guess I just don't know how to do the dosage reduction properly...I'd have to switch PPIs to do it, I think I mentioned I was thinking of using Prevacid instead which comes in 15mg OTC...I think once I get down to the 15 mg once a day I've seen a number of plans as to how to do it from there, I just don't know how to reduce the dosage, how long to hold each reduction, etc.  It's like benzos all over again.

 

I think my PPI may be causing bad side effects too.  I can't tell what's withdrawal and what isn't.  Also I'm scared of losing weight that I don't have to lose because I don't know what to eat.  Lately I've been eating a lot of almonds and peanut butter.  Now I find out I might not be able to eat those anymore because they have high fat content and can aggravate reflux.

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aj,

 

I took Nexium, and Protonix, too.  They all had side effects, at least for me.  Nexium, probably helped right after my c/t.  I had severe stomach pains, and also felt pains in my heart which I think now was spasms.  My doctor thought I needed to continue a PPI, but I could tell they were causing me to have more symptoms.  You have read about the side effects of these drugs, when taken long term.  Some people really need them, but I don't think that was the case for me. 

I think it would be wise to come down on your dosage, too.  My dosage was not as high as yours.  Is dexilant in a capsule, or pill form ?  You could probably switch to Prevacid, since they are similar...and take an eqal amount. Is that what you had in mind ?  If you have no problem, then gradually start reducing the amount.  It shouldn't take as long to taper, as the benzo.  Take your time though, and don't rush.  You could take some antacids, if you need some help.  That's what I did.  Don't add too many things...or it could confuse your system.  You know all of that, I know.  Watch what you eat.  Bland worked best for me...and I still have to watch my diet.  I am having the first flare up with digestive symptoms, since benzo free.  IBS, it seems.  I think the peanut butter, and almonds...you may have to put on hold for a while.  :laugh:  Fat can aggravate reflux, and I get heartburn from it. 

 

You know what ?  I think the PPI's caused me to lose weight.  I never felt like my food digested properly while I took them.  I ate lots of yogurt, turkey, chicken, fish, green beans, potatoes, carrots, bananas, applesauce, canned peaches, asparagus.  Raw foods bothered me.

 

I will be watching your progress with tapering.  Take it easy. You have plenty of time, and you don't want to do anything that will hurt you.  :therethere:

 

I know you need support with this taper...and feel alone.  I did...and I was scared.....but it all worked out. ;)

 

 

 

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Dexilant is in a capsule.  I don't think I really need them either.  As far as with the Prevacid, I wasn't thinking of switching to an equal amount but just switching to make the first cut, whatever that would be.  Since the OTC pills are only in 15mg strength, I don't want to be taking 4 of them a day for any amount of time.  I'm a college girl trying to manage a tight budget (my dad's insurance actually covers the Dexilant completely) and so the less of the Prevacid I have to buy, the better.

 

I just don't know what the first step down should be?  Should I do, say, 45 mg for a given amount of time?  And how long?  And then down to 30 from there, then down to 15, and then start skipping doses?  I did a fairly fast benzo taper (shouldn't have but I had a limited amount of meds)...it was about 2.5 months and I feel like any plan for this will last at least 2 months.

 

I was just eating the almonds and peanut butter to try and gain weight :(  Plus they're fast and easy when you have college classes.  It's hard to figure out what to eat when you only have 40 minutes or so to grab lunch...and can't just grab lunch somewhere either because I have a bit of a MSG sensitivity.  I've really got to figure out how to cook fish.  I've never done it.  Then again, the yogurt might work.  I eat a fair bit of Greek yogurt.  I wonder if that would bother me.  Also, I wonder if granola and/or oatmeal would bug me.  I eat those a lot too.

