WebMD Ask the Pharmacist

Stomachaches: Ask the Pharmacist

Dec. 22, 2009. Pharmacist Kristen Binaso, RPh, answers your questions about causes and relief for stomachaches.

Question:

Are there any contraindications for taking Protonix and Prilosec together?

Answer:

I would like to know why you want to take these medications together. You may not be aware but they are actually very similar medications -- think of them as family members so you want to take one or the other, not both.

Question:

Can I take expired Phenergan? I have a virus and am nauseated.

Answer:

You should not take expired medications, no matter how great the urge! Expired medications may not work at all or you may end up getting a severe reaction to them (since they have started to break down) and end up in the hospital. Each year you want to go through your medicine cabinet and go through all your medications. Don’t forget the over-the-counters, vitamins, and herbals, too! Make sure you dispose of them properly -- which means no more flushing! Get a sealable plastic bag and pour the medicine into it. You can add some water to help dissolve it a bit. Then add some coffee grinds or kitty litter (anything that would make it unattractive to a child or pet). Seal the bag up and toss into the trash. For more information, visit www.smarxtdisposal.net.

Question:

I have chronic constipation. My doctors are still workings on things to help me. My dad wants me to try castor oil. Is this something I should do?

Answer:

I know your Dad wants to help you, but I don’t think this “old remedy” is a good choice. It is important that you work with your doctors, trust them and their judgment because the treatment selected depends on the cause of the constipation. It’s work in progress.

Question:

My wife keeps giving my 3-year-old son Tums when he claims to have a stomachache. Is it good/safe to give it to him?

Answer:

The first thought that pops into my mind is, "How often are we talking about and is it the children’s version?" Tums makes a product for children but there are specific instructions on how and when to use them. This should not be a "usual" situation and I would recommend bringing this up with the doctor or health care provider for further evaluation.

Question:

My roommate has been throwing up all day. His stomach started to hurt at 2 a.m. and he started throwing up at 10:30 am. He has been throwing up all day (about every 30 to 60 minutes) and now it's 9:50 p.m. He hasn't eaten anything and has just tried sipping water. He is now throwing up bile. He doesn't have diarrhea or a fever. He had two beers last night (he drinks about that much regularly). We had the same dinner last night so it shouldn't be that. Do you have any thoughts or suggestions on how I can help him?

Answer:

You need to take him to the emergency room as soon as possible. Vomiting that does not subside needs to be treated immediately and he can be in a lot of trouble because he can become severely dehydrated (probably already is) which means his body is craving certain nutrients that help his blood pressure and his heart.

Question:

I had the seasonal flu shot. This past Friday I was diagnosed with the flu -- respiratory symptoms, chills, temperature, sore throat, severe body aches, stuffy head. The doctor said, more than likely I had H1N1. My question is: Once you have the H1N1 flu, why take the H1N1 vaccine, if the experts are saying you cannot get it again?

Answer:

Great question. It is hard to say because I don't know if your doctor performed the test to verify it was H1N1. If you fall into the groups to receive the H1N1 vaccine, I would still get it. If you had H1N1, you may have some immunity to it, but there are no guarantees. If you look on the CDC web site, it advises that there is no conflict if you choose to get the H1N1 vaccine if you have already had the H1N1 virus.

Question:

What medication is equivalent to fexofenadine?

Answer:

Fexofenadine is the generic name for Allegra. This is a medication that is used to treat allergies. If you ever have any questions about names of medications, talk to your pharmacist -- it is worth the extra time.

Question:

I take Metformin for my diabetes. I take 1,000 mg in the morning and 1,000 mg in the evening. I have started having very loose stool, bloating, and gas. Is this a side effect of this medication? I have been taking it for about two years.

Answer:

This a great question that you can always ask your pharmacist. Yes, these are common side effects from the medication. It is very important that you drink a lot of fluids so you do not become dehydrated. Are you taking the medication with food? This may help alleviate the gas and bloating. I would also recommend mentioning this to your health care provider on your next visit. They may adjust the dose of your medication.

Question:

Can I take Pepcid Complete if I am taking the beta-blocker Atenolol?

Answer:

This is a great question to ask your pharmacist and a great reason why you should always have your personal medication list on you so we can check for any interactions. You cannot take Pepcid Complete if you are taking Atenolol. The calcium component in Pepcid Complete can prevent the Atenolol from getting into your bloodstream, thus preventing it from working and may cause fluctuations in your blood pressure. I would need to find out a bit more about why you need to take the Pepcid Complete -- especially what exactly are your symptoms and how frequently they are. You may be able to take regular Pepcid instead. I encourage you to talk to your pharmacist for further assistance.

