Antacid meds recommended by ENT specialist

[bbi1]

Saw an ENT specialist at one of the major hospitals today. Was recommended Gaviscon sachets & Prevacid tablets.

 

Back in the West I never heard of Gaviscon sachets, I only know of the tablets & liquid in a bottle. I asked her if I mix it with a glass of water & she said yes. Does anyone know if there's any difference between a Gaviscon sachet or the tablets or liquid in a bottle? It's a bloody ripoff at 22 baht a sachet from a cheap pharmacy being $1 each sachet! Back home you can buy a 600ml of the liquid in the bottle for $10 or 16 tablets for $4. What's so special about the sachets? Seems like the sachets are full of liquid.

 

Also, does anyone know if Preacid has a generic cheaper brand? The pharmacy said no.

[thai3]

Best to buy a box from wholesaler works out 14 baht each, in pharmacy now most are 20 baht each. I was on losec and gaviscon for years, 15 for the losec. Recently got off it by eating almonds everyday, worked for me, 

[impulse]

I can't say if Prevacid has a generic in Thailand.  After using Prevacid (actually Lansoprazole generic in China) for many years, I switched to Miracid (Omeprazole) in Bangkok and it works just as well for me.  80 baht for 14 gelcaps at Boots, cheaper at smaller pharmacies.

 

I stay far away from Gaviscon because it has aluminum salts (and/or magnesium, depending on your location) in it and the connection between aluminum and Alzheimer isn't fully known.  If I  need the instant relief that Gaviscon offers, I take some baking soda.

 

FYI, Miracid takes a few hours to kick in, but stays with me for 24 hours.  Baking soda starts working immediately, but wears off right about the time the Miracid kicks in.

 

For my money, I take the advice of Thai doctors from famous hospitals with a grain of salt.  I've had too many problems with their diagnoses (Edit: or rather, their lack of a diagnosis) and their multitude of scripts- even though they often can't tell me what they're treating.   And too many times when they prescribed something extremely expensive, but not as appropriate.  I'm 100% covered so I don't care about the price.  But I'm convinced they do.

Edited August 19, 2016 by impulse

[thai3]

They are linking dementia to Omerprazole these days as well as losing bone density

Edited August 19, 2016 by thai3

[KhunBENQ]

ENT specialist dealing with reflux/heartburn?

 

[Witblitz]

1 hour ago, thai3 said:

They are linking dementia to Omerprazole these days as well as losing bone density

And kidney problems, used to take 20mg a day for years, and as strange as it sounds, my "cure" was cutting down/eliminating refined carbohydrates, ie white bread etc, increasing my fiber intake, and believe it or not drinking fresh lime juice as counter intuitive as it sounds...when i first started on the lime juice, after stopping the ppi's i expected serious heartburn...and it hasnt happened as yet, i do keep a box of omerprazole handy just in case, as some times dependent on what i have been eating, i do get a touch of heartburn...

But lets put it this way...i have gone from 20mg a day, down to maybe 20mg every 7-10 days...big improvement 

 

 

 

 

 

[Sheryl]

I suspect the OP saw an ENT because of something that felt like a lump in the throat, ENT found no ENT problem and concluded it was due to reflux (GERD).

 

AFAIK Gaviscon tablets and liquids will work every bit as well as the sachets. Note that there are 2 types of Gaviscom though, regular and with dual action. The latter is better but also more costly.

 

Prevacid = lansoprazole  and there is no other brand available in Thailand, but omeprazole which is in the same family of drugs, same action is available in many locally made brands and far less expensive.

 

However, it is worth considering whether you want to start taking this class of drug. While the side effects above posters have mentioned affect only a minority of people,  the drugs are very hard to stop taking as there tends to be a significant acid rebound. I would especially be hesitant about taking it for a diagnosis that has not been confirmed by a GI specialist and you might think about consulting one first. Alternatives to  PPIs are histamine-2 blockers like ranatidine , readily available in local brands.

