losec liquid being made at the pharmacy…help!

[Anonymous]

My son was just prescribed a PPI…the doctor phoned it in to our pharmacy without really stating which PPI it would be [he has an accent & mumbles & I often can’t make out exactly what he’s saying, but he’s a great doctor]. This morning the pharmacy called & said the prescription wouldn’t be ready until tomorrow, Friday. My husband took the call & didn’t ask what PPI or anything, so I just called back, because I was concerned about all the info I’ve been reading about prevacid being compounded at the pharmacy etc.

The pharmacist spoke with me & stated they had to order things in to make it, it’s liquid & she was referring to is as losec [so I’m assuming Prilosec?] but she said it was Lansoprazole. I said I was concerned about it degrading & asked how long it would last…she said it doesn’t get refrigerated & that it doesn’t matter when it’s given…before a meal, after a meal…it’s no concern.

She said that all of the info she has states it’s good for a month.

I’m absolutely confused. Can anyone shed light on what he’s being prescribed, if it sounds okay…or if we should request he be prescribed something else?

I’ve tried reading the other threads [such as Prevacid 101] but just end up more confused, hehe.

[Anonymous]

while true, timing does NOT matter with the suspension (that is one of the benefits) it was only stable for us for 2 weeks at a time, and we took the prescription and only used a compounding pharmacy that we knew would do the compound correctly. Can you get the pharmacist on the phone and confirm how the compound is being done and then even if you have to pay your copay twice a month, ask if they will make it two weeks at a time. Also NO flavoring…

If the compound is a big concern, you can also call the nurse at your pedi office and ask them to change the form of the med. With Carter this was amazingly easy for us, although others have not had success with the compounds at all. For Dylan we used Prevacid packets (hardly heard of anymore here) but I wouldn’t recommend that form anyway. If you can get the capsules and either use a buffer like caracream, or prevacid solutabs, those seem to be the easier forms to use…..

[Anonymous]

I would personally be cautious. I have never found a compounding pharmacy who made this stuff correctly. We’re in TO, not sure where you are. But hospital for sick children told us that they also don’t recommend the compounds anymore as they were not effective. They usually prescribe the prevacid FasTabs (aka solutabs in the US). They need to be given on an empty stomach and followed up with a meal 30 minutes later, so it can be hard to give, but many have had good success with them.
I’m not sure what med you’re getting, but if they’re telling you that it’s “losec” then that would be omeprazole not lansoprazole (which is prevacid). A properly made losec suspension should last 2 weeks refrigerated, but the pharmacy will tell you a month (based on pH studies only). If not refrigerated if won’t last you nearly that long. If they’ve added flavouring then it’s not being made correctly.
You might want to look into prevacid made with caracream/bufferbabies. We had good success with this with my daughter. You order the caracream and then make the stable compound at home and can give it at any time.
If your doc suggested a compound, I’m guessing that he also suggested a low dose. If you don’t see results, it may be either that the compound is no good or that the dose is too low.
Good luck.

[Anonymous]

Forgot to add: for caracream/bufferbabies, you need capsules. I suggest prevacid over losec just because losec is VERY bitter.

[Anonymous]

Yes, I was also going to say that if your dr. prescribed a suspension/compound it’s probably b/c it’s a low dose – that was the case w/ us with our 1st ped GI.

[Anonymous]

So…our pharmacy is quite near here, so I decided to go in & chat with the pharmacist. Esp. after reading another thread on the forum about flavoring, sodium bicarbonate etc…

The doctor had prescribed either Prilosec OR Prevacid compound, whichever the pharmacy could get the ingredients for more readily. The pharmacist is super nice, but she wasn’t willing to look at Marci-Kids as a reputable source. She said they usually get their recipes from Toronto Hospital for Sick Kids & that she’d double check on their website to see what they had to say. I tried to explain to her that flavoring, etc. diminished the effectiveness, but she kept saying she couldn’t go by what Marci-Kids says, that they have sourced they look at & that’s what they go by. She wouldn’t even take the paper I have written the notes down on about what to & not to do. She did say the “recipe” she had was flavored. Like I said, she did say she’d look into it though. & we can’t get Zegerid [sp?] here.

So…I’m not sure what the next step is. Should I look at other pharmacies for in the future? Should we call the ped? I think it’s pointless to put him on something that’s not going to help.

[Anonymous]

First, I’d find out what your dose is.

Then, visit marci-kids.com to see how you feel about that dose.

Then, I’d fax the dr. & request another form of Prevacid: solutabs or capsules & while you’re requesting things I would also request an increased dose (if you’re not happy w/ the other dose).

Hope that all makes sense.

