Infantreflux.org | is prevacid solutabs better than compound prilosec

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April 22, 2008 at 10:14 am #50679

Anonymous
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We are up to 20mg compounded prilosec/day. baby was getting lots better for about 4 days and then all the sudden she seems worse again. Dr. will let us go to 32mg/day or the prilosec but it is soooo hard to give her that much, especially since she can’t have anything with it to make it taste better. And we can’t even be sure it is still reflux or something else. She also had vaccines 3 days ago.

Pharmacist recommended for us to ask for prevacid solutabs so I have a call in to the dr. I just wonder if it works as good (not that prilosec is working for us yet). Or should we give the prilosec more time? She has been on it for 1 week starting at 8mg/day and increasing by 4mg each day up to 32mg/day divided into 2 doses.

We really don’t even know for sure if it is still reflux or somethine else. She is very fussy mainly at night but doesn’t have the same exact symptoms as before the prilosec. Could we be giving her too much medicine, prilosec or a combination of all the other crud?

She normally takes 5ml (10mg) of prilosec 2x/day, about 1/4teaspoon mylanta as needed up to 5x/day, mylicon & coliccalm in warm water. and sometimes even pepcid complete 1/2 tab at night but not the last two cause I wanted to see if that was what caused her recent fussiness.

Oh, and she is ALWAYS very fussy right after eating and still spits up after eating although not as much as before. She is starting to comfort feed a little more like before the prilosec.

Sorry for so much info, probably hard to read all this.

April 22, 2008 at 12:55 pm #50685

Anonymous
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First off the meds are both good, however the solutabs are more “stable” than the compound b/c of how they are made. The compounds are rarely made properly and tend to only be effective for 2wks at a time so you have to have them redone every 2 wks. The solutabs taste good and are easy to give so those are pluses for me. Cooper only have to see his prevacid packet and he gets all excited and loves to take this medicine. So we are fortunate. If you want to give it more time then I would, but if you truly think the prevacid will be better b/c of ease of giving then I would switch. Just make sure that you get a good dose. And remember that with the solutabs you have to give on an empty stomach and follow with a meal 30-60 min later. So timing is now an issue where as it isn’t with the compounds. HTH.

April 22, 2008 at 2:43 pm #50692

Anonymous
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So, are you telling me we don’t have to wait 30 minutes after the prilosec? I thought I read that the prilosec (delayed release omeprazole) was one that did have to be given 30-60 minutes before. That may mean that we can give it w/ milk or juice w/ a feeding??? if so that would make it sooo much easier.

The dr. did call in a prevacid solutab scrip for us but it is only 1 tablet/day and I don’t know how many mg that is, probably not enough. If it is not enough we may stick with the prilosec because she allowed us to have up to 32mg/day which is more than enough for her weight.

I’ll search a little more on the prilosec about whether or not we have to wait the 30 minutes and if we can give it w/ milk.

thanks.

April 22, 2008 at 2:48 pm #50693

Anonymous
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I believe that all compounds can be given whenever, but someone please correct me if I am wrong. Also the solutabs come in 15mg tablets. We are on 30mg (well actually 22.5mg but we are weaning down) but we started on 7.5mg/day so she may just want to see if 15mg/day will help. You do whatever you feel is the best for your situation.

April 22, 2008 at 3:02 pm #50697

Anonymous
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What you are saying is similar to what the pharmacist told me, that we don’t have to wait for the prilosec, we just did it because I thought that I read it here somewhere.

The dr.s nurse (kind of dingy that one) that I usually speak to told me the prevacid is the same, just give it to her anytime. And if I read the drug info from our isurance website it doens’t say to wait before eating (with prevacid) but even says you can take it with applesauce, juice, etc. I do believe I’ll go by the info I’ve gathered here though.

I’m not sure if she gave 15mg or 30mg, probably the 15mg. Which would be odd since she gave her 32mg of prilosec and the dosage seems to actually be less for prilosec on marci.

dang, that prevacid is $$$, insurance pays $135 for that drug, I’m glad we met our deductible already.

