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Doctors' Answers to "Frequently Asked Questions" - Prevacid

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 07/9/2000]
Question: I was prescribed Prevacid, along with Zocor and Mexitil last week while in the hospital. I take Mexitil twice daily with am and pm meals. In the hospital, I was given the Zocor and Prevacid together at bedtime. However, upon reading about Prevacid from my pharmacologyist& on the net, everything says I should take the Prevacid before a meal (My prescription just says once daily). Should I continue to take it with Zocor at night or before a meal? If before a meal, which meal? Since I take Mexitil with breakfast and dinner, should I take Prevacid before lunch?

Answer: It is absorbed better with food, so taking it right before a meal or during a meal is probably about the same. It is supposed to last 24 hours so the meal that you take it with doesn't seem to matter.

[posted 06/15/2000]
Question: What affect does Prevacid or Prilosec have on the libido and which one would have the least affect?

Answer: Neither one usually has much of any effect.

[posted 04/21/2000]
Question: Would there be any danger in taking Prevacid and Deglycyrrhizinated Licorice? THe Licorice therapy is taken 30-40 minutes before meal and the Prevacid is taken right after the meal. The Licorice is to help lining oc stomach become healed while the Prevacid is to lessen the amount of stomach acid secreted. Thank you. C. Findlay

Answer: Shouldn't be any problem.

[posted 03/10/2000]
Question: After many tests from the age of 15 to 21 finding nothing wrong a doctor finaly said that I have irratible bowel syndrome and the reasons he gave did make sense. The doctor before him had prescribed Prevacid which he told me to stop taking. This was at least 4 years ago and I did not go off the medication because any time I miss a dose I have terrible pains and diarhea. I need to know if this medication can be harming me in any way or harm my chances of pregnancy or to a fetus. And does it cause more of an appitite? Also any alternatives to taking the Prevacid. When I was in my teens I was on Zantac. I am now 25 and don't know how or if I can cure my stomache. I would be very grateful for any help!

Answer: It is not having any adverse effects on you that we are aware of. As to pregnancy, it will not impair fertility and is a Class B drug. That is about as low a risk as the FDA gives to prescription drugs. Nothing is 100% but, I would not be concerned about your fetus with this drug.

[posted 01/16/2000]
Question: In November I was put on a daily prescription of Prevacid for GERD. Shortly after taking the prescription I experienced specific adverse urogenital and nervous system side effects. I stopped taking the Prevacid over 3 weeks ago, however, almost all the symptons are still present. I have read the FAQ's and this does not seem to be a common side effect or a complication that is openly questioned . How long should I wait for my side effects to go away before seeing a specialist? Please advise. Thank you.

Answer: Doubt it is the prevacid and if so, they should be gone after a week at most. See a specialist it sounds like something else.

[posted 01/14/2000]
Question: As per my 'layman's knowledge' acid in stomach is important
for normal digestive function. If prevacid reduces the acid
production in the stomach(my fasting gastrin level was
tested 37-normal), how can the digestion be normal?
In other words, what is the compromise?

Answer: Doesn't seem to be much, some acid is still present and there is a mechanical action. B 12 needs acid to be cleaved from food, so additional B 12 is a good idea if you are the pill for in excess of 2 years(your B12 storage amount in the liver for most patients).

[posted 08/26/1999]
Question: I was given Prevasid for a problem with what the doctor called "sudden deafness" I do not have this problem but was wondering why the doctor would prescribe this medication?

Answer: Not a clue.

[posted 10/20/1999]
Question: I have taken Prevacid 30mg/day and prepulsid 20 mg/day for four years now and although my primary GI problems are under control (after fairly severe episods for the first 1-2 years while i was on regular H2 blockers and before starting treatment with prevacid), i am concerned about not being able to go off this medications and possible effects of long term treatment, especially with prevacid. I have twice tried to switch to axid, but the GI symtoms returned within days and have been put on prevacid again. I am starting to have a number of other more 'minor' complaints that have no apparent reason, as determined by laboratory results, such as back pain (can be severe at times) and mild arthritis-like joint pain, mild groin/testicular/bladder pain. As i have recently read, these can be side effects from Prevacid, but they are listed as 'rare'. Is it likely that the longer the treatment the more frequent these problems can be, are they just symtoms or can they be manifestation of incipient problems, are they reversible if I stop the medication, and what other avenues of treatment can be pursued (of course i tried the dietary approach, which by itself is not working very well unless I limit myself to a few very basic foods - this has caused me to drop 70 pounds and become too thin before starting on prevacid allowed me a more complete diet and returned to a normal weight) . I feel my doctor is competent , but considers these problems 'minor'. however so was the 'mild heartburn' I was having 10-15 years ago , only to develop into a semi-debilitating condition. Thank you in advance.