 

I DO feel very alone.  I'm not sure if I'm ready to start this yet being only just over a month benzo free but I can't help but thinking this medication is making me worse.  Yet again I've been thrown into the realm of clueless doctors and unsupportive family members.  Even on PPIs pizza and tomato sauce trigger reflux (I can eat raw tomatoes though?  But I know that'll have to go) and my dad won't stop bugging me and getting mad when I say I can't eat that stuff.  (Thank goodness I only had to come home for a few days and don't have to deal with it after this.)  I wonder if it'll ever get back to where I can eat those things...I could before benzos...my reflux and heartburn, although fairly mild, were ALL benzo-related from what I can tell.

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I think you have a good plan dropping to 45 mg, and see how you are after a week or two.  If you need something extra, then you could take a milder antacid.  The idea is too gradually reduce, so that you don't have acid rebound.  You may feel some discomfort, but don't be too alarmed.  You can always increase again, if you think you are going too fast.  Just thinking....that is a high mg your doctor put you on.

You might want to consider starting this at Christmas break....if you think it would be easier on you.  It is also possible that you might not feel any symptoms at all.

 

If your reflux and heartburn were benzo related, then you probably will be able to eat whatever you like, at some point.  Oatmeal may work fine for you...toast...some of the soups.  You'll find things that you can eat.  Don't worry.

 

Remember that stress causes more acid production...so avoid it..and find ways to de-stress.  I feel stress and tension as symptoms right now....but most likely I am having to learn how to cope again, without the drug. 

 

I'll be checking in to see how you are.  :hug:

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I don't know if starting it at Christmas break will be the best idea because I'll be home then and my dad will freak out if I'm not eating "normal."  As far as avoiding stress...it's difficult and darn near impossible as a college student, not to mention the benzo withdrawal.  I'm trying but it's so hard.

 

I'm just scared of staying on PPIs too long because I'm starting to wonder if I don't have vitamin/mineral deficiencies that are causing some of the symptoms that I think are withdrawal.  Anemia is something that comes to mind.  I don't really want to have blood tests done because they're expensive and they scare me too...I passed out after one once.

 

I hope toast and bread will be okay...I know some people have a problem with wheat.

 

It is a high mg...he just gave me samples and then prescribed the stuff and I didn't even really look at how many mg it was until later (stupid and naive, I know.)  I don't know why he thinks I can just take it every other day and stop.  I felt so awful having to put that poison into my body this morning...

 

I don't know what I'm going to do yet...as far as when to start...I think the earliest would be next weekend.  I've been in what I think is a benzo wave for the last four days...lots of depression, shortness of breath, shakiness and jitters, etc...and I hope that's what it is...a benzo wave and not a real health problem...and that it will pass soon.

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I just want to say thank you again though...I'm hoping this wave passes soon but I am so glad to have someone here to check up on me that understands that doctors don't always get it...I'm ditching the other forums...they're all "find a doctor, find a doctor, find a doctor!"

 

I'm sorry, I really don't have the time, money, or feel that I can deal with the stress of finding a doctor just to advise in a taper off a medication.  In fact the reason I went to my doctor back home after I was at school (it was a doctor at school that put me on Klonopin) was for a taper plan off the Klonopin.  I now have him to thank for trying to take me off cold turkey, giving me Ambien that gave me a paradoxical reaction, and updosing my Klonopin so much and pulling me off so fast that I'm now 10 times more miserable than I probably would have been if I just stayed on my original dose.

 

Don't read my comments the wrong way...doctors are certainly needed and all.  I just have little faith in the medical community when it comes to advice in tapering off of drugs.

 

Not to mention you guys are the only ones that also understand I'm in benzo withdrawal!  ::)

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I was going to start this tomorrow until I read the following statements on another message board about getting off PPIs:

 

"Overall I guess I can say that Things are slowly progressing (The only thing I'm on is Zantac) but that has come at a cost of avoiding many foods (even potentially safe ones) and dropping too much weight."

 

I can't afford to lose ANY weight!!!!

 

And worse yet:"I have to say that it took longer than two months for the rebound to go away. At first it was unbearable, and I spent most of my waking hours dealing with it.

 

I have a life to live!  It's hard enough fighting withdrawal but I've done a very reasonable job of it so far all things considered...and to read this!

 

I'm practically in tears right now.

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