switching from aciphex to zantac/ranitidine - "experiment"

[- jon -]

hi all

i'm curious on any opinions about this....or suggestions/things to watch out for etc...especially with the switch off a PPI & what to possibly expect....and just feel like venting i guess...sorry for the long post

i've been on ACIPHEX for 9 months, which greatly helps relieve my heartburn, but i've noticed some wierd things up with me since i've been on it, some i am positive are direct side effects of the drug which seem to be fairly common in the literature & user feedback i've read on the 'net, others may be indirect side-effects (eg: some disruption of a normal bodily function resulting in something else manifesting itself), others who knows/unrelated to aciphex altogether

for instance, i've had all of these "less common" side effects fairly frequently, dating back to when i first starting taking aciphex, which don't bother me that much actually:
- strange dreams (DOOZYS!!),
- insomnia,
- gas,
- constipation,
- belching,
- hair loss (under my arms! wierd!!),
- blurry vision (this one for the most part went away after the 1st two weeks),
- sleepiness/fatigue


but recently i've also noticed these problems, which have not gone away, despite waiting about 2 months & trying things like taking vitamins...these problems bother me more & i thought could be a cause for concern:
- ringing in my ears (which i've posted about b4 on the old board)
- gum inflammation/easily bleeding gums


none of these problems are as intolerable as the headaches/stomaches/rashes that nexium gave me (which was the 1st PPI i was put on), so i've been "happy" on aciphex as it really helps the 'burn, BUT as per the advice in the literature that i've read about aciphex on the 'net, or in the drugstore handouts that rite-aid gives with the prescription, i wanted to let my dr. know what things i've been experiencing to see if it is "ok" for me to keep taking it, especially with the red flags that the ear ringing/inflamed gums raises with me

so i went to see my dr. today

and as with the problems i told him about while i was on nexium (mostly headaches and rashes), he seemed skeptical/unconvinced that anything i mentioned now was actually due to the medicine (which i kind of expected to be his reaction based on how he responded to my probs on nexium b4, at first he even said that headache wasn't a possible side effect of nexium! get a clue...sigh...), but he wants me to try an "experiment" to see if any of the problems go away once i am off aciphex

this off course makes sense but doesn't actually answer what i really wanted to know, which was to see if it is ok to keep taking aciphex or what could these new problems be due to (but i realize that it was probably stupid of me to even hope to get any real answers on anything...doctoring just doesn't work that way in my experience, which is why i hardly ever bother to go to the dr.)

i also mentioned to him the issue of perhaps i am not absorbing some needed vitamins/minerals due to my stomach being impaired by the aciphex, perhaps that being what is causing me some new troubles, but he said that was "impossible"


so questions for you fellow GERD sufferers:

- have any of you had similar problems on aciphex (or other PPIs)? and if so what did you do?


- what can i look forward to with the switch to zantac (300mg 2x day)? should i expect the PPI "rebound" effect to hit me with even MORE stomach acid, lasting weeks/months of misery without a PPI?

i mentioned the rebound effect to the doctor as well and he discounted it like there is no such thing


- how long do you think it will it take for the aciphex to leave my system entirely & hope to see cessation/reversal of any side effects it may have caused?

i realize no one can really answer this as to how it relates to my own body, but if anyone has any of their own personal experiences of a similar nature to share, that could be helpful to me or others :)


thanks very much for any input,

- jon -

[Rebecca]

Hi Jon,

Sorry to hear of your troubles with the Aciphex. I've been on Aciphex off & on for a year now. After my first couple months I started noticing fatigue & dizziness which I attributed to the aciphex. So I told my doc I wanted to stop the Aciphex to see if the aciphex was causing these problems. He told me to allow at least 7 days for all the Aciphex to leave my body. In my case, the fatigue & dizziness remained even after 3 months of being off the aciphex, so I went back on the aciphex and at least my reflux symptoms are better.

Have you thought about seeing another doc for a 2nd opinion? I'm not a big fan of doctors, but a good one (although hard to find) is worth their weight in gold.

