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Home > Archive > Heartburn Support > August 2006 > larger dose Nexium
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larger dose Nexium
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| George Prager 2006-08-09, 4:26 pm |
| Sorry if this has been covered already. I am on 40 mg of Nexium with
spotty results. Is it safe to take a larger dose - say 40mgs in the
morning and 40 at night? The drug definitely does help somewhat
(without it the symptoms flare up) but it doesn't seem to be completely
controlling it.
thx
GP
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| Howard McCollister 2006-08-09, 9:24 pm |
|
"George Prager" <gtrvox@canoemail.com> wrote in message
news:1155156026.374373.182820@m79g2000cwm.googlegroups.com...
> Sorry if this has been covered already. I am on 40 mg of Nexium with
> spotty results. Is it safe to take a larger dose - say 40mgs in the
> morning and 40 at night? The drug definitely does help somewhat
> (without it the symptoms flare up) but it doesn't seem to be completely
> controlling it.
>
> thx
>
> GP
>
Such dosages are used occasionally as a diagnostic tool, or to maximize
healing of serious erosions, but I would strongly advise against YOU
increasing the dose without input from the doctor who knows you and your
medical history the best - presumably the one that prescribed the
medication.
I will say that, if it takes 80 mg of Nexium every day to control your
reflux, you either have some major-league LES dysfunction, or a very large
component of non-acid reflux. Either way, the prognosis for long-term
medical management isn't good.
You should definitely check in with your doctor on this issue.
HMc
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| George Prager 2006-08-09, 9:24 pm |
|
> I will say that, if it takes 80 mg of Nexium every day to control your
> reflux, you either have some major-league LES dysfunction, or a very large
> component of non-acid reflux. Either way, the prognosis for long-term
> medical management isn't good.
>
> You should definitely check in with your doctor on this issue.
>
> HMc
Not very encouraging but thanks for the reply. I've goggled LES
dysfunction but what would be the symptoms of non-acid reflux? I get
the standard burning sensation, no regurgitation or any other type of
reflux
Thx
GP
| |
| Howard McCollister 2006-08-09, 9:24 pm |
|
"George Prager" <gtrvox@canoemail.com> wrote in message
news:1155163715.739026.186070@i3g2000cwc.googlegroups.com...
>
>
> Not very encouraging but thanks for the reply. I've goggled LES
> dysfunction but what would be the symptoms of non-acid reflux? I get
> the standard burning sensation, no regurgitation or any other type of
> reflux
>
Symptoms can be the same. The simplest test for non-acid reflux is failure
of symptoms to resolve on therapeutic doses of a proton pump inhibitor. In
some cases, a doctor will double the dose for awhile to see if that makes a
difference. 80 mg of Nexium per day will shut down acid production in the
stomach with almost complete certainty, will have no effect on alkaline
secretions.
HMc
| |
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| Hi George,
I have been on 80 mg (40 mg before breakfast, 40 mg before evening meal or
bed) Nexium for a few days on the advice of my doc. and ended up as sick as
a dog. I felt as though I was being poisoned. My GP is of the opinion that
one can go higher (to 120 mg per day), but she does not seem to be aware of
any of the possible side-effects. But like any medication Nexium has
side-effects www.drugs.com or www.rxlist.com .
The medication alone will not help resolve the situation and you have to
implement life-style changes for the management of GERD
http://www.gicare.com/pated/ecdgs39.htm . If you stick to a rigid diet then
you might be able to control the symptoms together with the proton pump
inhibitor (PPI). If not, then you will have to consider surgery.
If you do not have any joy after implementing the life-style changes then I
suggest that you discuss with your doctor the possibility of trying another
PPI, such as Protonix. I switched to Protonix after two years of Nexium and
am doing slightly better on the Protonix. I certainly have not experienced
as many side-effects as those I experienced with Nexium.
http://www.medicinenet.com/proton-p...ors/article.htm "Which PPIs
are approved in the United States?
Available PPIs include omeprazole (Prilosec), lansoprazole (Prevacid),
rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium)."