April 22, 2008 at 5:40 pm #50699

hellbennt
Keymaster

compounded PPis can be given whenever. this includes zegerid, as it’s a form of compound- you take the packets & ‘compound’ it yourself….

solutabs need to be given on an empty stomach

April 22, 2008 at 6:01 pm #50700

Anonymous
Inactive

If you do end up getting Prevacid, there is a savings card you can sign up for. It will save you up to $25 every time you refill the script. I am not sure how this works for compounding, but with our solutabs the card saves us $25 per month. If your co-pay at the pharmacy is $60 every time you refill (like us), the card saves you $25 making the total you pay $35. If your co-pay is $20 the card saves you $20 and you pay NOTHING.

Once you sign up, the card and info packet takes about 2-3 weeks in the mail. Then all you have to do is activate the card. When you take it to the pharmacy, it is run as a secondary insurance. Here’s the link:

http://www.prevacid.com/offers/beyondtheburn.aspx

April 22, 2008 at 6:58 pm #50702

Anonymous
Inactive

luckily we don’t have copays, just a deductible which is met already after the birth, etc.

Now we have to decide if we want to switch her to 15mg prevacid or stay on prilosec since we have a choice to give her up to 32mg. WHy do the dr.s prescribe less prevacid when it is almost the same medication? I know I could get another scrip of prevacid from my older son’s family dr for his own occaisional heartburn, but I know this is a no no. I know people here like to give their newborns 30mg per day, is this extremely safe to do? Is it done as 2 15mg tabs or 1 30mg tab at once? Our ped gave her 1 15mg tab once per day.

Is it possible that the prilosec compound causes gassiness and cramps? I thought I had remembered reading that somewhere.

April 22, 2008 at 8:45 pm #50705

Anonymous
Inactive

Ok, my two cents… as a breastfeeding momma, the solutabs about drove me to the nuthouse. It was IMPOSSIBLE to time it correctly and get him to eat a full feed when I needed him too. It was too much for me to handle. We moved to Zegerid, which can be given whenever, but your compounded Prilosec works the same way and can be given whenever too. I would just double check to make sure they are making it correctly. It is possible that if they ARE making it correctly, the extra sodium bicarb could cause her to have gas. I would use the Mylanta to help with this.

If you should decide to go to the solutab, the best way to go is to give it 3 times/day. Marci-kids recommends this because babies metabolize the meds so fast, that the med doesn’t stay in their systems nearly as long as it does for us. AGain, the timing is a bear, but I would do it AT LEAST 2 times a day. One really won’t cover her for the whole day. Maybe you could do it twice a day and then keep using the Pepcid Complete as well.

As far as dosings go. I know 30 mgs. sounds like a ton, but many, many babies aren’t comfortable until they are on a HIGH dose.. my son was taking 48 mgs of Zegerid each day from about 4 months of age until he was a year. That’s really high, but it took that much for him to be comfortable. If you are worried, try emailing Dr. Phillips… from marci-kids.. he will respond. He’s great.. very busy man, so the email will be short and to the point, but he knows his stuff!

Also, I know you are trying to do one change at a time, and that’s a good thing, but the I would suggest that your wife start keeping a food diary. I know you mentioned that she wasn’t ready to really start cutting foods yet, but just keeping track of her food and babies’ reaction, may help you figure out when her fussier times are and if they are possibly food related. What your wife eats will typically be in her breast milk about 3-4 hours later.

HTH!!

April 22, 2008 at 9:47 pm #50712

Anonymous
Inactive

So do you think I should jump right in to the 30mg/day or work our way up starting with the 15mg? The nurse told me three times (cause I kept asking her) that it didn’t matter when we gave it, before or after feeding. Maybe we’ll try 15mg for a few days and see how that works, I really don’t want to give her more w/o the dr.s blessing.

Do we just break the solutab in half and dissolve it in some water? There are no instructions on how to give it. I’ll search around here a little.

area1232008-04-22 21:53:46

April 23, 2008 at 9:54 am #50723

Anonymous
Inactive

Ok, I’m not a doctor or a nurse, but your nurse is WRONG! It totally matters when you give it to her. It needs to be 30-60 minutes before a full feed. It is a delayed release PPI, so if you feed her too soon, the food will prevent the med from being absorbed into her system and it won’t work as well. Many docs are clueless about this. http://www.marci-kids.com has great info on this. Might be worth checking it out and maybe printing some info for your doc too!

