Notes to Discuss with Doctor contributed by Theresa F., June 2016. Click here to get to page with Links to Articles & Research
Peer Reviewed Article Support for Increased Dosing (adult levels or greater) of PPI’s
- larger daily doses of PPI’s in children to control GERD
- children require larger doses than adults due to shorter half-life
- study 1-16 year olds with erosive esophagitis and pathological acid reflux-used 24 h intraesophageal pH study to determine healing dose that brought
- intraesophageal pH to normal
- dosing was monitored for 3 months
- indicating faster metabolism/shorter half-life with decreasing age
- -explain the need for higher doses of omeprazole on a per kilogram basis for younger children than in adults
- retrospective analysis of records from 500 hospitals, 5000 newborns, 15000 infants
- PPI’s prescribed for infants even before FDA approval in hospital settings
- Hospital charge data suggest that infants age <1 year of age may have been prescribed PPI’s at adult doses
INPATIENT
- children were frequently prescribed doses of 60 and 30 mg daily
- lansoprazole prescribed more commonly
- most common dosage was 30mg daily regardless of weight
OUTPATIENT
- most common PPIs used in newborns and infants with GERD were lansoprazole then omeprazole
- most frequently prescribed daily doses of 15 mg lansoprazole, 20 mg omeprazole, 20 or 40 mg esomeprazole, or 40 mg pantoprazole
- 8% titrated to higher dose within a year
- Procedure for compounding omeprazole (Zegrid) suspension 2 mg/mL notated
- Omeprazole–sodium bicarbonate suspension 2 mg/mL prepared from 20 mg packets was stable for at least 45 days when stored at 3–5 °C.
