InfantReflux.Org Forums: Zantac dosing

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ejjpepomama
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Topic: Zantac dosing
Posted: 08 November 2009 at 8:40pm

My son just started taking Zantac a little over two weeks ago. He is now 5 months old. He is doing 1.3 mL 2 times per day and probably weighs just slightly over 13.5 lbs. Anyway, the Zantac was working great for about a week. Then I started noticing him struggle at his feeds a little more, though he was still finishing his feeds ok. But the few days have gotten a little tougher and now he is not finishing his feeds anymore (he is breastfed). In particular, he really struggles finishing on either side and is in more pain in general. So I am thinking he might just need to up the dose as I know Zantac is very weight sensitive. But just wondering if any of you have any thoughts. I am going to talk to the doc tomorrow and want to be knowledgable when I talk to her. It seems a little soon to have to be upping his dose, but I want him to be able to eat enough food and not be in pain when he eats. His weight has been an issue in the past b/c he wasn't eating enough to gain much weight - probably b/c it was so uncomfortable for him. And I wonder if Zantac is the best med for him? I want to ask her about Prevacid, but also heard it has some dairy in it which I know my son is sensitive too.

Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months
Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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hellbennt
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Posted: 09 November 2009 at 7:46am

the prevacid solutabs have some lactose in them, milk sugar, not milk protein...what might affect your baby is the aspertame and other ingredients in the solutabs. you can also get prevacid in capsules and order Bufferbabies (formerly known as Caracream)- this is what we (and a lot of posters on this board) did. <>

Prevacid 101(last post on the page): http://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

as for the zantac:
from this <>

conversion chart: http://www.sfca.co.uk/match/kilolbs.htm

your lo is 6 kilos

maximum zantac is 10mgs per kilo

so 10 x 6 = 60 mgs, total for the day of zantac

it comes in a liquid, check your bottle it will read

15mgs/kg

so this means for each 1ml of medicine, your lo gets 15mgs of zantac

so 60 divided by 15 = 4mls, total for the day of zantac

you can divide this into 'uneven' doses- it can be

a dose of 1.5mls in the morning and 2.5 in the evening, or however works best for your baby

Edited by hellbennt - 09 November 2009 at 7:46am

~laura~
Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos
Ari 7/06 REFLUX FREE, so miracles do happen!

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ejjpepomama
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Posted: 09 November 2009 at 5:03pm

So we talked to the doctor today and she said he was already on a "hefty" dose of zantac and didn't feel comfortable prescribing more. She asked if it could be anything else. He's been sneezing a lot but doesn't seem sick otherwise - and he is drooling like crazy and in pain when I burp him between feeds, has hiccups, waking up early from naps in pain etc. But I still second guess myself at times. Could it be something else, and if so, what?

Anyway, she prescribed prevacid to be taken once a day and said if it doesn't help that his issue is probably something else. I am also concerned b/c she doesn't want us to continue with the zantac and I know prevacid takes a while to kick in. Is it safe to continue the zantac while starting prevacid? He seems to be on the verge and I don't want him to stop eating altogether like he did a couple of weeks ago. Anyway, I know I am rambling and not really making much sense, but any help is much appreciated!

Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months
Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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hellbennt
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Posted: 09 November 2009 at 5:21pm

the help I want to give is to tell you to:
get to another doctor.
something else??
yeah, like undermedicated reflux symptoms?
sorry for the sarcasm.
but many many have had to fight the good fight for their babies.
it's easy for ME to tell you that it's safe to continue on the two meds.
I can tell you MY son's story: no one told us to continue w/ the zantac when we switched to a PPI and, w/o the zantac, it was as if my son wasn't on any meds at all. he shrieked/howled so much from pain that he lost his voice!!! an infant trying to yelp in a hoarse whisper is not only pitiful, but FRIGHTENING. It was the weekend, of course- called the ped on call who told us to put him in his carseat on the dryer, in the bathroom w/ the water running, run the vaccum, you name it. he was unconsolable. called the Ped GI who then said to give the two meds until the PPI started to show it's effects. how did I know when it (PPI) was working? it was day 12. it was THAT obvious.
I don't know what to tell you. I wish you luck finding a dr who seems to know her/his stuff. I wish you luck fighting the fight. It's hard.
we're here for you. www.marci-kids.com is here for you.
if you do decide to continue the zantac (& I hope you do, but I AM NOT A DR!!!), be sure to give it 4hrs from the prevacid.
when you give the prevacid, if it's the solutabs, give on an empty stomach, followed by a 'meal' 30 minutes later.
read everything, including the reasoning behind the calculations that I did for you for the zantac- it's all here from this link (even though it says 'Prevacid 101' there is info about all PPIs and the link to the zantac dosing- I questioned it myself, the zantac dosing that is, and I posted my findings)

Prevacid 101(last post on the page): http://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

Edited by hellbennt - 09 November 2009 at 5:22pm

~laura~
Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos
Ari 7/06 REFLUX FREE, so miracles do happen!