Yes, you break the solutab in half. Store the other half in some aluminum foil in the fridge, as it is light sensitive.

When we were trying the solutabs, we were told to dissolve it in a bit of water and syringe it to him. However, it doesn’t totally dissolve. There are little granuals, and I could never get them all in. What seems to work for a lot of parents is to hold the piece in the baby’s mouth on the inside of her cheek. Then syringe in just a few drops of water to help it dissolve. I never did it this way, but hopefully some other moms who have will chime in.

So, the doc only prescribed the 15 mgs? I guess you can just start with that twice a day and maybe use the Pepcid as well. My guess though is that she will probably need more, but cross that bridge if/when you come to it.

April 23, 2008 at 10:11 am #50724

Anonymous
Inactive

Yea, I figured out that our nurse was quite dingy early on. But our dr. is very willing to try different things and has been very helpful so we’ve stayed there. I think the 15mg is a trial thing and she would probably be open to increasing it. But I don’t mind starting lower as I don’t want to give her unneeded medication. I’m just concerned about the 1x/day thing.

I wonder if we’ll be able to see some improvement for the part of the day while it is working, or does it not work that way? In that case we’d just give it at night because she always has her episodes around midnight-3am, never during the day.

Last question, is there a way to safely increase her dosage on my own in case the dr. won’t do it? I read here that you can open the capsules and sprinkle some of the granuals, but I imagine then I would need my own scrip for the capsules, which probably wouldn’t be a big deal to get.

April 23, 2008 at 10:22 am #50725

Anonymous
Inactive

I agree that the timing is very important for a non-compounded PPI! It is really hard to time in the beginning. I never knew when Landen’s stomach was empty bc he ate so sporadically in tiny amounts here and there. But you do the best you can. I would follow his cues and if he appeared to get hungry, I’d give the solutab, put in a paci and hold him for 30 mins, even take him outside, whatever I had to do to distract him. Daunting, but WORTH it! We also started on 15 mgs and our pedi would NOT increase it for a long time. So I gave 7.5 mgs (half tablet) in the AM and 7.5 mgs (the other half) around 3pm and then pepcid complete before bed. It’s what helped us until I found a new doc to give us 30mg.

Good luck! I hope the solutabs work wonders for her!

Oh and as for your question. I’ve read on here plenty of times where moms would increase the dose themselves, following the marci-kids dosing recommendation. I never had that option b/c our doc would write 15mg Rx for 30 days only and you could not refill it until 2 days before you ran out. I never knew how to get more of them to increase it myself. If you can, then that is in your favor. I would have done it! Another tip, even when landen was a tiny baby I did this: for dosing the solutab, I placed it on a baby spoon, added a few drops of water and he’d open his mouth and I’d drop it in. Not too much water as you don’t want it running all over the place and out of their mouth. Just a few drops to moisten the tab so it doesn’t choke them. 🙂

jilly782008-04-23 10:28:39

April 23, 2008 at 11:12 am #50728

Anonymous
Inactive

Great, you guys have been a ton of help. I don’t think we’ll have a problem w/ timing as we thought we were supposed to time the compount prilosec 20-30 minutes before eating so always tried to do that & it worked ok because she only eats every 3-4 hours about.

I was thinking of trying to increase it (if needed) by opening the adult capsules and sprinkling some of the granuals into water or juice or something . I’ve read here somewhere that is how to give the capsules. But it would have to be a prescription from another source if the doc would not increase the solutabs.

April 23, 2008 at 11:22 am #50729

Anonymous
Inactive

btw- Would it be too obvious or strange if I called my own family dr. and asked him to call me in a scrip for Prevacid solutabs? He usually gives me just about whatever I ask for, as far as for colds, infections, antibiotics, allergy, etc. I do have occaisonal heartburn but malox or tums work fine for me. I just don’t know if it makes sense to ask for solutabs for an Adult. I guess at least he would give me capsules and I could use the granuals as described here.

Just a thought if we need more & dr. won’t increase w/o doing all sorts of appts and tests, etc. I’m really getting tired of the frequent dr. appts.
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