Okay, vet has my horse (once again) on Omeprazole. I’m pushing to try misoprostol even though colon came back with no visible ulcers, omep isn’t working and I really want to push for some hind gut treatment. My question is, can I give Omeprazole with misoprostol? Say, at different times? if so, what timing do you suggest?
Yes. Vet put my horse on Gastroguard, Misoprostol and Sucralfate for Grade 4 ulcers. Yes, you need to feed things at different times of day, but your vet should be able to walk you through that.
Okay, called him and he said “that won’t work” … but I say I want to try anyways. He suggested feed omeprazole first thing in the morning, and misoprostol in the evening. Does that sound like about what everyone else does?
My recollection is that Sucralfate is the “problem” medication in terms of feeding schedule. It interferes with the absorption of Gastrogard - so you have to keep at least 2 hours between the two drugs.
If you aren’t adding Sucralfate, it should be pretty easy- I’d give the Gastrogard immediately upon arrival in the AM, then put the Miso in the am and pm grain (I believe it’s 2x/day, but it might be 3x - been a while).
1 Like
When my guy was on omeprazole and misoprostal it was on the same schedule as joiedevie! Basically he was given the omeprazole at 6 am and then half an hour later his first dose of misoprostal then at 11 we went outside to his paddock and gave him his 2nd dose of misoprostal . He was on this for a few months during his loooooong treatment until he was eventually pulled off the misprosta and put on bethanochol chloride which we gave on the same schedule. (Whenever he was at the vet clinic for scoping and treatment he was oalso on sulfracate but I never had to give this at home)
My mare is on Miso in the morning and omep in the evening. No problems 
yes you can. i’ve done it. misoprostol helped mine when omep didn’t
eta: mine got omeprazole powerder (he already did the 7 weeks of tubes) am and Miso am and pm.
We ended up stopping the misoprostal on my guy when he actually got worse! Bethanochol was his turnaround then eventually Sulfa antibiotics after a year, but he was an abnormality! He has still not shown any symptoms of hind gut issues even with the continued omeprazole but it’s someth we worry about! Has yours shown any possible hind gut issues or had an ultrasound that shows any concern? If so, I’d not worry about giving misoprostal and omeprazole together!
Im not a big fan of just giving meds “just because” … maybe you’d be better trying something like Suceed if your vet is not wanting to give misoprostal!
Misoprostal caused a full on colitis in my guy. Attending vet said she doesn’t prescribe it unless horse has ulcers thought to be associated with prolonged bute administration and then only when the horse can be carefully monitored.
1 Like