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ejjpepomama
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Posted: 09 November 2009 at 7:53pm

Thanks so much! I think the main reason I second guess myself is that in general my son has such a great disposition and is so cheery. Other than struggles with eating and his struggles on and off with sleeping (which honestly could be so much worse) he really is cheerful almost all the time. I see clear reflux symptoms at the same time though, but they are not super severe most of the time. I really would not have even gone the medicine route had it not been compromising his milk intake. When it was clear to me that he was struggling to eat I knew something had to be done. But b/c all around he does so well I sometimes struggle to "fight for him" thinking maybe I have missed the mark on this. I had already decided to find a new doctor, but I really don't know how to find a good one - especially a good one who will "hear me" on this issue. Anyway, I appreciate your help a ton!

Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months
Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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ejjpepomama
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Posted: 10 November 2009 at 5:44pm

I am going to see another doctor tonight. We were going to do the prevacid and she was getting some sort of compound done that would work with his dairy issue, but our inusrance wouldn't cover it. We opted to stick with the zantac for now, but today has gotten worse and he is really struggling. So I am taking him in but am really feeling overwhelmed. Do you have any advice of what meds tend to work the best. Should I just push for more zantac since that was working for a while. I read on Marci-kids that tolerance can be built to it though and I am wondering if this is what happened with Erk. Is prevacid a better route (with the bufferbabies - what is that by the way - do you just get it online or should I ask the doctor about it). Or is Zegerid the best choice b/c it is FDA approved?

Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months
Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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ejjpepomama
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Posted: 10 November 2009 at 5:52pm

Oh, and sorry but one other question. Do you happen to know what is available with a generic? Our lovely insurance only covers generics...

Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months
Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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hellbennt
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Posted: 11 November 2009 at 2:32pm

I would get the zantac anyway, bcse you'll need it as you wait to see the full effects of the PPI and also bcse you might need it if you need to 'work' (ok, fight) to get the proper PPI dosing.

as for generic, I truly don't know. I would contact marci-kids directly.
< ="Content-" content="text/; charset=utf-8">< name="ProgId" content="Word.">< name="Generator" content="Microsoft Word 11">< name="Originator" content="Microsoft Word 11"><>

Dr. Philips: phillipsjo@health.missouri.edu
Office Phone: (573) 884-0672

Dr. Philips will even talk to your dr- he has for MANY posters here on this board. He is not a medical dr per se, he is a PharmD, but he is at the forefront of the research in this area!
as for FDA approved, there actually aren't any PPIs that are FDA approved for use in infants- maybe I'm wrong; maybe zegerid is? but my point is that the PPIs have been shown to be safe, etc. and marci-kids has done a lot of research...

as for bufferbabies w/ prevacid or using zegerid, I suppose you could look at what your final bill will be? also I suppose you'd have to find out if zegerid is even covered bcse that's not a generic...

personally I would go w/ prevacid and bufferbabies, but that's bcse that's what I know- there wasn't any zegerid when jonah was a baby and also bcse many babies 'start' w/ prilosec (the PPI in zegerid) and then move on to prevacid. that being said though, there are MANY MANY babies who did fabulously w/ the zegerid! do a search & go back past a year and you can read posts from the many zegerid fans!

~laura~
Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos
Ari 7/06 REFLUX FREE, so miracles do happen!