[hellbennt]

Lori is in Toronto & has a lot of experience in this- read her post above…

so what you might want to do is look into bufferbabies/caracream:

https://www.infantreflux.org/forum/forum_posts.asp?TID=11191&PID=94236#94236

hellbennt2008-12-04 16:51:58

[Anonymous]

I’m in Toronto. When this was happening with Hailey, Sick Kids hospital told us that they don’t recommend compounding anymore because of the issues with effectiveness. They prescribe solutabs. We did prevacid in caracream.

Where is your pharmacy. We went to the most reputable compounding pharmacy in the city (supposedly) until I heard about the problems with compounding. They eventually closed down.

Good luck.

[hellbennt]

oops- looks like they called sick kids toronto…not that she’s in toronto…

[Anonymous]

Hmmmm…is there any concrete place online to refer to as far as Sick Kids hospital’s stance on compounding is concerned? This pharmacist doesn’t seem to want to budge & just telling her “I read this on a forum” or online isn’t going to cut it. Anyone know if Sick Kids has a telephone # for info such as this?

I found out we have a compounding pharmacy about an hour from here, but I wonder if it’s even worth it…I wonder if they’d be able to compound it properly. Then I’d probably have to have it shipped here.

We go to pick up his prescription tomorrow, which I already know is flavored. Is it too much to ask for them to make a new batch unflavored? I’m not entirely sure how much is involved in the process of compounding. I actually fear she won’t even want to make it unflavored. I asked about the flavoring & she said that she’ using a recipe she got from Sick Kids…which now I wonder if that’s true…& that removing the flavoring could change it’s effectiveness. So I don’t know what to do :/

I’m in Saint John NB.

[Anonymous]

Laura, I am in Toronto.

Hailey has had the bulk of her GERD tx from the GI team at Sick Kids. Our GI told us this directly: NO PPI compounds.

Prior to getting an appointment there, I called the phamarcy at Sick Kids hospital who was preparing the scripts for a lot of the inpatients on discharge home. I wanted to know how they made their compounds. I spoke to the head pharmacist there. She told me how they were breaking open the losec mups and dissolving in a bit of apple juice or water and then giving on an empty stomach. Solutabs weren’t available then, only losec not prevacid so that’s what they did. They told me that Sick Kids doesn’t compound PPIs anymore and doesn’t recommend it for their patients. This was 3 years ago. They faxed me the info how they suggest giving them, but I threw it away since. At our last appointment there, our GI wanted us to give Hailey the prevacid Fastabs as per the 30 minute rule. We were succesfully using capsules in CaraCream with good success with the pain, but little success with the feeding aversion. He didn’t know about CaraCream and didn’t want to look at my information either.

You can call the sick kids pharmacy and talk to the pharmacist like I did. Have them fax the info directly to you and then bring it to your pharmacy. That way you know what they said and are not relying on your pharmacist to tell you. I don’t have the number, but it’s a Shopper’s drug mart so you should be able to get it from the shopper’s website search or through canada 411.

If your pharmacist is doing sick kid’s recipe then it must be old. What flavouring did they add?

You might also consider having Dr. Phillips from marci-kids call your pharmacist directly, if he would agree. Dr. Phillips is a PharmD and he is the head of all the research on compounds done by marci-kids.

I find that most professionals don’t take marci-kids as reputable info- I understand that as it comes from the internet and they must be bombarded with people bringing them trash from the internet all the time. So they disregard everything from the internet. But it’s harder to argue with another professional directly.

Good luck.

[Anonymous]

This is the phone number I have for the Shopper’s Drug Mart at Sick Kid’s Hospital in Toronto-

(416) 813-6700

I would ask to speak to the pharmacist, and then ask her if they make compound PPIs there. Tell her that your physician has written a script for a prevacid compound to be made for your baby. Then ask her how they suggest giving the prevacid to a baby. Ask her if they have information sheets that they give out to patients at the hospital and if they’d be willing to fax or email you one.

[Anonymous]

Thanks SO much Lori! I intend to give them a call later this morning.

I did find one recipe on the Sick Kids site….not sure if this is an okay recipe or not…any thoughts on it? If it is, I could print it off or provide the link to the pharmacist.

[Anonymous]

I gave the pharmacy at Sick Kids a call…the only oral suspension they use & have a recipe for is for G tube use & she said it’s very very sensitive to temperature & lasts 28 days. She said they use Prevacid & if not, Omeprazole tablets.

When we go in to pick up my son’s meds today I’ll mention this all to the pharmacist. We’ll probably take the meds, even though it’s a compound & flavored, & give it a go. If We don’t see any effect after 2 weeks or if the effects diminish after 2 weeks, we’ll contact the ped & mention this info from Sick Kids as he’s the one that originally prescribed the compound & regardless of how the pharmacist would WANT to give omeprazole, I’m assuming she can only give it in the form the ped prescribed.

[Author]

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