Question:

In an emergency, will Cipro 500 mg prescribed for a dog (by a veterinarian) help with a serious infection in a human?

Answer:

I have to draw the line when someone asks if they can take medication that was prescribed for their pet. If you have a "serious" infection, you are beyond Cipro, my friend. Any infection needs to be evaluated by a health care provider. Serious infections usually mean a trip to the hospital for IV antibiotics. We really need to focus in the U.S. on inappropriate use of antibiotics -- we are running out of choices to fight the "bad bugs" because of our careless use of antibiotics.

Question:

Why do you take some medicines on an empty stomach and at the same time every day?

Answer:

Great question. Some medications have to be taken on an empty stomach because it helps the medication dissolve and get into your bloodstream quicker. Certain medications need to be taken around the same time every day so you have a consistent level in your bloodstream and body. A good example of this is blood pressure medications -- you should take your dose at the same time each day so you benefit from the medication. If you ever have any questions about how to take your medications, ask your pharmacist. We are happy to help.

Question:

I have a bad head cold, my nose is clogged but it does drain occasionally, and both of my ears have a lot of pressure in them. What can I take to release my nasal drainage and clear my ears? I have tried Sudafed in the past but it just dries me out and makes me uncomfortable.

Answer:

This is a question that I got this past weekend. I would need to ask you a few more questions, especially if you have high blood pressure and how long you have had this for. Have you tried a saline rinse or something along the lines of a neti pot? This has helped many people with chronic congestion and may be worthwhile to try. It also should not have the same side effects that you felt with Sudafed. You want to monitor for signs of a sinus infection -- like puffy, painful areas under your eyes, headache, etc. At that point, you need to see a health care provider for further evaluation.

Question:

Can I take Augmentin and Zantac 75?

Answer:

You can take these medications together. I advise my patients on Augmentin that it can be harsh on the stomach (which may be the reason why you are inquiring about the Zantac -- I am not so sure it will help). So make sure you take it with a full meal, rather than just some crackers or toast. It is also common to have diarrhea while on this antibiotic as well. If you have any questions about side effects from a medication, talk to your pharmacist, we are happy to help.

Question:

What do I do if I have a horrible stomachache, body aches, nausea, and weakness ... but have no fever?

Answer:

You could actually have the flu so you want to stay home from work and rest! This doesn’t mean you get to go to the mall or to the movies. You can take Tylenol or acetaminophen for fever, aches, and pains. You should focus on staying well-hydrated and eating a normal diet as much as you can. If you don't start to feel better in a few days, or develop a high fever, contact your health care provider for further evaluation.

Question:

Is there anything I can do/give for a 5-year-old who is vomiting -- which now is dry heaving bringing up just thick substance. She has pain in her belly before she vomits. No cough, no stuffy nose, no sore throat. Can I give her Pepto-Bismol? Something to halt the dry heaves?

Answer:

The first thing that came to my mind is "how long has this been going on for?" Anytime I hear that children have been vomiting for some time or is starting to dry heave my first words are "call the pediatrician and go to the ER"--the child is probably severely dehydrated and probably needs IV fluids. You should not give her Pepto-Bismol because it is not for vomiting and since this may be a virus you should not use Pepto-Bismol liquid because one of the ingredients is related to aspirin and is associated with Reye's syndrome. Pepto-Bismol actually has a children’s formulation that contains calcium carbonate instead, which is safe to use.

Question:

How much Zofran do I give my 2-year-old?

Answer:

The first thing that I would like to ask is "Why are you giving a 2-year-old Zofran?" Zofran is a medication that is used to help nausea with chemotherapy. I hope you are not giving a child a medication that you had "handy" in the medicine cabinet. Remember, you should not give anyone medication that was not prescribed for them and children are not "little adults."

Question:

My husband is taking 40 mg of Prozac and is really depressed and has thought of suicide. What do we do?

Answer:

I would recommend voicing these concerns to his doctor or health care provider. We are learning that therapy has to be individualized and that therapy may have to be changed to find the right fit. Is he also seeing a psychologist? There have been some recent studies that have shown that therapy and medication are very beneficial to patients with depression. I would also like to know if he is taking his medication every day -- this is very important so he builds consistent blood levels of the medication. Help is available and if you need additional guidance, talk to your pharmacist.

Question:

I'm having pains in my stomach. I feel lightheaded and dizziness, the feeling of vomiting and pains in my chest. What are these symptoms of?