Answer: The acid reflux is a major problem if unchecked, leading to narrowing of the esophagus(stenosis) as well as a risk factor in esophageal cancer. Currently, the long term side effects of these medications appear minimal, but they haven't been around 20 years either. However, with the severity of your problem you have no medical alternative. There are surgical alternatives that will reduce/stop reflux. If you haven't discussed these with your doctor, you need to. A competent surgeon can often fix this problem with minimal risk.

[posted 08/15/1999]
Question: For years I have had exteme heartburn and have had difficultiy hold food down. My doctor receintly gave me prilosec to try. It was effective beyone belief. My medical provider provided me with a subsitute drug named prevacid. When I questioned this they indicated it was an equivlant medication cleared by my doctor (I quess they forgot to include me in their discussion).

My question: After taking the prevacid, I noticed that I am experiencing craps, and dirhera. I am often very tired, feeling worn out. Are these side effects of the medication? If so, are they the same with Prilosec? Is there a way to balance both the heartburn and dirhera?

Thank you.

Answer: Either of these drugs can cause diarrhea, probably the most common complaint of patients. If one does and the other doesn't, I'll go with the one without the diarrhea. However, I suspect you'll have it with either. Fiber helps in some cases and occasionally Immodium or Lomotil is necessary.

[posted 08/10/1999]
Question: As one other individual asked, I note what may be minor hair loss with Prevacid. However, I am also finding (as I experiment)that supplemental iron not only improves my feeling of wellbeing, energy, and considerably reduces stomach gas, it may also have some effect on the hair loss. Might this not indicate some latent iron deficiency or is there a known iron/Prevacid interaction I should be aware of?

Answer: Iron supplements usually cause gas and bloating. If you had lost some blood with excess acid, iron might be of help-otherwise not. However, one of the possible causes of hair thinning is iron deficiency. So, you may be treating a problem you didn't know you had.

[posted 08/4/1999]
Question: After recovering from pancreatitis 2.5 years ago, I
continuted to have upper abdominal pain
with buring in the center of my stomach. All tests were run
and nothing was found. The drs. conclude the pain was probably
a stress-related IBS, but the only meds that ever worked to
eliminate the pain was Prevacid. I have been taking 30 mg a day
for two years now. Every time I try stop this medicine,
the pain returns within two days. Most recently I've had problems with feeling
like I can't get a good breath along with chest pains. All
tests confirm no heart problems and no lung problems.
One dr. suggested it might be related to the GERD, but I've
never actually been diagnosed with GERD. My basic question:
how can I get off the Prevacid and if I can't, what are the
long term problems I have to worry about? I really don't
like taking meds on a long term basis and I'm worried the Prevacid
might be doing more harm then good in light of my new symptoms. If
it is an acid problem, couldn't I just use something like Tagament?

Answer: Well, it might be worth trying large doses of Tagamet to see if your symptoms resolve-has this been previously done? The only advantage to Tagamet and its cousins, Pepcid, etc is the long term track record. Prevacid and Prilosec seem to have no major long term problems, at least to date. Your problem clearly is acid related, doesn't really matter what one calls it. The only reason to establish if it is GERD is that there are potential surgical approaches to fixing reflux, thus decreasing the medications necessary. This can be established by nocturnal ph testing by a GI specialist.

Prevacid and Vitamin b12 deficiency [posted 1/11/99]
Question: I take 30 mg of prevacid each day (two, 15 mg tablets) because of a 14 month old diagnosis of short Barretts Esophagus (1.5 cm, no dysplasia). I have been told that taking this much prevacid can lead to a vitamin b12 deficiency since prevacid reduces the ability of intrinsic factor to process the vitamin. I have also been told that taking additional vitamin b12 orally will not help because it will not be processed. I now have some slight symptoms of a vitamin b12 deficiency (periodic tingling in the feet and hands, some unexplained fatigue, slight muscle spasms and an odd sense that my balance is not quite right). Is it true that prevacid can lead to vitamin b12 deficiency?

Answer: I guess I'm not sure what you are asking me. The problem with B 12 is the decrease in acid necessary to cleave B12 from its intrinsic food source. This is theoretical and hasn't been seen clinically, as far as I know. However, oral B12 would fix this problem.

Prevacid & Hair Loss  [posted 12/01/98]
Question: I am 54 yr. old and have taken Prevacid for 6 months. About 2 months ago I began to notice hair loss for the first time. Is there a relationship?

Answer: Possibly, listed as one of the side effects, stop it and see.

Prevacid vs. Prilosec [posted 11/25/98]
Question: I have been taking Prilosec for a year. The Insurance company now says that it will pay for Prevacid. What is the difference? Will Prevacid work as well for stomach acid/reflux as Prilosec? Are there any drawback to either medicine? Am I better off having the surgery to fix the reflux? I realize that this is just general information and that I will get more information from my doctor. I am working with our family doctor. I am just interested in additional opinions. Thanks for listening and responses.

