Tablets, Different brand different results

[2008bangkok]

I have been taking medication to combat stomach pain ( suspected ulcers) for the last 6 months, the active ingredient is omeprazole 20mg morning and night, I have been taking one brand most of the time, but then the shop ran out so they had a different brand with the same active ingredient and and same 20mg but this brand doesn't seem to work. Im just wondering why one brand kills the pain and the other doesn't even though they both look to be the same.

Anybody had similar experience with tablets?

[johnatong]

Omeprazole is not intended to be used as a pain killer and it has no analgesic properties.

If you are suffering pain despite taking the Omeprazole you should consider having your condition re-evaluated by your doctor.

[Sheryl]

While not an analgesic as such, by reducing gastric acidity omeprazole will relieve pain due to gastritis or irritation of a peptic ulcer, and I think that is what he means.

Two brands with the same ingrediants will have the same action. Depending on the manufacturer, some possibility that the second brand is of poor manufacturing quality i.e. contains less of the active ingrediant than it should. Another possibility is that it may have been stored for a prolonged period at high temperatures and/or exposed to direct sunlight and thus lost potency.

[impulse]

I have the same issue with different brands of omeprazole here in Thailand. MIRACID (green box) is the brand I normally buy, and it works consistently.

Whenever I get a different brand, it's a coin toss. Sometimes it works, sometimes, not.

I can't explain it. I don't even try. I just stick with what works for me.

Edit: That's not an endorsement of my brand. It may not work for others.

Edited May 16, 2016 by impulse

[2008bangkok]

Omeprazole is not intended to be used as a pain killer and it has no analgesic properties.

If you are suffering pain despite taking the Omeprazole you should consider having your condition re-evaluated by your doctor.

Although not a pain killer (its not going to cure a tooth ache) it sure does relief the pain in my stomach,

I think the next course of action is to have a endoscopy to see exactly what the issue is but if the tablets work you got to figure its an ulcer i think.

I have the same issue with different brands of omeprazole here in Thailand. MIRACID (green box) is the brand I normally buy, and it works consistently.

Whenever I get a different brand, it's a coin toss. Sometimes it works, sometimes, not.

I can't explain it. I don't even try. I just stick with what works for me.

Edit: That's not an endorsement of my brand. It may not work for others.

Exactly the same for me Miracid are the ones I take which works ok, the other one doesnt work at all.

BTW do ou take the tablets for an ulcer to? If so how long are they meant to take to go away.

[impulse]

Exactly the same for me Miracid are the ones I take which works ok, the other one doesnt work at all.

BTW do ou take the tablets for an ulcer to? If so how long are they meant to take to go away.

Can't speak for ulcers since I take them for GERD (acid reflux).

Along with an occasional endoscope to make sure it's not getting away from me...

[Sheryl]

Doesn't necessarily have to be an ulcer. Could just be gastritis....or, if the pain is in the throat/chest area, GERD.

If you have not yet, should be tested for h. pylori as this is a frequent cause of gastritis and while omeprazole will ease the symptoms, it will likely not heal until the h. pylori is eradicated.

Note that the non-invasive urease breath test is not reliable if PPIs like omeprazole have been taken recently.

If you undergo endoscopy they will test directly for the presence of h. pylori. The endoscopy will also reveal whether there is an ulcer(s), gastritis, esophagitis etc.

[2008bangkok]

Doesn't necessarily have to be an ulcer. Could just be gastritis....or, if the pain is in the throat/chest area, GERD.

If you have not yet, should be tested for h. pylori as this is a frequent cause of gastritis and while omeprazole will ease the symptoms, it will likely not heal until the h. pylori is eradicated.

Note that the non-invasive urease breath test is not reliable if PPIs like omeprazole have been taken recently.

If you undergo endoscopy they will test directly for the presence of h. pylori. The endoscopy will also reveal whether there is an ulcer(s), gastritis, esophagitis etc.

