Prilosec

My Dr. has me on Axid for 6 months for ulcer protection.  It is part of their normal post-op procedure.  They also use Actigal and a prescription iron supplement.

thanks for everyones thoughts...I had the RNY surgery. Originally, Dr. Geller prescribed something which I can not remember; however, he also put in the post op instructions that I could use Prilosec in liu of the prescription...I remember that my insurance either (a) would not cover the cost of the original prescription or (b) it was substaintally higher than priolosec...I've found Prilosec at Sams club for about $21.00 for a months worth and saw it today for about $18.50 at Rite Aid...Frankly, I ran out of the stuff and wondered how long I should be taking it. I'll ask the dr.next month and let you guys Know... again thanks! David

My insurance wouldnt cover the prescription Prilosec, but it covered Prilocec OTC, and all I had to do was pay the $5.00 co-pay my insurance requires for a 90 day scrip.  The difference is miniscule between the two, and could save you a ton of money.  My Doc wants me on it fo a year, because I had previous reflux issues.

 I wondered what the difference was in terms of strength, as I have never gotten the prescription strength P before ..   not much I guess?

Prescription Prilosec comes in two strengths: 20mg and 40mg capsules.  Most people who don't have a stomach (or pouch) full of battery acid do quite well with 20mg/day.  Others can be prescribed the 40mg/day. The prescription formulation comes in the form of a capsule, containing little coated sprinkles.  No, they're not "tiny time pills" which are to be avoided by RNYers, each sprinkle is coated with an acid-resistant coating which eventually dissolves in the small intestine.  (Most every PPI like Prilosec is inactivated by stomach acid, so it has to be protected against it, so it can be absorbed in the intestine.)  Capsules are handy, because they can be broken open, the contents sprinkled on applesause or yogurt, and be given immediately post-op. BUT, capsules haven't been used for OTC drugs ever since the infamous Tylenol scare of 1982: some nutjob placed cyanide in Tylenol caps, killing seven people.  So-called "gelcaps" available today are really capsule-shaped tablets coated with a capsule-like gelatin coating; they can't be broken open and tampered with. Anywho, Prilosec OTC can't be formulated as a capsule for the reason above, so Proctor & Gamble, along with Astra/Zenica, the Swedish manufacturer of Prilosec, came up with a solid tablet that protects the drug against stomach acid and dissolves in the intestine. Prilosec OTC comes in a single dosage, 20mg, the same as the lowest prescription strength.  So, if 20mg is enough for you, it doesn't make any therapeutic difference whether you buy it by prescription or OTC; it's mainly just a matter of cost, depending on what your insurance covers. /Steve

 very interesting, Steve ..     So, it sounds like OTC Prilosec won't even work for us w. DS or RNY ..   right?

Hmmm... I don't see why it wouldn't. Prilosec OTC might be a tablet, but it dissolves in the intestine where it's absorbed.  Both the prescription form and the OTC form are delayed-release--the drug is protected against stomach acid until it enters the intestine.  But once it's in the intestine, the tablet should dissolve and be absorbed completely.  And if you need 40mg rather than 20mg, just take 2 20mg tablets. I suppose that there's a theoretical possibility that the environment of the jejunum (for both RNY and DS folks) won't be similar to an intact GI tract in which the tablet or capsule passes from the stomach into the duodenum.  Duodenal juices are quite alkaline compared to the stomach, and it's that change in pH that promotes the dissolution of the acid-resistant coating.  Of course, in RNYers and DSers, the duodenal juices don't encounter anything swallowed until both limbs meet in the common channel, further downstream.  But as far as I know, there haven't been any studies looking the efficacy of any PPI drug in patients who have had RNY or DS surgeries.  I'd think, however, that MDs who prescribe PPIs for GERD and ulcers would notice if they suddenly became ineffective in RNY and DS patients, simply because they're usually SO powerful and effective at reducing acid production. /Steve