Answer: The drugs work about the same. If anything Prevacid might be a little better, but clinically about the same. If you are having severe reflux and are young, surgery is an alternative. If only occasionally and older, focus on the Prevacid.

Can You Crush Prevacid in Order to Ingest It [posted 11/10/98]
Question: My daugher was diagnosed with gastritis a week and a half ago. She has cerebral palsy and has great difficulty eating or swallowing. Her total nutrition is fed through a G-tube, as her medication is also put through the G-tube. She was prescribed prevacid to help her with her reflux and gastritis, but the bottle says to "swallow whole, do not crush". In order to get the medication through the G-tube, I have found that I have to lightly crush the contents, otherwise they get stuck. Is this all right? I sent an e-mail last week, but have not heard anything. Thanks

Answer: Prevacid can be crushed, prilosec cannot.

Concerns of Prevacid & Lipitor Interactions [posted 10/28/98]
Question: I have been taking Lipitor for a year with good results 147 total 78 ldl 40 hdl 140 tri. Started taking prevacid two months ago for severe acid reflux. Taking 2 30mg's per day for acid control. Last week had Cholesteral panel redone and number were very high for me 199 total, 114 ldl, 40 hdl, 223 tri. Diet is unchanged. Could prevacid react or cause Lipitor from working?

Answer: Not that I'm aware of. Recheck it. Have you gained weight since you stomach has been doing better?

Longterm Concerns about Prevacid [posted 10/28/98]
Question: I was wondering if there were any side effect from long term usage of prevasid. Or what are the short term effects are. Thank you

Answer: Hasn't been around long enough to get an accurate assessment of long term effects. Short term effects are usually GI, nausea, diarrhea etc. There is a long list of possible problems, but, they are rarely seen.

Headaches from Prevacid [posted 7/23/98]
Question: After taking 30 mg. of Prevacid twice a day for five days, I developed a headache in the temple area extending back over the ear. Waiting a week, I tried it again but developed the same headache on the fifth day again. What is the technical explanation for these type headaches? Is it advisable not to take Prevacid? If the headaches are not injurious, could I take Prevacid with a pain killer?

Answer: I haven't had any patients with this symptom complex and offhand I don't know of any connection. The PDR does not list it as a side effect, but if this occurs with you then it is. Try Prilosec. It's similar, but structurally different. Also, there would be no reason not to take some analgesia with the medication. I'd prefer to avoid aspirin and NSAIDS to decrease the inflammation of your stomach that prevacid is to treat.

Prevacid and H. Pylori
Question: I was diagnosed having H. Pylori. I took the antibiotic, and was also prescribed Prevacid. I feel great when I take the prevacid, (I take one 30 mg tab each day) and it knocks out my stomach pain. However, as soon as 24 hours rolls around, the pain comes back. Is Prevacid safe to take for long periods of time? If not, what should my next move be?

Answer: It seems to be safe, but it has only been around for a couple of years. Has the infection been eradicated? This is very tough to do in some patients. Usually, I prescribe 3 or 4 antibiotics plus pepto bismol plus prevacid to increase the "cure" rate. Ensure that the bacteria is gone.

Prevacid and Ticlid
Question: Diagnosed from EGD - Small intestine mild acute and chronic inflammation. Stomach-chronic gastritis without activity. Prescribed Prevacid. Also diagnosed TIA and some stroke risk. Using Calan SR to control hypertension for a number of years. Under Doctors care but have some questions about drug therapies. Can I used both drugs together safely? How long should I use Prevacid and how do I know if it is working? I am a 67 year old male.

Answer: There shouldn't be any interaction that I am aware of . Prevacid is usually used for a maximum of 2-3 months although with continued experience 6-8 months durations are sometimes used. You will know if it is working if your symptoms of acidity, pain, gastritis are reduced.

Prevacid for Gas
Question: I was told to swallow one Prevacid tablet per day to cure Gas problem(Bulging). I have already taken 55 tablets in 65 days. But still I am suffering with Bulging. I have undergone upper endoscopy test. It seems there is no infection or no ulcer, nothing. Every thing seems to be good. Since every thing is good, why do I have this gas problem? According to my self study, I think, I am getting gas due to anxiety? Is it correct? If I don't take prevacid one day, that day I get heart burn in the night. So how long I should take this tablet? Please give some details about Gas and cure.

Answer: Prevacid is very good as decreasing acid and heartburn. Less good at decreasing gas. We aren't really sure why people get gas. It is clear that some patients swallow air(especially with chronic anxiety). Dairy products and high fiber products will also occasionally produce this problem. I'd keep on the prevacid for the acid; but, I suspect your gas will continue. Has your gall bladder been evaluated?

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