Hope you feel better soon, Rebecca

[Rebecca]

Hi Jon-

Forgot to mention, about the PPI rebound, some people do have a real problem with this. When I transitioned from PPIs to high dose H2s I was very worried about this, so I kept to a strictly liquid diet for the first three days, no GERD-triggers (coffee, soda, etc.), no eating within 3 hours of going to bed, etc. and I didn't have any acid rebound effect that I was aware of.

--Rebecca

[- jon -]

after one horrible sleepness night i think this experiment is a major failure

heartburn bothering me

stomach hurts

guts hurt/churning all night

now having problems swallowing

just feel like crapola....

don't think i want to take any more zantac & will go back on the aciphex :-(

- jon -

[Hawk]

Zantac is a H2 blocker like Tagament and Axid.

Aciphex is in the much more powerful Proton Pump Inhibitor class.

Having said that, there have been a few people that have reported in the past that they had better results with the H2 blockers.

If Aciphex does not control your symptoms totally you might want to talk to your doctor about changing the dose or switching to another PPI.

[Pete]

Trying the same experiment also. Will keep you informed

Pete

[- jon -]

Originally posted by Hawk
Zantac is a H2 blocker like Tagament and Axid.

Aciphex is in the much more powerful Proton Pump Inhibitor class.

Having said that, there have been a few people that have reported in the past that they had better results with the H2 blockers.

If Aciphex does not control your symptoms totally you might want to talk to your doctor about changing the dose or switching to another PPI.


thanks for your feedback hawk

note again, aciphex has been working great heartburn-wise

again, the reason i was trying ZANTAC was because aciphex seemed to be causing some wierd side effects & the doctor (& i) wanted to see if they would go away if i was off a PPI

but now it appears that i can't tolerate the ZANTAC...or that it can't help me as much as the aciphex did...or maybe the rebound effect of stopping the aciphex is too much for the zantac to overcome, so i'm stuck with it

i would love to get off a PPI to a less "intense" drug like zantac (or no drug at all) but that doesn't appear to be an option for me, at least not at this point :-(

am going back on aciphex now trying to get back to where i was prior to last night, let my esophagus/larynx heal again, then may be trying another test in a few weeks, this time with a different PPI (again, the goal here is to try to see if some of my recent wierd "side effects" are caused by the aciphex...which i don't think is really going to be that EZ to do though)

health to all,

- jon -

[- jon -]

Originally posted by Rebecca
Hi Jon-

Forgot to mention, about the PPI rebound, some people do have a real problem with this. When I transitioned from PPIs to high dose H2s I was very worried about this, so I kept to a strictly liquid diet for the first three days, no GERD-triggers (coffee, soda, etc.), no eating within 3 hours of going to bed, etc. and I didn't have any acid rebound effect that I was aware of.

--Rebecca

thanks for your feedback rebecca

if i ever try a repeat of this particular experiment with zantac or other H2, i will try to find out what i can do to stack the cards a bit more in the H2's favor b4 i start

maybe there is some way to decrease the aciphex dosage gradually, or start taking both at the same time & let my body adjust to the zantac at a smaller dose, or something...i was having alot of gut pain last night, don't think my guts liked 300 mg of zantac as a first introduction, i dunno

one thing i wish i thought of b4 i went to bed was to take the bedspring off the frame & prop it up....that might have helped prevent the reflux from hitting my larynx/esoph. as much as it did during the night...godammit...

best to all,

- jon -

[- jon -]

Originally posted by Pete
Trying the same experiment also. Will keep you informed

Pete

best of luck pete :)

try to see if there is anything you can do to help the H2 b4 you go off the PPI, like perhaps what rebecca suggested (eating liquid meals), elevate your bed at night etc

dunno what to tell you other than things did not work out for me

am now playing phone tag with my dr....he left a msg that he wants me to try a different PPI for the next test (again, my immediate goal is to try to rule out/reduce some possible side effects of aciphex), but i dunno yet what he wants to do...i will push to remain on aciphex at least until i can heal up again & feel relatively "normal" b4 i try any other experiments

- jon -

[Trish]

Hi Jon,

Sorry to hear you are feeling rough. I have been on a few different PPI's and am currently taking Protonix (pantoloc here in Canada) which is working well for me. I am taking it every second day with a generic acid reducer twice a day on my off days. So far so good. It can be done!! But - I wanted to tell you that Aciphex (Pariet in Canada) was very good for me also with respect to heartburn but I had absolutely horrible headaches everyday that I took it and was very down and edgy. As soon as I went off I was sooo much better. So I had a similar problem - great for heartburn - baaaad for everything else.