 

There are also a lot of non-pharmacological measures that will help GERD (f that is what you have). This include:

 

- sleeping with your upper body a bit elevated, either by special pillows or a few bricks/concrete blocks under the head of the bed

 

- not eating for at least 2 hours before going to bed or lying down

 

- losing weight if you are overweight

 

- cutting back on or eliminating caffeine (coffee, tea, colas, even chocolate) - caffeine weakens the sphincter between the esophagus and stomach

 

Many people find that these measures only plus an occasional gaviscon when needed are sufficient

[swissie]

On top of Miracid (omeprazole), Thai Doctor prescribed "LIBVAX'. I found it to be quite effective. Unheard of in Switzerland. Under what brand name would this be available in Europe?  Took LIBVAX for over 2 years, although Pharmacist told me "should not take for long time". Any clues?

 

Thx & cheers.

[impulse]

10 hours ago, thai3 said:

They are linking dementia to Omerprazole these days as well as losing bone density

 

Is that specific to Omeprazole, or all of the 'prazoles?

[meatboy]

after yrs.of abuse, 60's,70's and 80's i can definately qualify as a rearly bad sufferer.that was until i got prescribed lansoprozole in the uk.

since moving permantly to thailand 2007 i have been taking the generic omeprazone [MIRACID] 20mg.twice a day.

YES IT DOES WORK, as for gaviscone useless.

miracid around 50bht.x box of 14.

[impulse]

2 hours ago, meatboy said:

after yrs.of abuse, 60's,70's and 80's i can definately qualify as a rearly bad sufferer.that was until i got prescribed lansoprozole in the uk.

since moving permantly to thailand 2007 i have been taking the generic omeprazone [MIRACID] 20mg.twice a day.

YES IT DOES WORK, as for gaviscone useless.

miracid around 50bht.x box of 14.

 

That's another reason I'm wondering if the correlation with dementia is real, and is it specific to Omeprazole.

 

Our switch from Lansoprazole to Omeprazole, in Thailand may explain some of our similar symptoms?

 

It works great for the reflux symptoms, but maybe there are long term effects that we didn't see with Prevacid?

Edited August 20, 2016 by impulse

[Sheryl]

1. All the PPIs ("prazoles") are similiar in both action and adverse effects though there is much more info specific to omeprazole as it has been used the longest. Many of the concerns about side effects of omeprazole have emerged only post-markketing, once it was in very wide spread use, so lack of reports of similiar problems with very new PPIs should be taken with a grain of salt. But note that these problems occur in only a minority of patients.

 

2. Swissie: I think you mean LIBRAX not  not LIBVAX. It is a combination of  highly addictive tranquilizer (hence advice not to use for long) and an antispasmodic. Basically used in cases where there is no clear cause of the GI symptoms and they are thought to be possibly anxiety related. Of dubious efficacy, and there is risk of addiction.

[impulse]

3 minutes ago, Sheryl said:

1. All the PPIs ("prazoles") are similiar in both action and adverse effects though there is much more info specific to omeprazole as it has been used the longest. Many of the concerns about side effects of omeprazole have emerged only post-markketing, once it was in very wide spread use, so lack of reports of similiar problems with very new PPIs should be taken with a grain of salt. But note that these problems occur in only a minority of patients.

 

Are the famotidine, ranitidine, cimetidene (sp?) family showing up any better in the lang haul?  I took Pepcid for years, then cimetidine when I couldn't afford Pepcid in China.  They worked okay, but required 2-3 doses a day, whereas Prevacid and Prilosec only required one in the morning.

[bbi1]

14 hours ago, Sheryl said:

I suspect the OP saw an ENT because of something that felt like a lump in the throat, ENT found no ENT problem and concluded it was due to reflux (GERD).

 

AFAIK Gaviscon tablets and liquids will work every bit as well as the sachets. Note that there are 2 types of Gaviscom though, regular and with dual action. The latter is better but also more costly.

 

Prevacid = lansoprazole  and there is no other brand available in Thailand, but omeprazole which is in the same family of drugs, same action is available in many locally made brands and far less expensive.

 

However, it is worth considering whether you want to start taking this class of drug. While the side effects above posters have mentioned affect only a minority of people,  the drugs are very hard to stop taking as there tends to be a significant acid rebound. I would especially be hesitant about taking it for a diagnosis that has not been confirmed by a GI specialist and you might think about consulting one first. Alternatives to  PPIs are histamine-2 blockers like ranatidine , readily available in local brands.

