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When should I take my reflux meds? Morning or night?

June 2 2010 at 2:33 PM
  (Login intermezzo)

 
Just developed reflux and I'm feeling awful. I've been taking Pantoprazol 40 mg (a German drug) at night a few hours before I go to sleep. But it seems to kick in the middle of the next day. Should I be taking it in the morning?

I could get Nexium. Why is it the better drug for singers? How does it work differently than the others?

Thanks!

 
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Chickadee
(Login Chickadee13)
NFCS Regular

i haven't taken those particular drugs

June 2 2010, 3:00 PM 

but the ones i have taken work better for me taken at night (currently liking how aciphex works for me). i find it impossible to take it 30 min. before dinner not ever knowing when that's going to be so i shoot for 2 hours after eating @ night and it seems to work for me. on the occassions that i have weaned off and had to go back on it took a good 5 days to really work consistently so if you haven't been on it for very long give it a couple more days to see.

if you tend to suffer the most during the day (i had teh most trouble @ night) i don't think there would be any harm in taking it in the AM either 30 min before eating or 2 hours after breakfast to see how that goes for you.



"There is a difference between outrageous and fabulous, ... you can decide to be outrageous, but you have to be crowned fabulous."

- PRESTON BAILEY

 
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JeffoftheFrench
(Login JeffoftheFrench)
NFCS Member

I will generally take it in the morning.

June 2 2010, 3:06 PM 

This seems to work better for me. I would rather have the effects of the drug during the day. There would be a build up of acid on some mornings, but I found that if I did not eat late I could lessen the occurrences in the morning.

Nexium was not as effective for me. I was a fan of the Prevacid Chewable tablets. For whatever reason, the chewables seemed to work better for me. I take Aciphex right now.

Do the doctors know what is causing the reflux? I had a deviated septum. It was pretty bad. After I got that fixed things seemed to improve. I hate reflux!

 
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crossover-sop1
(Login crossover-sop1)
NFCS Member

curious - deviated septum?

June 2 2010, 3:17 PM 

How did this affect/cause your reflux?

Not doubting you - just curious.

 
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JeffoftheFrench
(Login JeffoftheFrench)
NFCS Member

I thought it was wierd too.

June 2 2010, 3:35 PM 

It's kind of a chain reaction thing. Deviated septums often cause sinus infections. The sinus infections create post nasal drip, which can trigger the acid reflux. Food can be a factor, but not always. I rarely got heart burn and still had serious acid problems. I had the surgery to fix the deviation and shortly afterwards I felt dramatically better. I still get some reflux occasionally, but it is much better and more managable.

 
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intermezzo
(Login intermezzo)

Yes, deviated septum, sinus infections, pharyngitis, etc.

June 3 2010, 5:27 AM 

I have a slightly deviated septum, which normally doesn't disturb my breathing. But when I have a cold, I usually always get either a sinus or pharynx infection. At the start of a cold I irrigate twice a day and use nose sprays to no avail. My voice always gets hoarse and I thought it was the post nasal drip, but now I realize it could be a combination of the drip and silent reflux.

I would like to avoid septum surgery, although I know it can be very effective. (It works for my husband.) So I've starting using Breathe Right strips at night, and they really open up my nasal passages, which is a sign that my deviation is not that large.

I ate 6 small meals yesterday, the last one at 5:30 pm, then I took my meds at 8 pm. Elevated the head of my mattress. Everything seems to be less swelled up today. But I still feel queasiness at the heartburn place. I'm truly wondering if I have too little stomach acid, as opposed to too much. Everytime I drink or eat something I feel somehow the sphincter staying wide open and letting out gas. I read that reflux meds weaken the sphincter.
Thinking about trying Betaine HCl. I know it's a completely different approach to reflux.

Does reflux have to be permanent, or could this just be a temporary inflammation of the esophagus?

 
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JeffoftheFrench
(Login JeffoftheFrench)
NFCS Member

I don't think it has to be permanent, but...

June 4 2010, 10:02 AM 

you need to find the trigger and deal with that. I had heard that long term usage of proton pump inhibitors can be bad for you, but unfortunately I can't speak to that.