In depth GERD article: http://www.reutershealth.com/wellconnected/doc85.html
All the best,
Vanny
"George Prager" <gtrvox@canoemail.com> schrieb im Newsbeitrag
news:1155156026.374373.182820@m79g2000cwm.googlegroups.com...
> Sorry if this has been covered already. I am on 40 mg of Nexium with
> spotty results. Is it safe to take a larger dose - say 40mgs in the
> morning and 40 at night? The drug definitely does help somewhat
> (without it the symptoms flare up) but it doesn't seem to be completely
> controlling it.
>
> thx
>
> GP
>
| |
| George Prager 2006-08-10, 4:26 pm |
|
> The medication alone will not help resolve the situation and you have to
> implement life-style changes for the management of GERD
> http://www.gicare.com/pated/ecdgs39.htm . If you stick to a rigid diet then
> you might be able to control the symptoms together with the proton pump
> inhibitor (PPI). If not, then you will have to consider surgery.
Thanks for your detailed reply. My heartburn seems to come and go...I
have fairly good days, then a few bad days which are scary, as I always
think they're here to stay. The problem is that sticking to a very
rigid diet is tougher than enduring the symptoms sometimes. I love
tomatoes, I love dark chocolate and I've had to cut them out. Though I
don't drink much coffee, I am a tea addict. Last night I had a glass of
milk and some cookies (no ill effect), then I read that even milk is on
the *banned* list! I am already on a sodium restricted diet because of
an inner ear problem. So by the time you implemet all those changes,
what are you left with? A diet that makes your life as miserable as any
symptom. Additionally, I am a musician and have to travel frequently
for work. It is seldom possible to stick to any kind of diet on the
road.
Btw, the "raising your head while sleeping" advice does nothing for me.
My reflux is the worst in the morning after breakfast, then waxes and
wanes during the day and never bothers me at night. Appetite isn't
always affected - though sometimes it's hard to tell through the wall
of symptoms whether I'm really hungry. A meal can either make it worse
or better - both scenarios have been known to happen.
Lastly: I try to drink copious amounts of water. Isn't it logical that
if you dilute the acid, it should alleviate the symptoms? No doctor
told me this but logic dictates that water whould help
Thx
GP
| |
| Howard McCollister 2006-08-10, 4:26 pm |
|
"George Prager" <gtrvox@canoemail.com> wrote in message
news:1155217987.335334.87960@i42g2000cwa.googlegroups.com...
>
> Btw, the "raising your head while sleeping" advice does nothing for me.
> My reflux is the worst in the morning after breakfast, then waxes and
> wanes during the day and never bothers me at night. Appetite isn't
> always affected - though sometimes it's hard to tell through the wall
> of symptoms whether I'm really hungry. A meal can either make it worse
> or better - both scenarios have been known to happen.
>
> Lastly: I try to drink copious amounts of water. Isn't it logical that
> if you dilute the acid, it should alleviate the symptoms? No doctor
> told me this but logic dictates that water whould help
>
Yes, sometimes raising the head of the bed helps, usually it's a waste of
time.
No, drinking water won't really help. Gastric distention will actually
increase the reflux.
HMc
| |
|
| Believe you me, we know how you feel. I think most of us here have had to
implement the same dietary changes. I empathise with the problems of being
on the road as I have, in the past, had to do a lot of business lunches and
dinners - the Russian roulette of GERD! I have been ill each time I have
eaten out in the evening this year. Sometimes after I explain what I can't
eat then all I receive is a plate that is a third full and I leave starving.
I don't eat out at all now - I carry food with me. I was eating a cold lunch
of pasta on the train at Xmas and a couple of Chinese (I think) started
laughing at me, but I thought if they only knew what I had to put up with
(and if they only had half my health problems).
I notched up considerably when I stopped drinking milk in 2003 and walnuts
are bad for my GERD too. Black tea is also a no no. Try fennel, nettle,
ginger, camomile, apple (careful here) or a low acid fruit tea. Although I
have to be careful with ginger in food, I make a tea out of a couple of
centimetres of root ginger (peeled and chopped) and I find it very soothing
on my stomach. Anything else I drink is like dicing with death.