 

 

Are there any issues with rebound happening if taking the PPI Preacid & Gaviscon Dual Action sachets for 2 weeks only?

 

Yep, went 1st to a pulmonologist due to problems a lot of sticky phlegm being built up in the throat/lungs and feeling of a blockage when that happened, which would affect the breathing and make the body cough violently sometimes. CT scan showed lungs are fine with very little phlegm, but a problem with my esophagus to my stomach always opened when it should be closed. Nose Xray showed a lot of nasal congestion & inflammation. Was recommended to see an ENT so went there. Doc placed a fibre optic videoscope down the nose & throat. Diagnosis was acute rhinosinusitis & allergic rhinitis. Was asked to do nasal washing, use Naxonex, Cravit antibiotic & allergy meds Aerius & Xyzal. Today was the follow-up appointment & was looking better from the videoscope exam. Told the doc about the opening in the esophagus always & she said that could be what is causing it to go up to my throat/sinus & causing the phlegm. Was recommended to see a GI specialist later if problems aren't solved with the meds. She recommended taking Preacid  & Gaviscon Dual Action for 2 weeks then follow up with her.

[Sheryl]

Rebound is an issue with the prevcid not the gacviscon.

 

The rebound syndrome (which can be seriously awful) is more common with "long term" use of PPIs but there is no clear cut info on after how long it would occur. In any case from what you describe, a consultation with a good GI specialist is  definitley indicated.  You should also implement the home measures I listed. Besides the symptoms you have experienced, prolonged/severe  reflux increases the risk of  esophageal cancer so not to be taken lightly.

 

Rebound acidity can also occur after use of  ranitidine, cimetidine etc but seems less severe. These are much older drugs so the adverse effects are more well established whereas  rare adverse effects of PPIs (and less rare effects limited to very prolonged use, which would also not have shown up in pre-marketing trials) are still coming to light.

[meatboy]

On 8/20/2016 at 8:39 AM, meatboy said:

after yrs.of abuse, 60's,70's and 80's i can definately qualify as a rearly bad sufferer.that was until i got prescribed lansoprozole in the uk.

since moving permantly to thailand 2007 i have been taking the generic omeprazone [MIRACID] 20mg.twice a day.

YES IT DOES WORK, as for gaviscone useless.

miracid around 50bht.x box of 14.

i wonder how many that suffer like me have been diagnosed with the reason for excesive heartburn.

1976 after many many trips back and forth to hospital it was finally found that i have a HIATUS HERNIA.

so for some sufferers heartburn could be more than just the occasional bout of acid reflux.

not sure that if you suffer like i do,is there anyone who could diagnose HIATUS HERNIA.

[thai3]

I have HH as well and have had ulcers and constant gastritis, on Miracid for years as well. You can stop taking this muck if you want to, in my experience.

[WhiteHatPhil]

On 22/08/2016 at 1:59 AM, thai3 said:

I have HH as well and have had ulcers and constant gastritis, on Miracid for years as well. You can stop taking this muck if you want to, in my experience.

You CAN or you CANNOT stop taking it..?

[Sheryl]

I don't know what he meant, but I can tell you that it can be difficult to stop taking as there is often a severe acid rebound, with symptoms as bad or worse than those that initially led to taking it.

 

I personally had great difficulty getting off omeprazole, managed finally by first switching to ranitidine and then tapering off that.

 

 

[xylophone]

On 19/08/2016 at 10:40 PM, Sheryl said:

There are also a lot of non-pharmacological measures that will help GERD (f that is what you have). This include:

 

- sleeping with your upper body a bit elevated, either by special pillows or a few bricks/concrete blocks under the head of the bed

 

- not eating for at least 2 hours before going to bed or lying down

 

- losing weight if you are overweight

 

- cutting back on or eliminating caffeine (coffee, tea, colas, even chocolate) - caffeine weakens the sphincter between the esophagus and stomach

 

Many people find that these measures only plus an occasional gaviscon when needed are sufficient

I had gastric reflux very badly at one time which led to something called Barrett's oesophagus, which in some cases can become a precursor to oesophageal cancer, so obviously I was very worried.