My deviated septum was pretty insane. Initially, my doctor looked at it they said it was a slight deviation. During that visit, my doctor gave me antibiotics to deal with the sinus infection. After I took that I felt great. I was singing well, but a few weeks later it all came back. I thought I had another sinus infection. Rather than prescribe me antibiotics again, she wanted to take a look at my sinus cavities. She had me get a cat scan and what she found was that my septum did not have a slight deviation, but almost a 90 degree deviation. She couldn't see it at first because the deviation started further back and just looking up my nose wasn't enough. On top of that, the other side of my nose was also messed up. There is a little fleshy strip (I can't remember the name of it) that everyone has on both sides of the nose. This either caused the deviation or filled up the room the deviation had made. My doctor was surprised I could breathe out of my nose at all. Whenever I got colds, it was virtually impossible to do just that. I had the surgery and things have improved. I recently had been scoped by a new doctor and he could not find any evidence of reflux.

The reflux comes back occasionally, but is much easier to manage. Sorry this is so long, but it might be worth looking into more extensive tests if you haven't already. I know some doctors will just prescribe medication if you just say "acid reflux" and not really thoroughly check you out.

Have you tried changing your diet? Avoiding tomatoes, chocolate and happiness can help, also. This was hard for me, as you may have guessed. I love chocolate. You can find a list online of foods to avoid, but if it's an issue with your septum, it won't help completely.

 
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intermezzo
(Login intermezzo)

Feeling great today!

June 4 2010, 1:41 PM 

I wonder if the meds kicked in, or if the acid just disappeared. No heartburn, and my voice is clear and healthy. How do I know if I can stop taking the meds?

 
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JeffoftheFrench
(Login JeffoftheFrench)
NFCS Member

I only know one way.

June 4 2010, 1:49 PM 

After making adjustments to your life (diet, not eating late, bed on incline, etc.) and you start feeling ok, try a day without taking them and see how you feel.

I did this on accident. I usually take them at work in the morning. A couple days in a row I hadn't noticed any problem and the doctor didn't notice anything either.


 
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crossover-sop1
(Login crossover-sop1)
NFCS Member

both

June 2 2010, 3:17 PM 

I have mine split into two doses and take it twice a day.

 
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(Login aanon3709)
NFCS Member

40 minutes before breakfast or dinner

June 2 2010, 3:20 PM 

Hi there,

Pantoprazole is available in the US, it's brand name is Protonix. This is a very good question since timing is very important in a reflux drug. First of all, be patient, these drugs are very powerful and while it may take awhile to find the right drug, they generally take a few weeks (2-12) to come to full strength.

Always take these drugs 40 minutes before eating your big meals, no more no less. The drug needs acid to work, so you can't take it 3 hours before eating, or at bedtime when you're not going to eat. Most people on one dose a day take it 40 minutes before breakfast.

Good luck!

 
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LMB
(Login largemouthbass)
NFCS Member

Either, but with a caveat...

June 2 2010, 7:00 PM 

The key thing is taking it on an empty stomach and giving it time there to dissolve and get absorbed. Won't bore you with the details, but suffice it to say that on an empty stomach for 1-2 hours is probably best. Most people take it at night, myself included, 2-3 hours after dinner, and that seems to work well. Morning would work just as well though, provided you don't eat for an hour or so after taking it. Truthfully, 2 hours is a bit overkill to wait after eating; one will do it, and even 30 minutes gets things rolling decently.

Nexium may or may not be better for you and it's really an individual thing. Nexium is simply a pure S-isomer of the parent compound omeprazole mg. If you remember chemistry from high school/college, you might remember that when chiral molecule are synthesized, they are almost always in a racemic mixture(meaning that they are half and half of each isomeric form). Generally, only one isomer is actually biologically active, so a pure mixture would theoretically be more effective. When a drug is a pure S isomer, they add the prefix "es" onto the parent compound name, hence Nexium's name: esomeprazole mg.

There is some debate over there being any advantage to Nexium's pure mixture over the others as there doesn't seem to be any solid evidence that it's any more effective. There's no debate that it's WAY more expensive! This is due to the additional cost of purifying the parent compound, plus the greediness of astra-zeneca. Many docs tell their patients to just take double the dose of the Prilosec(omeprazole mg) as that has the exact same amount of S-isomer that nexium has, but again that may be overkill.

All that said, I recently saw a study linking decreased bone density with chronic use of these PPI drugs(nexium, protonix, achiphex, et al). I haven't had time to really read the study yet, but until more is known, I would advise caution especially for women as they are more susceptible to bone density diseases as it is.

 
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