Have you tried Protonix yet? That one really seems to be doing the trick for me.

Good luck Jon...

[- jon -]

Originally posted by Trish

Have you tried Protonix yet? That one really seems to be doing the trick for me.


i am going back to the doc on monday to pickup some samples of 2 other PPIs, i think he will be giving me both protonix and prevacid to try

i hate taking this stuff & turning my body into a chemistry experiment, but guess i have no choice

regards,

- jon -

[Canyonbabe711]

I took Nexium for months and it worked well.Doctor switched me to Protonix after endo where it was discovered I had Barretts and Protonix was cheaper. Bought 3 months supply and after a few weeks started itch and bloat an burp, etc. Went back to Nexium for a month and it was working well when I started with severe nausea. Now I have a 3 month supply of Nexium which I cannot take. I am accumulating a large pharmacy and a big credit card bill since I have to pay for my meds.I am currently taking Tagamet 200 mgs twice a day before breakfast and dinner. The reflux is not noticable, no bloating, no nausea. I am going to try Prevacid because I have to be on the strongest med possible with Barretts and GERD is often "silent" so maybe I have it and don't know it. I didn't know I had it before I was diagnosed. I was taking Nexium for bloating and gas not GERD. Never had burning, sour taste or anything till I was on Protonix. Our system change so meds do start causing problems. I am getting suspicious of all these PPI's

[cpadpl]

jon

Here's a little info that might help, I've seen different numbers, but this should give you an idea of what you might want to take:

"Famotidine is 32 times stronger in its ability to inhibit stomach acid than is cimetidine and is 9 times stronger than ranitidine."

Famotidine is Pepcid AC
Zantac is ranitidine
Tagamet is cimetidine.

Thus, Pepcid is 9 times stronger than Zantac and 32 times stronger than Tagamet.

Zantac is roughly 4 times stronger than Tagamet.

Perhaps you should step off the PPI onto Pepcid AC. I have heard that Axid (nazitidine) is a little more powerful than Zantac but not as powerful as Pepcid.

Hope this helps..

[Canyonbabe711]

It says in my book that 40mg of Pepcid(famitodine) is equal to 1000mg of Tagamet so mg by mg it is stronger. But I find 400mg of Tagamet work better for me than 20 mg of Pepcid plus the Tagamet can be taken closer to the meal. I take 400mg twice a day.

[Tom]

I read with interest the side effects you have experienced while using Aciphex. I have been on 20 mg of Aciphex for the past two months. During this time, I noticed a slight ringing in my ears but did not think to much about it as it was mild and easy to ignore. However, about nine days ago the ringing became severe. I stopped taking the Aciphex immediately. I take no other medications and it seemed to me that there was a direct cause and effect relationship between the ringing and Achiphex. I have been off the Aciphex for seven days now and the ringing continues. It interferes with my sleep and has made me anxious. I've had my hearing tested and have experienced no hearing loss. My ENT and audiologist suggested I try biofeedback and TRT to manage the ringing/pain. I'm also interested in learning if others have experienced the ringing and if it went away after they stopped taking the Aciphex and if so how long after.

[linderlu]

Tom and Jon

Yep, I have had the dreams, head hair loss, extreme fatigue, headaches and the darned ear ringing. I was on 9 PPI's a day(aciphex). After Fundo, I'm down to one and hope to get rid of that one soon. The ringing still bothers on some days. Sometimes one ear and not the same ear and other times, both ears. If I could just get a beat going I'd be happier! All kidding aside, it is 7 weeks post Fundo and the ringing is less often, maybe once a week now. It is very annoying and at it's worst, drives you nuts! Hope you both feel better soon.

