Ah, so that's why people habitually shoplift Prilosec.

June 24, 2008 9:19 AM

How do I get off of Prilosec?

On doctor's orders I've been taking 80mg a day of Prilosec for four months. Out of desperation for something to pin my cardiac symptoms on, I was diagnosed with acid reflux and sent on my way with a prescription which did nothing for my initial problems but did saddle me with spending twenty dollars a week on pills.

Right now I'm taking 40mg every 12 hours, and the obvious answer to my question is to taper down. Unfortunately, the minimum step size is a 20mg time release pill and if I skip one I pay for it with two days of acid rebound that is just as strong as if I didn't take any at all. Can I split the pills without disrupting the time release action?

posted by bunnytricks to Health & Fitness (13 answers total)

i believe this is something you should discuss with your doctor. if the medication isn't working, s/he needs to know in order to investigate other possibilities.
posted by thinkingwoman at 9:37 AM on June 24, 2008

I don't think you can split the pills-- the coating's there to assist the time release action, and once you break it, there's no guarantee.

Find a good GI specialist-- who's not your current doc-- and lay the situation out to him or her. A specialist in gastric reflux should be able to set you straight and address the underlying issue more competently.
posted by fairytale of los angeles at 9:47 AM on June 24, 2008

Ask your doctor, especially since he/she told you to take them.



Then, maybe try these if your doc doesn't mind. They work like a charm.
posted by mds35 at 10:11 AM on June 24, 2008

Best answer: Replace one of your daily Prilosecs with famotidine (Pepcid or generic) 20-40mg or ranitidine (Zantac) 150-300mg. [I'm a primary care physician and I've been managing reflux cases daily for 15 years.] [YMMV]
posted by neuron at 10:31 AM on June 24, 2008 [1 favorite]

Seconding neuron, although with the numbers you've given, a specialist definitely seems in order (I had very bad acid reflux and after 4 months was down from 40mg to 20mg once a day, where I've remained, again, YMMV)
posted by StrikeTheViol at 10:47 AM on June 24, 2008

Replace one of your daily Prilosecs with famotidine (Pepcid or generic) 20-40mg or ranitidine (Zantac) 150-300mg. [I'm a primary care physician and I've been managing reflux cases daily for 15 years.] [YMMV]

Just know that famotidine simply does not work for some folks (hello!), and that if you need omeprazole, you really need the stuff.

It went generic recently though, so you might ask your pharmacist about that.
posted by SlyBevel at 11:21 AM on June 24, 2008

After 20 years of fighting reflux I finally broke down and went to a Gastro when I started having problems swallowing food. It turned out my esophagus was 90% constricted due to damage from reflux. One upper endoscopy later the doc put me on pantoprazole, which is IMHO, a miracle drug. So I'm seconding the go see a Gastro. If you have suffered from reflux long term you may have some intestinal damage that needs to be repaired.
posted by COD at 11:58 AM on June 24, 2008

Also, see a competent physician generally. If you have cardiac 'symptoms', that could be the sign of something more serious -- especially given that Prilosec has been essentially cleared of cardiac side effects by the FDA now, it's a better idea to check than to self-diagnose and self-medicate...
posted by felix at 1:52 PM on June 24, 2008

If you have insurance, paradoxically, Nexium is sometimes cheaper now that prilo is OTC and therefore not covered at all. Do see a specialist though, since if it's not badly damaged or an ulcer, it can be managed with diet and if it is those things, a specialist is best equipped to deal with it. I managed mine with low-carb diet once I got permission from my gastro.
posted by melissam at 3:14 PM on June 24, 2008

Hats off to Neuron for being a Doctor and actually making a recommendation. Rarely willl a doctor or lawyer make a definitive statement. Quite frankly, if I wasn't so tired and shy I would post a link to Metachat. Big moment in Mefi history.
posted by JohnnyGunn at 8:37 PM on June 24, 2008

Can you lose weight?
posted by docpops at 9:13 PM on June 24, 2008

I used to bite the OTC time-release prilosecs in half to hurry up their action. They definitely took effect quicker when I did that.

All that Prilosec definitely delayed my finding out what was actually wrong with me by 5 years or so, too.
posted by ikkyu2 at 12:46 AM on June 27, 2008

I have been taking daily 20mg Prilosec for about 5-6 years. I discovered after missing a dose how dependent I had become on it -- the withdrawal was intense. I asked a GI doctor, and he went as far as to endoscopy me. He said he didn't see anything acutely wrong, so if the Prilosec was working, to just keep at it. Not the most satisfactory of answers, I thought.

I haven't found other reports of Prilosec dependencies - so I'm curious to hear how your experience unfolds.
posted by prophetsearcher at 5:16 AM on June 27, 2008