Infantreflux.org | prilosec not working

This topic has 4 replies, 1 voice, and was last updated 16 years, 8 months ago by Anonymous.

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February 4, 2008 at 11:18 am #47970

Anonymous
Inactive

Hello,

My Ds is 10 weeks and is taking 2.8 mL of prilosec twice a day. He spits it ALL up after about 5 minutes. His spit up is also going further than just dribbling down his chin. It kind of shoots which is new. THe GI doctor said that he thought that more than anything he has a MPI, since I had it and my 4 yr old did as well. But my question is this he said that he would switch the prilosec to something else if it didn’t work (he has been on it since the 23rd of Jan) BUt I am also BFing and his symptoms of MPI are VERY similar to foremilk/hindmilk imbalance. Does anyone have any experience with all of these issues. I am about ready to pull my hair out. I have cut out all dairy and would love to not have to do it if it is a BFing issue rather than a MPI….I am so confused!

February 4, 2008 at 7:21 pm #47980

hellbennt
Keymaster

sorry you’re going through all of this!

thoughts:

1) work on OAL/foremilk/hindmilk to rule it out:

What to do about OAL scroll down to the 4th post by Bensmama:

https://www.infantreflux.org/forum/forum_posts.asp?TID=9959

OAL:Gaining, Gulping, and Grimacing?
http://www.wiessinger.baka.com/bfing/trouble/gulping.html

http://www.users.qwest.net/~fsdebra1/refluxoal.html

2) check prilosec dose (look at bottle to see how many mgs/ml to figure out how many mgs) & check out dosing at http://www.marci-kids.com

3) check out how it’s being made! unfortunately, it’s most likely not being made properly…

compounding from lori: https://www.infantreflux.org/forum/forum_posts.asp?TID=7855&TPN=1

4) consider Zegerid– it’s prilosec in a STABLE compound (Liquid) that you mix up your self (from packets)

5) if it’s being made PROPERLY and you’re at a PROPER dose for baby, then consider switching to prevacid

6) in the meantime, give the zantac, too, just make sure to give it 4hrs seperate from the prilosec- we can help you with MAX dose- it’s 10mgs per kilo

7) if, after being on a PROPER dose & form (prilosec compounded properly, zegerid, etc) of PPI, you still think it’s MSPI, then do the TED

February 5, 2008 at 12:46 am #47999

Anonymous
Inactive

The prilosec is 10 mgs/5mL, and he takes 2.8 mL twice a day. He weighs 12 lbs 3.9 oz. I do think that is is OAL and foremilk/hindmilk imbalance. But I have been doing block feeding and it is not working at all. When we went to the Ped Gi specialist he said he didn’t RX zegrid (not sure why though). I can’t switch doctors wither because of insurance issues. I do know that it is compounded but as far as it being correct I am not sure. When I mentioned to him about it not lasting long if it was compounded incorrectly his response was ” well it will only last two weeks and by then you will know if it is working or not” Plus we are dealing with a military pharmacy to top it off. The prevacid is strawberry flavored I think and he thought that the flavor would cause allergies for his age?!

Also as far as the prilosec, am I supposed to give it at a certain time (before feeds, after or something)? They never said.

Gosh this is all soooo frustrating!

February 5, 2008 at 7:35 pm #48031

hellbennt
Keymaster

This is me showing you the math[edited to add that I’m not trying to be snarky, just factual]:

10mgs in 5mls

5mgs in 2.5mls

2.5mgs in 1.25mls

1.25 mgs in .6mls

~~~~~~~~~~~~~~~~~~~~~~

Dose is:

2.8 + 2.8 = 5.5mls a day

There’s 10mgs in every 5mls you give him.

So he’s basically 10mgs plus 1.25mgs = 11.25mgs a day

weight is 12lbs

12lbs = 5.5 kilos

CONSERVATIVE dose is 3mgs per kilo.

that’s 5.5 x 3 = 16.5mgs a day

baby’s dose is only 11.25mgs a day….

The dose is low.

FIRST I would FAX the Doctor. keep it short & sweet with NO FEELINGS OR EMOTIONS (other than the THANK YOU SO MUCH FOR HELPING MY BABY!).

First THANK DOCTOR.

then state baby’s weight (5.5 kilos) and dose (11.25mgs a day).

state baby’s symptoms.

then state: Prilosec dosing is 3mgs per kilo. baby weighs 5.5 kilos, so his dose can be increased to 16.5mgs a day.

THANK you for your all of your help!

Please send new prescription to (fill in pharmacist’s name and phone number & fax number).

THANKS AGAIN,

________________

Then:

I would write out/type out how EXACTLY you want the compound to be made. TELL. Don’t ask. Talk to the pharmacist and ask (beg) her/him to pretty please humour you. Hand over your instructions. If THAT doesnt’ work, FAX YOUR DOCTOR and TELL her/him to write the prescription this way (then put the instructions). THANK the doctor for humouring you! call the office to tell fax was sent. call office later to ask when you can come pick up the prescription you asked for OR if it’s going to be sent to the pharmacy directly? THANK THEM.

I gave you the link above. From that link, here is what you need to know:

[quote s&h’smum] it needs to be made with 16.8 percent sodium bicarbonate. (If you are giving 7ml or more each time then you can do 8.4 percent.) The concentration should be somewhere between 2-4mg/ml so that each dose has at least 3.5ml to ensure enough buffer.

then request the flavoring on the side

SO: you have some faxing to do. You might be surprised and the dr won’t even question you as to where you got your dosing. The dosing I’m giving you is CONSERVATIVE and was CONSERVATIVE FOUR YEARS AGO.

I did EXACTLY THIS (the faxing for the dose increase, just stating the dosing and what I was requesting) and it worked for me…

a PROPERLY compounded medicine can be given at any time, nothing to do with meal times or with or without food.

hellbennt2008-02-05 22:11:42

February 6, 2008 at 12:47 pm #48044

Anonymous
Inactive

If he’s getting 2mg/ml suspension but only 5.6ml a day, then he’s only getting 11.2mg/day. Which is low. The other problem, is as laura mentioned that according to marci-kids, you really need to give at least 3.5ml per dose to ensure enough buffer, and it needs to be make with 16.8 percent sodium bicarb at those lower doses. I’d check out http://www.marci-kids.com to see how high you can go. They’re aggressive, but the doses do work. I’d personally try zegerid if you’re going to do a prilosec suspension, though I’ve never tried it myself. The prevacid soultabs are another option, but then you need to time them around meals.
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