Answer:

I would highly recommend heading to the ER and having it checked out. Sometimes, it could be an episode of severe heartburn or it could be something else -- especially since you have pains in your chest.

Question:

My daughter was prescribed ranitidine for stomachaches. We filled the prescription. But the taste is so bad she cries when she has to take it. I even tried it; it's gross. Is Maalox Max even close to the effectiveness of ranitidine?

Answer:

For starters, I took a look at the Maalox Max label and saw that it clearly states "keep out of reach of children" and for children under 12, "consult a physician." We have to be very careful about trying to give adult medications to children especially when they are being treated for a condition with a prescription medication like ranitidine.

Next, did you ask the pharmacist if they offer flavoring of medications? Many pharmacies now offer this so they could try flavoring it to something that will make it taste better. Did you also talk to your health care provider about it? It is really important that you always talk to your pharmacist and your health care providers when you have children, not matter how big or small the issue.

Question:

I am taking azithromycin 250 mg and now I have diarrhea. Can I take Imodium with this?

Answer:

Good question -- mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your health care provider right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea, even with Imodium, without first checking with your doctor or health care provider.

Question:

What over-the-counter (OTC) medication is OK to take for headaches when you have stomach ulcers?

Answer:

This is a popular question that I get a lot at the pharmacy. For a headache, you can take Tylenol or acetaminophen. This medication is safe to take if you have stomach ulcers. You want to make sure you follow the dosage instructions on the package and if you have any questions, talk to your pharmacist -- we will be happy to answer questions like this.

Question:

My husband has a stomach pain. I give him Pepto-Bismol. Is that good for him to take?

Answer:

How long has he had the "pain?" I would also want to ask if he has had any blood in his stool because this could be the signs of an ulcer. Has he been to the doctor recently and did he mention it? I would recommend holding off on the Pepto-Bismol until we can get more information.

Question:

I believe I have a urinary tract infection (UTI). I have lost my job and cannot afford to see a doctor now. Can I take amoxicillin and will it help? I have 875 mg and enough for about nine days. I was trying to see if I had to have prescription for Cipro, or if amoxicillin would be an OK replacement for now?

Answer:

You should not be taking amoxicillin for a UTI -- it will not help. Antibiotics have specific uses for specific infections, that is why it is important to see a doctor or health care provider for evaluation. I encourage you to call your local hospital to see if they are running any free clinics or see one of the "retail clinics" in some of the pharmacy locations like CVS and Walgreens. They will charge a minimal fee. If you don't get this checked out, your infection will get worse and you will probably end up in the hospital and require stronger medications, which in the end lead to a bigger bill.

Question:

I'm taking omeprazole 20 mg and Norvasc 10 mg. Can I take Zantac with them? Thank you.

Answer:

This is a good example of a duplication of therapy. You cannot take omeprazole and Zantac because they both try to do the same thing, decrease the amount of acid in the stomach. I would ask what symptoms you are having that make you think you need the Zantac. Most likely, I would recommend you calling your health care provider to alert them to your symptoms. They may want to re-evaluate your condition and medications.

Question:

My sister recently cut off part of her finger slicing something for dinner. She has no insurance; however, she's greatly concerned about infection. She is also a nursing mother, which now brings me to the question: She has two types of antibiotics, amoxicillin 500 mg and cephalexin 250 mg. Which one should she take and are either one of them safe while nursing?

Answer:

This is a very serious situation. You should not be "evaluating" what antibiotics you should use that you have in the house for this. She needs to be seen by a health care provider. She may need stitches along with strong antibiotics because skin infections are very hard to treat and sometimes may even require IV antibiotics. You may want to call a "retail clinic" to see if they handle this, local hospital to see if they have a walk in clinic, etc. and if not, go immediately to the emergency room.

Question:

Is the H1N1 vaccine shot safe for nursing women? I am nursing an 11-week-old.

Answer:

Yes and what a great question. Both seasonal and 2009 H1N1 flu shots or nasal spray should be given to breastfeeding mothers. Breastfeeding is fully compatible with flu vaccination, and preventing the flu in mothers can reduce the chance that the infant will get the flu. Also, by breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant’s chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies, since they are too young to be vaccinated.

Question:

Is it safe to take ginger root with prescribed medications?

Answer:

The FDA considers ginger to be a safe food supplement. So in food the root is OK and does not have any activity. Larger doses carry the potential for adverse reactions. Adverse reactions can include mild effects such as heartburn, diarrhea, and mouth irritation. I would recommend speaking with your health care provider first especially if you are on prescription medications. They may want to monitor you more closely for a few months.