 

All of the things above which Cheryl mentioned I did and also found a few other things which triggered it, however the main antagonist was stress and I had to cut down on things which were causing that, including work, which I did.

In addition, I was prescribed omeprazole 40 mg twice per day and could take Gaviscon on occasions.

 

All of those things together helped tremendously and now I have some omeprazole in reserve and only need to take 20 mg for a couple of days if the problem resurfaces. However, and I have mentioned this before, what really did help me and has helped many others was D-limonene capsules, at one time marketed under the name of "Esophaguard" (or similar).

 

Now I'm not one for getting into quackery and the like, however the feedback from folks who had taken these was so overwhelming that I tried them, and they worked tremendously well, so much so that my specialist/surgeon was going to do some research into them to see if he could recommend them to some of his patients, where just about everything else had failed, apart from surgery.

 

I ordered two more lots of capsules and keep them in the fridge and just the other day I took one a day for five days because of slight discomfort, and that cured it, so the omeprazole really is a last resort these days.

 

Have a look at what folks say about D-limonene as you have nothing to lose.

[xylophone]

9 minutes ago, xylophone said:

I had gastric reflux very badly at one time which led to something called Barrett's oesophagus, which in some cases can become a precursor to oesophageal cancer, so obviously I was very worried.

 

All of the things above which Cheryl mentioned I did and also found a few other things which triggered it, however the main antagonist was stress and I had to cut down on things which were causing that, including work, which I did.

In addition, I was prescribed omeprazole 40 mg twice per day and could take Gaviscon on occasions.

 

All of those things together helped tremendously and now I have some omeprazole in reserve and only need to take 20 mg for a couple of days if the problem resurfaces. However, and I have mentioned this before, what really did help me and has helped many others was D-limonene capsules, at one time marketed under the name of "Esophaguard" (or similar).

 

Now I'm not one for getting into quackery and the like, however the feedback from folks who had taken these was so overwhelming that I tried them, and they worked tremendously well, so much so that my specialist/surgeon was going to do some research into them to see if he could recommend them to some of his patients, where just about everything else had failed, apart from surgery.

 

I ordered two more lots of capsules and keep them in the fridge and just the other day I took one a day for five days because of slight discomfort, and that cured it, so the omeprazole really is a last resort these days.

 

Have a look at what folks say about D-limonene as you have nothing to lose.

Check this link out.........https://www.ncbi.nlm.nih.gov/pubmed/18072821 

 

 "In humans, d-limonene has demonstrated low toxicity after single and repeated dosing for up to one year. Being a solvent of cholesterol, d-limonene has been used clinically to dissolve cholesterol-containing gallstones. Because of its gastric acid neutralizing effect and its support of normal peristalsis, it has also been used for relief of heartburn and gastroesophageal reflux (GERD). D-limonene has well-established chemopreventive activity against many types of cancer. Evidence from a phase I clinical trial demonstrated a partial response in a patient with breast cancer and stable disease for more than six months in three patients with colorectal cancer".

 

[rodknock]

i am allergic to omeprazole. if i take it i turn fire engine red and itch all over.

i use prevacid fdt 30 when necessary and no allergic reaction.

[WhiteHatPhil]

21 hours ago, xylophone said:

Check this link out.........https://www.ncbi.nlm.nih.gov/pubmed/18072821 

 

 "In humans, d-limonene has demonstrated low toxicity after single and repeated dosing for up to one year. Being a solvent of cholesterol, d-limonene has been used clinically to dissolve cholesterol-containing gallstones. Because of its gastric acid neutralizing effect and its support of normal peristalsis, it has also been used for relief of heartburn and gastroesophageal reflux (GERD). D-limonene has well-established chemopreventive activity against many types of cancer. Evidence from a phase I clinical trial demonstrated a partial response in a patient with breast cancer and stable disease for more than six months in three patients with colorectal cancer".

 

 

"Page does not exist"....

[xylophone]

D-limonene link.docx