I had some chocolate truffles and drank a half glass of wine over Xmas
(trying to fit in and caving in to a bit of light peer pressure) and was
very ill with nocturnal reflux (plus a dodgy gall bladder, which was removed
in May this year). I have bad nocturnal GERD, during the day I can more or
less keep in under control. I also drink a lot of water, but as Howard says
it does do much to help the GERD. If I sin, then it has to be in the morning
after I have taken the Protonix.
Actually GERD is the least of my problems because I have short bowel
syndrome due to Crohn's disease (4 resections of the ileum and
panproctocolectomy) with the resulting malabsorption/malassimilation and
understandably chronic fatigue plus concentration problems due to 2-3 litres
steatorrhoea per day. I had an ileostomy when I was 33, a year after the
Crohn's diagnosis. This was a result of years of neglect due to doctors
telling me that my medical problems were all in my head. I also have heart
failure (due to uncontrolled Crohn's inflammation and inadequate medical
supervision or concern - I was well on the road to toxic megacolon),
recurrent bladder problems due to dehydration (despite drinking 3-4 litres
of water/isotonic solution per day) and exocrine pancreas
insufficiency/white or disappearing pancreas (most probably a
Crohn's-related issue) and hence am a strong diabetes candidate. I also have
enteropathic arthritis (Crohn's again). They have removed most of my
internal organs and I could only spare one kidney now, at the outside. I had
a cancer scare last year and also in 2002.
I am in a state of starvation all the time, but the last time (Oct. 2005) I
was parenterally fed I ended up with Pseudomonas aeruginosa sepsis and they
had to scan my brain for abcesses (which is one of the side-effects of P.a.
sepsis, fortunately I was not aware of this at the time). I have been
severely disabled since the last major gut operation in Feb. 2005 and cannot
travel or work and even getting out of the house can be a real challenge. I
was out yesterday and had to pop glucose tablets every few minutes to keep
myself upright because I can't keep my blood sugar up by eating normally or
even drinking my enteral drinks. I am up in the middle of the night because
I am starving as a result of my jaunt to the shops yesterday, which has
depleted any energy reserves I might have had and have just eaten and drunk
an enteral drink. I am 46 (female, 1.62 m, 52 kg, BMI 19.8) and weigh a few
pounds more than I weighed when I was 18 and look like a 35 year old (wow
lucky me!). I have to have vitamin injections every month.
I am not looking for sympathy as health issues are just part of life's rich
tapestry - and meant to be an enriching and rewarding experience, or perhaps
I am getting confused and the latter just applies to my doctors. I would
just like to say I would swap with you anytime! Perhaps, then I could get
round to playing my guitar again.
All the best,
Vanny
"George Prager" <gtrvox@canoemail.com> schrieb im Newsbeitrag
news:1155217987.335334.87960@i42g2000cwa.googlegroups.com...
>
then[vbcol=seagreen]
>
> Thanks for your detailed reply. My heartburn seems to come and go...I
> have fairly good days, then a few bad days which are scary, as I always
> think they're here to stay. The problem is that sticking to a very
> rigid diet is tougher than enduring the symptoms sometimes. I love
> tomatoes, I love dark chocolate and I've had to cut them out. Though I
> don't drink much coffee, I am a tea addict. Last night I had a glass of
> milk and some cookies (no ill effect), then I read that even milk is on
> the *banned* list! I am already on a sodium restricted diet because of
> an inner ear problem. So by the time you implemet all those changes,
> what are you left with? A diet that makes your life as miserable as any
> symptom. Additionally, I am a musician and have to travel frequently
> for work. It is seldom possible to stick to any kind of diet on the
> road.
>
> Btw, the "raising your head while sleeping" advice does nothing for me.
> My reflux is the worst in the morning after breakfast, then waxes and
> wanes during the day and never bothers me at night. Appetite isn't
> always affected - though sometimes it's hard to tell through the wall
> of symptoms whether I'm really hungry. A meal can either make it worse
> or better - both scenarios have been known to happen.
>
> Lastly: I try to drink copious amounts of water. Isn't it logical that
> if you dilute the acid, it should alleviate the symptoms? No doctor
> told me this but logic dictates that water whould help
>
> Thx
>
> GP
>
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