[Tom]

Your message was very interesting and much appreciated. Can you please define for me what you mean by Fundo?

In my case, I was taking only 1 20mg aciphex tablet per day.

Your message indicates that the effects underwent a gradual wearing off, now down to an infrequent ringing. I sure hope that will be the case for me. My ringing is so loud it keeps me awake at night. I hope this ends soon, and any messages from others that can give me some reason for optimism will be a blessing.

Thanks for your kind thoughts.

[linderlu]

I'm sorry it is Nissen Fundoplication, or stomach wrap. And yes, the ringing is getting less and less. Hang in there. And mine does not last as long when it does come back.

[Tom]

Linderlu and Jon -

Just an additional note. I spoke by phone with a representative of the pharmaceutical firm that produces aciphex. She confirmed that tinnitus ( ear ringing ) is a "1 in 100 category" side effect, meaning that between one tenth of a percent and one percent of the patients get this side effect. She also had info from their original patient database / clinical studies that stated of those who reported ringing "most reported back to us that the ringing went away after discontinuation of the aciphex." They did NOT have data on how long it took for this to subside.

This was good news, but I was assuming perhaps that it might be a quicker response - - almost immediate upon discontinuation. I am going on a week now. Linderlu - your comments that this may take some time are actually reassuring . . . I am going to be patient and hopeful.

My best to you - Tom

[moqueur]

[QUOTE]Originally posted by Tom
[B]Linderlu and Jon -

"most reported back to us that the ringing went away after discontinuation of the aciphex." They did NOT have data on how long it took for this to subside.

Tom.
Back when I could take ppis Aciphex was the last one,
the ear ringing was so bad like you, I could not sleep.
I didn't associate it with the medicine at the time. However I developed a severe allergic reaction to all the acid meds. so had to stop and the ear ringing lasted about another month.
At that time I didn't think it would ever cease, than one day it was just gone, all of a sudden. I also went to three different doctors than finally one was familiar with this reaction from the medicine and he felt certain it would clear.

Take Care.

[erickquinto8301]

Everybody using ppi should be aware that actuall acid secretion could not be the cause of the ulcer or heartburn but h.pylori bacteria. Even if you are supresing the acid of your stomach ,the bacteria could have infected your ulcer and with or withour acid is doing damage.
I understand what you people are suffering is humiliating .
With time when you prevent the acid of your stomach , your digestion becomes terrible and the food in your stomach remains indigested and passes to the small intesine causing there belching and bloating because carbs and sugar cannot be well digested producing gases and other toxins.
But there is hope , you should eliminate the real cause of ulcers (h.pylori bacteria). There are two options one is go for antibiotics (difficult to mantain but necessary in some cases) and the other is go natural (MASTIC GUM).

I'll put what is working for me , i hope from the bottom of my heart that it works with you.
You have to buy licorice DGL chewables, MASTIC GUM, digestive enzymes (one with good bacteria included and bromelain, no HCL in its formulation and in caps form). These are all natural products you could find in vitamin cottage or any other health store.
If your heartburn i horrible go for ranitidine which is a mild to medium strenght PPI.
Putting everthing together.

Morning
chew two tablet of DGL Licorice on an empty stomach.
20 minutes after take 2 to 4 tablets of mastic gum with a glass of warm water in an empty stomach. Then wait half an hour till you start eating your first meal.
right before you start eating take your enzymes taking the powder out of the 2 caps and mixing it with your prefered juice (warm your juice in the microwave , a good digestion needs a warm temperture to occur).
Eat slowly (relax, turn off tv or radio)

Afternoon
chew two tablets of DGL Licorice on emty stomach
eat 20 minutes after, but before you eat drink your juice the same way you did it in the morning.
eat slowly (relax, turn off tv or radio)

Night
Do as the afternoon

Before going to sleep do a pray and take your ranitidine with milk or warm water.
Go to sleep at 10 o'clock ,ulcers cure from 10 to 12. If you can sleep pray and try to relax.

During the day take your DGL licorice with you and chew two tablets 10 to 20minutes before you eat any snak or small meal .

