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Stopping Heartburn Medicines Pose Challenge

Messing with Mother Nature sometimes leads to unintended consequences. This is especially true when it comes to your body.

Drug companies are quite adept at developing medications that make us feel better. They often have a harder time dealing with the fallout of their efforts.

Take decongestant nose drops, for example. Anyone with a stuffy nose will tell you it is a very uncomfortable feeling. Congestion can be brought on by a cold, allergies or a sinus infection.

Pharmacies sell lots of nasal sprays like Afrin (oxymetazoline) and Neo-Synephrine 4-Hour (phenylephrine). Such drugs are effective because they constrict blood vessels in the nose. Used for a couple of days, they can relieve symptoms with relatively few side effects.

But if you use a nasal decongestant spray for more than a few days, your body begins to compensate. The tiny blood vessels in the lining of the nasal passages try extra hard to bring blood to the tissues that have been deprived. As the medication wears off, the blood vessels dilate and cause rebound nasal congestion.

This can lead to a vicious cycle. We have heard from readers who were so dependent on their Afrin nasal spray that they kept containers under their pillow, in the car and on their desk at work. They may keep on using the spray long after the cold or allergy is gone, sometimes even for years.

The same thing can be true for acid-suppressing drugs. Medications such as Aciphex, Nexium, Prevacid, Prilosec and Protonix are best sellers in the pharmacy. They are known as proton pump inhibitors (PPIs). These drugs are very helpful for healing ulcers and can also ease symptoms of serious heartburn (acid reflux).

The body, however, seems to think that acid in the stomach is a good idea. Just as the blood vessels in your nose dilate after repeated use of a vasoconstrictor, so too the cells in your stomach lining work extra hard to make acid when repeatedly exposed to one of these powerful medications.

If a PPI is discontinued abruptly, acid-making cells go into overdrive, sometimes for weeks or months. Rebound acid production is a lot like rebound congestion. The resulting discomfort makes it hard not to start using the medication again.

One reader wrote: “I have been taking Protonix for heartburn for about six months. After learning of potential ill effects from long-term use (weak bones or pneumonia), I tried to stop taking it. After about a week, I had to start taking it again due to severe heartburn–the rebound effect, I suppose. I asked my pharmacist how one should discontinue use, but she was unable to find out.”

There is very little information about how to stop taking PPIs. Some doctors suggest gradual dose tapering and using weaker drugs such as Tagamet, Pepcid or Zantac during the transition.

A leading expert on natural medicines, Tierenoa Low Dog, MD, has had success helping patients with this problem by using a natural licorice compound called DGL (deglycyrrhizinated licorice). You can listen to Dr. Low Dog discussing the issue at www.peoplespharmacy.com.

Before you start taking medicine, find out how and when to stop. Sometimes getting off a drug can be harder than you expect.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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