#22

If purchased from Japan, Voquezna (Takecab/vonoprazan) would cost about $40 per month at 20 mg per day with a 500 pill purchase. The study below found it was effective at 10 mg. If so, as little as $20 per month if 20 mg pills are cut in half.

1 Like
#23

From a published literature review, October 2022:

“This article concludes that VPZ (Voquezna) is superior to PPI in terms of efficacy, safety and cost-effectiveness in reflux disorders and H. pylori eradication. Hence, use of vonoprazan should be preferred over conventional PPIs in these disorders.”

#24

Vonoprazen was familiar to me and now I remember why:
Efficacy of Vonoprazan for Helicobacter pylori Eradication - PMC.

Asian countries seem to be way ahead of the us and europe when it comes to treating upper GI issues. Stomach cancer is much more common in asia. H pylori is the most common cause of gerd, lpr, and stomach adenocarcinoma. The recommended therapy keeps changing and usually includes at least two antibiotics plus a ppi plus bismuth.

#25

I know this is old but I just found this, and got very excited. I’ve dealt with severe reflux for years and did get that TIF procedure mentioned back in 2020. It improved the belching by maybe 60%, so it is still not completely resolved. I notice sites like Alldaychemist don’t carry it.

I noticed it was just FDA approved in America

Only side effect I’ve researched is it reduces magnesium levels (so upping the magnesium dose sounds imperative).

#26

I take famotidine daily (10-20mg) for my GERD symptoms. While I’m slightly concerned about the possibility of increased dementia risk, I think the trade-off is still a no-brainer.

According to ChatGPT:

There has been some speculation about a potential link between certain medications, including histamine-2 receptor antagonists (H2 blockers) like famotidine, and dementia. However, the evidence does not strongly support this claim for famotidine. Here’s what current research indicates:

Background:

  • Famotidine is an H2 blocker commonly used to reduce stomach acid and treat conditions like heartburn, GERD, and ulcers.
  • Earlier studies raised concerns about other H2 blockers, such as cimetidine or ranitidine, being potentially associated with cognitive decline, but these studies often had limitations.

Current Evidence:

  • Limited Data Specific to Famotidine: Most studies evaluating the connection between H2 blockers and dementia risk focus on the class of drugs as a whole or on older medications. Famotidine is newer and has not been as widely studied in this context.
  • Contradictory Results: Some observational studies have suggested a potential association between long-term use of certain H2 blockers and an increased risk of dementia, but other studies found no such link or even suggested a protective effect.
1 Like
#27

The suppression of normal acidity in the stomach is probably the basis for all the bad things that happen with PPI’s, so Voquenza would be expected to be an even worse agent if it is indeed so potent. The majority of individuals who have GERD don’t have excessive stomach acidity, and there are functional items, especially being ideal body weight, not eating a few hours before bed and for some having a little elevation of the head can help. Dietary changes, avoidance of ethanol. caffeine, chocolate, blueberries are common items of advice.

To the original question that started this quote 2 years ago, here is the best answer I’ve found:
To reduce the health risks associated with the use of proton pump inhibitors (PPIs), several strategies can be implemented. Firstly, it is crucial to ensure that PPIs are prescribed only when there is a clear and appropriate indication, such as GERD, erosive esophagitis, or Zollinger-Ellison syndrome. Regularly reviewing the necessity of ongoing PPI therapy can help minimize unnecessary long-term use 1.

De-prescribing is an important strategy for patients without a definitive indication for chronic PPI use. This involves either tapering the dose or discontinuing the medication abruptly, depending on the patient’s condition and risk factors 1. Patients should be informed about the possibility of transient upper gastrointestinal symptoms due to rebound acid hypersecretion after stopping PPIs 1.

For patients who require long-term PPI therapy, using the lowest effective dose for the shortest duration necessary can help mitigate risks. Monitoring for potential adverse effects, such as vitamin B12 deficiency, hypomagnesemia, and increased fracture risk, is recommended, especially in patients with prolonged use 3 5.

In patients with multimorbidity and polypharmacy, careful assessment of PPI use is essential to avoid potential drug interactions and adverse effects. This population is particularly vulnerable to the risks associated with long-term PPI use, such as increased hospital admissions 4.

Additionally, clinicians should be aware of the potential for PPIs to alter the gut microbiota, which can increase the risk of infections like Clostridium difficile and pneumonia 5 7. Educating patients about these risks and ensuring they understand the importance of adhering to prescribed doses can further reduce health risks.