I have been to the doctors about 5 times now and he originally said it was gastritis however Iv heard that to have gastritis for 7-8 months is unusual. Then the doctor said It was an ulcer, went to a thai hospital and without even checking they just gave me the omeprazole pills.

The only symptoms I have is that pain in my stomach everything else is normal however if I drink alcohol for 1-2 days then the day after the pain increases 10 fold, curling up on the bed pain and that can last for 2 days.

[Sheryl]

With stomach pain persisiting for 7 months, you should have a gastroscopy to get a clear diagnosis. While unlikely, a stomach malignancy is among the things that need to be ruled out. And - more likely - h. pylori infection.

The care you describe is sub-standard. Where do you live? You need a better doctor.

[2008bangkok]

I live in Pattaya, I have been using local doctors and government hospital, there are better hospitals but like Bangkok Pattaya but they always want silly money and as I don't have medical insurance I have to pay myself.

[2008bangkok]

With stomach pain persisiting for 7 months, you should have a gastroscopy to get a clear diagnosis. While unlikely, a stomach malignancy is among the things that need to be ruled out. And - more likely - h. pylori infection.

The care you describe is sub-standard. Where do you live? You need a better doctor.

What is the difference between a endoscopy and a gastroscopy, is the gastroscopy more thorough?

[johnatong]

With stomach pain persisiting for 7 months, you should have a gastroscopy to get a clear diagnosis. While unlikely, a stomach malignancy is among the things that need to be ruled out. And - more likely - h. pylori infection.

The care you describe is sub-standard. Where do you live? You need a better doctor.

What is the difference between a endoscopy and a gastroscopy, is the gastroscopy more thorough?

An endoscope is an instrument. An endoscopy is a procedure undertaken using an endoscope.

A Gastroscopy is an examination of the stomach achieved by the use of an endoscope.

Hope that helps.

[thai3]

Been taking this stuff for 15 years and am trying to cut it down due to the reports of side effect of osteoporosis and dementia. Not easy to stop taking it though.

[Sheryl]

I live in Pattaya, I have been using local doctors and government hospital, there are better hospitals but like Bangkok Pattaya but they always want silly money and as I don't have medical insurance I have to pay myself.

Yes, BPH is very costly - more so than the main Bangkok Hospital in Bangkok, in fact, and with usually less qualified doctors.

Suggest you come into Bangkok and consult

Dr. Varicha Mahachai, a US trained GI specialists:

she is at:

1.Bangkok Hospital (Bangkok) http://www.bangkokhospital.com/index.php/en/doctor/gi/gi-01

2. Chulalongkhorn Hospital (she is a Professor there) - can try to get an appointment through their after hours clinic but have to go in person to make the appointment (13 th floor from about 4 PM onward, register to get a patient number downstairs first and then there may be a wait to get the actual appointment, and even longer wait for endoscopy.. This is the least expensive option but also the most time intensive as multiple trips may be necessary, and while the doctor speaks english fluently, the admin and nursing staff do not making the initial registration and appointment process difficult if you do not speak Thai well.

3. BNH Hospital https://www.bnhhospital.com/en/find_doctor/detail/119

4. RSU Health Care Center on Sukhumvit Road at about Soi 31 - this is a mid-range option, a gastrscopy will be about half the price of one done at Bangkok Hospita or BNH but still more than done at Chula, but far easier to arrnage. In fact might be possible to set it all up by phone and go straight in for it without having to have a prior consultation (not sure, but can try - call them http://www.rsuhealth.com/en/ourcenter/medical-center.html). in that instance she'll take your history before the procedure on the same vsit - very convenient for those traveling from afar. (Make sure to completely fast from midnight the night before)

She also comes down to BPH once a week on Sundays https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=240&c=1&depid=11

Will cost the most there but on the other hand removes need to travel to Bangkok

[2008bangkok]

I live in Pattaya, I have been using local doctors and government hospital, there are better hospitals but like Bangkok Pattaya but they always want silly money and as I don't have medical insurance I have to pay myself.