If your heartburn is horrible take ranitidine during the day but try to stay await of it as much as you can and replace it by DGL licorice.

About multivitamins .They are great for health, but they are not recommended for at least the first part of the treatment (2 weeks).Instead you could buy bee pollen and take two tablespoon with the meal in the morning.
Eat fruits, preferable bananas, papaya, oranges. You should eat vegetables but start with small portions (preferrable broccolli, carrots, a lot of spinach )
Consume alfalfa honey with toast whole grain bread.
Dont forget about God's power. He is always with you (even when you dont want to believe in him) and his power is infinite.
It is inevitable that in two weeks you will feel better . Then you could try€ stopping the ranitidine since it is not recomendble for more than two weeks.
Licorice and Mastic gum you could take forever but in lower dosis. Digestive Enzymes you should take them always specially if you follow a bad diet but you shouldnt since a bad diet leads to ulcers.
Wishing you all the best , i hope this works for you.
Be aware of the power of god in your health and in your life.Never forget about him.
Bye

[daw]

Everybody using ppi should be aware that actuall acid secretion could not be the cause of the ulcer or heartburn but h.pylori bacteria....There are two options one is go for antibiotics (difficult to mantain but necessary in some cases) and the other is go natural (MASTIC GUM).

Hi erick,
That is why everyone who is having GERD/LPR problems and/or is taking GERD medications (prescribed,over the counter and /or natural) long term should have an endoscopy to rule out what is actually going on in the esophagus and stomach. Doctors can test for H.Pylori via biopsy, blood test or breath test and everyone with GI complaints should ask for it. There is controversary as to if all cases of H. Pylori should be eradicated.

As for the Mastic Gum....
http://www.health4youonline.com/article_ulcers_is_%20mastic_gum_the_breakthrough.h tm
http://content.nejm.org/cgi/content/short/339/26/1946

[AlexM]

I have been on Prevacid 30 mg/1x a day for three years. Except that for about 8 months within this 3 year period I was on only Zantac, 150 mg in the morning & 75 mg at night. This was because my GI doctor claimed that Prevacid would increase my risk for stomach bacterial infections, as the Prevacid would turn off acid pumps in the stomach and some acid was needed to kill bacteria. Anyways, my GI doctor sort of sprung that news onto me out of nowhere and then just refused to prescribe me Prevacid, so she gave me that Zantac regimen.

Being on Zantac for those 8 months was not awful, but I definitely felt that, either A) the Zantac wasn't strong enough to subdue my symptoms or B) that the Zantac gave me a set of new symptoms (I think this latter choice is more unlikely). The symptoms were: a lot of bloating accompanied by pain, a lot of heartburn, and increased belching. I don't think Zantac gave me "new" symptoms, but rather that it just wasn't covering up those symptoms as well as Prevacid had.

Anyways, after a particularly bad flare-up, a different doctor (my general doctor, instead of the GI one) put me back on Prevacid. I've been on Prevacid ever since, except again, for another brief stint on Zantac. During this 2nd stint on Zantac, I was taking 150 mg in the morning, 150 mg at night. And, I completely did not expect this to happen, but Zantac didn't work as "well" (if you can even say that it worked well the first time) as it did the 1st time. I had the same symptoms as before, but just way magnified. Silly me was expecting the 2nd stint on Zantac to be the same as the 1st one, in terms of my symptoms.

So now, I am back on Prevacid, and it definitely works better for me than Zantac. However, I just feel that all this switching back and forth hasn't really done anything but perhaps just to make my condition worse. I say this because now that I'm back on Prevacid, I still don't feel "back to normal," as I did on any other previous stint on Prevacid. Now, that might be due to me just being on Prevacid so long that it's starting to lose its effect on me. Or, it might be due to all the back and forth switching between the meds. I really don't know.

Anyways, sorry for such a long post. But my point was 1) Zantac was never as effective for me as Prevacid is and 2) Constant "experimenting" between meds definitely had some kind of effect on me - it feels like it weakened my response to Prevacid. If anyone can explain how this might happen, I'd appreciate your input.