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Medicines
InfantReflux.Org Forums : Infant Reflux Information : Medicines

Author	Message
ejjpepomama Newbie Joined: 22 October 2009 Location: United States Online Status: Offline Posts: 24	Topic: Zantac dosing Posted: 08 November 2009 at 8:40pm
	My son just started taking Zantac a little over two weeks ago. He is now 5 months old. He is doing 1.3 mL 2 times per day and probably weighs just slightly over 13.5 lbs. Anyway, the Zantac was working great for about a week. Then I started noticing him struggle at his feeds a little more, though he was still finishing his feeds ok. But the few days have gotten a little tougher and now he is not finishing his feeds anymore (he is breastfed). In particular, he really struggles finishing on either side and is in more pain in general. So I am thinking he might just need to up the dose as I know Zantac is very weight sensitive. But just wondering if any of you have any thoughts. I am going to talk to the doc tomorrow and want to be knowledgable when I talk to her. It seems a little soon to have to be upping his dose, but I want him to be able to eat enough food and not be in pain when he eats. His weight has been an issue in the past b/c he wasn't eating enough to gain much weight - probably b/c it was so uncomfortable for him. And I wonder if Zantac is the best med for him? I want to ask her about Prevacid, but also heard it has some dairy in it which I know my son is sensitive too.
	Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids

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hellbennt Moderator Group Joined: 28 August 2003 Location: United States Online Status: Offline Posts: 11386	Posted: 09 November 2009 at 7:46am
	the prevacid solutabs have some lactose in them, milk sugar, not milk protein...what might affect your baby is the aspertame and other ingredients in the solutabs. you can also get prevacid in capsules and order Bufferbabies (formerly known as Caracream)- this is what we (and a lot of posters on this board) did. <> Prevacid 101(last post on the page): http://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1 as for the zantac: from this <> conversion chart: http://www.sfca.co.uk/match/kilolbs.htm your lo is 6 kilos maximum zantac is 10mgs per kilo so 10 x 6 = 60 mgs, total for the day of zantac it comes in a liquid, check your bottle it will read 15mgs/kg so this means for each 1ml of medicine, your lo gets 15mgs of zantac so 60 divided by 15 = 4mls, total for the day of zantac you can divide this into 'uneven' doses- it can be a dose of 1.5mls in the morning and 2.5 in the evening, or however works best for your baby Edited by hellbennt - 09 November 2009 at 7:46am
	~laura~ Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos Ari 7/06 REFLUX FREE, so miracles do happen!
	IP Logged

ejjpepomama Newbie Joined: 22 October 2009 Location: United States Online Status: Offline Posts: 24	Posted: 09 November 2009 at 5:03pm
	So we talked to the doctor today and she said he was already on a "hefty" dose of zantac and didn't feel comfortable prescribing more. She asked if it could be anything else. He's been sneezing a lot but doesn't seem sick otherwise - and he is drooling like crazy and in pain when I burp him between feeds, has hiccups, waking up early from naps in pain etc. But I still second guess myself at times. Could it be something else, and if so, what? Anyway, she prescribed prevacid to be taken once a day and said if it doesn't help that his issue is probably something else. I am also concerned b/c she doesn't want us to continue with the zantac and I know prevacid takes a while to kick in. Is it safe to continue the zantac while starting prevacid? He seems to be on the verge and I don't want him to stop eating altogether like he did a couple of weeks ago. Anyway, I know I am rambling and not really making much sense, but any help is much appreciated!
	Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids
	IP Logged

hellbennt Moderator Group Joined: 28 August 2003 Location: United States Online Status: Offline Posts: 11386	Posted: 09 November 2009 at 5:21pm
	the help I want to give is to tell you to: get to another doctor. something else?? yeah, like undermedicated reflux symptoms? sorry for the sarcasm. but many many have had to fight the good fight for their babies. it's easy for ME to tell you that it's safe to continue on the two meds. I can tell you MY son's story: no one told us to continue w/ the zantac when we switched to a PPI and, w/o the zantac, it was as if my son wasn't on any meds at all. he shrieked/howled so much from pain that he lost his voice!!! an infant trying to yelp in a hoarse whisper is not only pitiful, but FRIGHTENING. It was the weekend, of course- called the ped on call who told us to put him in his carseat on the dryer, in the bathroom w/ the water running, run the vaccum, you name it. he was unconsolable. called the Ped GI who then said to give the two meds until the PPI started to show it's effects. how did I know when it (PPI) was working? it was day 12. it was THAT obvious. I don't know what to tell you. I wish you luck finding a dr who seems to know her/his stuff. I wish you luck fighting the fight. It's hard. we're here for you. www.marci-kids.com is here for you. if you do decide to continue the zantac (& I hope you do, but I AM NOT A DR!!!), be sure to give it 4hrs from the prevacid. when you give the prevacid, if it's the solutabs, give on an empty stomach, followed by a 'meal' 30 minutes later. read everything, including the reasoning behind the calculations that I did for you for the zantac- it's all here from this link (even though it says 'Prevacid 101' there is info about all PPIs and the link to the zantac dosing- I questioned it myself, the zantac dosing that is, and I posted my findings) Prevacid 101(last post on the page): http://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1 Edited by hellbennt - 09 November 2009 at 5:22pm
	~laura~ Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos Ari 7/06 REFLUX FREE, so miracles do happen!
	IP Logged