Yes, BPH is very costly - more so than the main Bangkok Hospital in Bangkok, in fact, and with usually less qualified doctors.

Suggest you come into Bangkok and consult

Dr. Varicha Mahachai, a US trained GI specialists:

she is at:

1.Bangkok Hospital (Bangkok) http://www.bangkokhospital.com/index.php/en/doctor/gi/gi-01

2. Chulalongkhorn Hospital (she is a Professor there) - can try to get an appointment through their after hours clinic but have to go in person to make the appointment (13 th floor from about 4 PM onward, register to get a patient number downstairs first and then there may be a wait to get the actual appointment, and even longer wait for endoscopy.. This is the least expensive option but also the most time intensive as multiple trips may be necessary, and while the doctor speaks english fluently, the admin and nursing staff do not making the initial registration and appointment process difficult if you do not speak Thai well.

3. BNH Hospital https://www.bnhhospital.com/en/find_doctor/detail/119

4. RSU Health Care Center on Sukhumvit Road at about Soi 31 - this is a mid-range option, a gastrscopy will be about half the price of one done at Bangkok Hospita or BNH but still more than done at Chula, but far easier to arrnage. In fact might be possible to set it all up by phone and go straight in for it without having to have a prior consultation (not sure, but can try - call them http://www.rsuhealth.com/en/ourcenter/medical-center.html). in that instance she'll take your history before the procedure on the same vsit - very convenient for those traveling from afar. (Make sure to completely fast from midnight the night before)

She also comes down to BPH once a week on Sundays https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=240&c=1&depid=11

Will cost the most there but on the other hand removes need to travel to Bangkok

Thanks alot for the information really helpful, i think maybe I will see if it is possible to see her on a Sunday because I work full time so travelling to Bangkok is a problem in the week

[2008bangkok]

So I went and had a gastroscopy and it came back normal, disappointed really as it means Im no further from the truth and the pain is obviously coming from somewhere!

She recommended a CT scan next which she recons is more thorough.

She also said this could be because im slightly overweight, can this also give problem with stomach pain.

[Sheryl]

Actually the negative gastroscopy is good news. I take it akso negative for h. Pylori?

The pain is likely from somewhere orher than the stomach.

[wpcoe]

Back to the OP and thread title, I've sometimes wondered if the inert materials in a tablet can make a difference. What we look for when trying generics or different brand name pills is the active ingredient. Is it possible that the "inert" contents can make a difference in how an active ingredient is absorbed/used in different people? By definition, I guess, it can be assumed that the inert components don't interact directly with the active ones, but what if an individual's body has some interaction with the inert ingredients that then affects the absorption or other factor of the active ingredient?

[2008bangkok]

Actually the negative gastroscopy is good news. I take it akso negative for h. Pylori?

The pain is likely from somewhere orher than the stomach.

They didn't mention either way they just said there was no ulcers and it was fine and gave me a piece of paper with some photo. he propblem was i went to a government hospital to save costs but they could only speak basics of english.

I think im going to have to bite the bullet and pay for another scan privately, do as anybody know the best scan to get for stomach related issues that will give me the highest possibility of finding the problem in 1 scan rather than keep hafing different scans, would it be a MRI or CT scan.

Edited June 18, 2016 by 2008bangkok

[sawadee1947]

Well, it's the same as baking a cake by you and me. Same ingredients, different results. Some tablets got a matrix, some come in capsules, some are simply pressed., no matter of bio equivalence.

[Sheryl]

You need to consult a good gastroenterologist and let them decide, after obtaining history and doing a physical exam, what additional tests if any are needed. It is not just a question of type of test but also of organsystem since with a negative gastroscopy the pain likely is not from your stomach but rather elsewhere in the abdomen. Sometimes history and physical exam findings are sufficient to reach a tentative diagnosis.

Gastroscopy is usually filmed and recorded on a CD. Try first to get this from the hospital where it was done as the doctor you see for second opinion an review it and may save the need for a second procedure. At a minimum they will have pictures.