In summary, reducing the health risks of PPIs involves appropriate prescribing, regular review of therapy necessity, dose minimization, monitoring for adverse effects, and patient education. These strategies can help balance the benefits of PPI therapy with the potential risks, ensuring safer use of these medications. (ASHP Drug Compendium [Pantoprazole; Acid Ulcer Dyspepsia])

2 Likes
#28

I have always flat out refused PPI’s, despite them being prescribed to me. I’ve read all about the dangers of using them. Gastroenterologists hated me for saying I was concerned about taking them. That’s why I went straight for the TIF procedure.

These articles make Vonoprazan sound safer but who knows. It has been used for ten years in Japan.

#29

Ironically, I was at CVS this morning and decided to get famotidine since my reflux has been worse lately. I took a dose and it’s been better since. I don’t remember it working well before I had the TIF procedure but nothing could have made me feel better back then, it was so severe. Hopefully this continues to offer relief. Just have to watch out for any long term risks…

#30

You do not need to worry about Famotidine. It’s actually anti-age medicine:
Famotidine reduces acetylcholinesterase, lipid peroxidation, and oxidative stress, providing neuroprotective effects. Famotidine significantly decreases GSK-3β, IL-6, and Aβ(1-42), markers linked to Alzheimer’s disease. The research highlights famotidine’s potential as a GSK-3β inhibitor for Alzheimer’s treatment.

We all know lithium and his role in anti-age. Lithium and famotidine are the only two supplements that inhibit GSK-3β.

Besides, Famotidine does not affect gut microbiome, like PPI does.

Stay away from PPI like hell. For short period like 3 months it is ok to take. Chronic use of PPI are linked to many bad outcomes. It alerts gut microbiome.

If you have chronic reflux, then try ARMA procedure. This is only procedure that is invasive, safe and can be repeated.

4 Likes
#31

I tried PPIs briefly on two occasions (each time for a few weeks) back when I was dealing with gastritis and they made my symptoms worse, whereas famotidine had a small positive effect.

My reflux used to be quite bad when I was younger, even though I didn’t have many other symptoms. Now I don’t really get reflux (mainly due to a better diet, I think), whereas I get some other unpleasant GERD symptoms like excessive belching (I think this is a residual effect from the gastritis).

Anyways, the famotidine is sufficient to mostly manage these GERD symptoms and that’s a massive increase in QoL. I also sleep with a wedge under my mattress and have to mostly avoid coffee, chocolate, and alcohol. Caffeine doesn’t bother me as long as I stay below 250mg/day.

2 Likes
#32

For anyone who deals with GI issues, I would strongly recommend tributyrin. This is one of the few supplements that I strongly believe in.

I think it was one of the primary catalysts in allowing me to heal from a debilitating bout of gastritis that lasted for 3 years.
I’ve taken it daily for 2 years now and will continue to take it.

#33

Sounds like we have very similar issues, and I agree that QoL is very important. Do you split the Fatomidine into two daily doses? 10mg morning and 10mg evening? Or all 20mg in the morning?

#34

Great info.

Do you know if they can perform the ARMA procedure on someone who already had TIF?

EDIT: It looks like the procedure is only available in a few countries and I’m not sure the USA is one of them.

#35

I’ve had good results with the peptide BPC-57, both injections and capsules. A moderate dose of 250 mcg EOD is effective. Unfortunately, the benefits cease when the use is discontinued.

#36

I was able to get it for a relative of mine through Sigma Medex on Indiamart back in August while he waits for surgery. I don’t remember how much it was, but it wasn’t expensive. Brand name was Vonefi.

1 Like
#37

Good looking out. I just found it on Indiamart

I don’t think I’ll order any at the moment (want to give Famotidine a shot first) but just in case, they don’t ask for a prescription, right?

#38

A new finding with limited research, PPI’s may also significantly interfere with the biosynthesis of acetylcholine.

https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13477#:~:text=A%20recent%20study%20showed%20that,neuronal%20signaling%20in%20the%20brain.

1 Like
#39

No, you don’t need a prescription on IndiaMart. But you should be aware of any drug import laws in your home country and be sure not to order anything controlled. You need to check for drug interactions if you take anything else. Ideally of course, your doctor should give the okay for any medication, and then IndiaMart becomes an affordable source of medication when your insurance isn’t adequate for reducing cost locally.

1 Like
#40

I take a lot of sodium alginate that I make into a gel after eating, before bed, before gym. I’ve gotten foam wedges for the bed, but don’t like them. I’d like to get the LINX procedure performed next year, unfortunately the insurance calls it exploratory and currently doesn’t cover it. I’ve been taking PPI’s for years, but take magnesium malate and vitamin D and B to compensate.

How has TIF worked out for you?