My cough, Proton Pump inhibernators (Pepcid) & Biologicals

I've had this slight cough for the past 2+ years, I thought it was allergies to my dog because it happened about the same time that I got her as a puppy. I thought that maybe it was allergies to something else or the antibiotics that I was taking at the time. The cough would happen a few times a day and it was hard to replicate it for the doctors when I was at visits.

It was getting worse so I finally went to an allergist last week and they tested me for asthma and allergies but nothing really showed up except for a slight allergy to dust mites.

I must have finally triggered something at my insurance company with all of my claims and they assigned me a nurse to discuss my medical conditions and she called yesterday asking me if she could help me & discuss my health.

She thought that since I'm not responding to antihistamines that the cough could be due to acid reflux. But I've had heartburn 2-3 times in my life, how can it be acid reflux? She said that it presents differently for people and a cough could be my only symptom.

I grabbed some Pepcid yesterday and most of my cough went away. I took my 2nd dose this morning and I'm doing even better.

So my question is, can you take Pepcid (or another PPI) with a biological? On the warning label, it mentions not to take it with Methotrexate or Tacrolimus with Pepcid. Should I be worried about a biological like Stelara and a PPI? Just a general question about your GI's have told you about biologicals and PPIs.

My other concern is that I have bone issues (hip replacement) and long-term PPI use can make them worse. I'll have to discuss this further with my GI and my ortho surgeon. I've only taken two pills so I'm not worried about this just yet.

Stelara is for pouchitis. I've only been taking Pepcid for 48 hours. If and when I get diagnosed with acid reflux then I'll consider all options including diet. I need to go for a scope soon so I'll ask for an upper endoscopy while I'm under sedation.

My GI is unavailable because he is in the process of moving to a new hospital/practice. Hopefully, soon I'll be able to get in touch with him, I don't want to deal with a GI at his old practice, I've been using the same GI for almost 14 years.

I was given a full set of allergy tests by the allergy doctor last week. I had no allergies during the first test (skin pricks) and so they went with the more invasive skin injections and I had a moderate reaction to dust mites.

What also makes me think that it is Acid Reflux is that I have it mainly after eating or drink and laying in bed. I never put that together until the nurse mentioned that it could be acid reflux.

They did not do a food allergy test on me. They said that they only do it if necessary but the allergist wants me to come back in 45 days.

I'm on an antihistamine called Xyzal and it really knocks me out plus dries my skin out; I'm not a fan of it.

I'm pretty certain that I have Silent reflux.

Back to my original question, can you take PPIs with a biological? The packaging warned against using them with Methotrexate and Tacrolimus; do we need to worry about biologicals with PPIs?

Yes you can take them. I was prescribed and took Prilosec for a year but recently switched to Pepcid.

I had an office visit yesterday with my GI at his new office.

I was trying Gaviscon, Prilosec, tums and they all made my j-pouch act up so I had to discontinue them. Some people take them with their j-pouches to help lower the acid to prevent butt burn. They actually gave me butt burn for the first time since having my jpouch. Crazy.

So I had to stop taking them and switched to Zantec which was only mildly helpful.

He gave me a script for Aciphex and it instantly stopped my coughing, congestion and acid reflux. The problem is that Aciphex is not a long term solution, you can only take it for a few months, up to a year max.

I feel like a new person on Aciphex, I can sleep, I am not hungry, my stomach is quiet, my gas is gone, and I have lots of energy. The output of my pouch is great.

All of my blood work from yesterday came back great, Sed Rate is at an 11 and all my CBC numbers came in within range.

I now have to schedule an upper endoscopy and and flexible sigmoidoscope, going to have them done at the same time.