ejjpepomama Newbie Joined: 22 October 2009 Location: United States Online Status: Offline Posts: 24	Posted: 09 November 2009 at 7:53pm
	Thanks so much! I think the main reason I second guess myself is that in general my son has such a great disposition and is so cheery. Other than struggles with eating and his struggles on and off with sleeping (which honestly could be so much worse) he really is cheerful almost all the time. I see clear reflux symptoms at the same time though, but they are not super severe most of the time. I really would not have even gone the medicine route had it not been compromising his milk intake. When it was clear to me that he was struggling to eat I knew something had to be done. But b/c all around he does so well I sometimes struggle to "fight for him" thinking maybe I have missed the mark on this. I had already decided to find a new doctor, but I really don't know how to find a good one - especially a good one who will "hear me" on this issue. Anyway, I appreciate your help a ton!
	Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids
	IP Logged

ejjpepomama Newbie Joined: 22 October 2009 Location: United States Online Status: Offline Posts: 24	Posted: 10 November 2009 at 5:44pm
	I am going to see another doctor tonight. We were going to do the prevacid and she was getting some sort of compound done that would work with his dairy issue, but our inusrance wouldn't cover it. We opted to stick with the zantac for now, but today has gotten worse and he is really struggling. So I am taking him in but am really feeling overwhelmed. Do you have any advice of what meds tend to work the best. Should I just push for more zantac since that was working for a while. I read on Marci-kids that tolerance can be built to it though and I am wondering if this is what happened with Erk. Is prevacid a better route (with the bufferbabies - what is that by the way - do you just get it online or should I ask the doctor about it). Or is Zegerid the best choice b/c it is FDA approved?
	Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids
	IP Logged

ejjpepomama Newbie Joined: 22 October 2009 Location: United States Online Status: Offline Posts: 24	Posted: 10 November 2009 at 5:52pm
	Oh, and sorry but one other question. Do you happen to know what is available with a generic? Our lovely insurance only covers generics...
	Elise - 5/11/07 - no reflux!; Joel - 2/15/07 - reflux free at 12 months Erik - 5/27/09 - zantac 2/25 2X/day, Zegerid 10mL 3x/day breastfeeding & just starting solids
	IP Logged

hellbennt Moderator Group Joined: 28 August 2003 Location: United States Online Status: Offline Posts: 11386	Posted: 11 November 2009 at 2:32pm
	I would get the zantac anyway, bcse you'll need it as you wait to see the full effects of the PPI and also bcse you might need it if you need to 'work' (ok, fight) to get the proper PPI dosing. as for generic, I truly don't know. I would contact marci-kids directly. < ="Content-" content="text/; charset=utf-8">< name="ProgId" content="Word.">< name="Generator" content="Microsoft Word 11">< name="Originator" content="Microsoft Word 11"><> Dr. Philips: phillipsjo@health.missouri.edu Office Phone: (573) 884-0672 Dr. Philips will even talk to your dr- he has for MANY posters here on this board. He is not a medical dr per se, he is a PharmD, but he is at the forefront of the research in this area! as for FDA approved, there actually aren't any PPIs that are FDA approved for use in infants- maybe I'm wrong; maybe zegerid is? but my point is that the PPIs have been shown to be safe, etc. and marci-kids has done a lot of research... as for bufferbabies w/ prevacid or using zegerid, I suppose you could look at what your final bill will be? also I suppose you'd have to find out if zegerid is even covered bcse that's not a generic... personally I would go w/ prevacid and bufferbabies, but that's bcse that's what I know- there wasn't any zegerid when jonah was a baby and also bcse many babies 'start' w/ prilosec (the PPI in zegerid) and then move on to prevacid. that being said though, there are MANY MANY babies who did fabulously w/ the zegerid! do a search & go back past a year and you can read posts from the many zegerid fans!
	~laura~ Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos Ari 7/06 REFLUX FREE, so miracles do happen!
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