Home › Forums › Infant Reflux Information › Medicines › Zegerid 40 mg + Mylanta Cherry Supreme
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June 20, 2006 at 6:42 pm #10162
Anonymous
InactiveI have some information to share with those of you who are using Zegerid or are interested in doing so. I have mentioned in the past that we (MARCI-Kids) generally recommend using the 20 mg strength packets of Zegerid for infants and children. This is because they contain proportionally twice as much buffer per milliliter as the 40 mg strength packets. This buffer is needed in order to protect the drug that is in each dose (omeprazole) from being degraded by the acid in the stomach. The buffer provides this protection by neutralizing the acid that is present in the stomach.
Recently we have found that it is possible to make up for the missing buffer in the 40 mg packets by adding Mylanta Cherry Supreme liquid antacid. This has the added benefits of 1) improving the flavor of the Zegerid (which some babies do not like) and 2) reducing the sodium content in the dose, which decreases the likelyhood that your baby will throw up the dose (Salty liquids can cause a vomit response. Mylanta Cherry Supreme contains no sodium.).
If you are able to use the 40 mg strength packets, then you also have the added benefit of saving some money, as they cost about the same as the 20 mg packets but will last you twice as long.
So here’s how to mix up Zegerid 40 mg packets with Mylanta Cherry Supreme:
The main thing you want to keep in mind is that you want the final volume of each dose to be at least 7 mL. You will add the necessary volume of Mylanta Cherry Supreme to make the volume of each dose total 7-7.5 mL.
1) Determine the recommended dosage of Zegerid for your child, based on the charts found on our website: http://www.marci-kids.com/dosing.html
2) Get a prescription for Zegerid 40 mg packets.
3) Mix each packet in a large syringe by adding 6.5 mL of tap water (more detailed instructions found here). This will give you a 4 mg/mL concentration – meaning that each milliliter of liquid contains 4 milligrams of the drug omeprazole. Note that this is not the same concentration as found on the regular mixing instructions on our website. These instructions are specific to this usage.
4) Add one dose to a small oral dosing syringe. [For example, if you want to give a dose of 10 mg, you would put in 2.5 mL – since it is a 4 mg/mL concentration.]
5) Add Mylanta Cherry Supreme to the syringe until the total volume reaches about 7.5 mL. Replace the plunger and shake up the contents until they are mixed well. Then administer the dose, either directly or mixed in a small amount of milk, formula or rice cereal (just make sure that they can finish the whole amount).
If you have any questions about any of this information, please feel free to post them here or email me: andrewsjj@health.missouri.edu.
RefluxSol 2006-6-20 18:43:20 June 20, 2006 at 9:12 pm #10168InactiveJoel, that’s interesting about the vomit response to salty liquids. Would that also occur with CaraCream? I’ve noticed that Hailey often gags up/vomits up her dose of CaraCream. She usually swallows it back down, but I’ve always wondered why that happens. Can we add anything to the CaraCream to make it less salty?
Also, I thought that you weren’t supposed to give antacid and PPI within a 3-4 hour window of each other?
s&h’s mum2006-6-20 21:13:6
June 20, 2006 at 9:32 pm #10172InactiveWhat if you have the 20mg packets? Can you add the Mylanta to that so that it will taste better and to see if that will work on the vomiting?
June 21, 2006 at 11:08 am #10205InactiveLori,
Our CaraCream Jr kits have the same amount of buffer as the 20 mg packets of Zegerid, and our regular sized CaraCream kits have the same amount as the Zegerid 40 mg packets. So if you wanted to reduce the sodium content in the CaraCream dose, then you could use the regular sized kits and add in Mylanta to bring it up to 7 mL. Email or call me if you want more info on that.
It is PPIs and H2 blockers like Zantac, Axid, Tagamet, or Pepcid that you should not give within 4 hours of a PPI dose. If you are using an enteric coated form of PPI, then you should not give an antacid within about an hour of the PPI dose because it can destroy the coating and expose the drug to pockets of acid in the stomach. But with CaraCream or Zegerid it is fine to give it along with an antacid.
Cindy,
It’s fine if you want to add some Mylanta to a dose from the Zegerid 20 mg packets, but it will not reduce the amount of sodium in the dose.
RefluxSol2006-6-21 11:8:34
June 21, 2006 at 11:42 am #10209InactiveThanks Joel. I think we’ll just keep going as we have been. I was more just curious than anything.
June 26, 2006 at 4:49 pm #10575InactiveIt should be noted that giving large amounts of Mylanta Cherry Supreme (or any other antacid containing magnesium) can cause loose stools. We are currently looking into mixing a suspension that only contains calcium carbonate with the Zegerid 40 mg, since this should take care of this problem. But at this point we are not sure about how that would taste. I’ll update when I have more info.
June 26, 2006 at 6:59 pm #10584InactiveI look forward to hearing about that Joel. Thanks for all that you are doing.
July 4, 2006 at 6:22 am #11027InactiveJoel,
My twins are having diarhea since starting the 40mg packets. Should I go back to the 20?
July 5, 2006 at 3:10 pm #11067InactiveThat would probably help with the diarrhea, but if they have trouble keeping down the 20 mg Zegerid then it’s a question of the lesser of two evils. Keeping down the medicine and having diarrhea is probably better than not getting any medicine because it gets spit out.
I will post as soon as I know more about adding liquid calcium carbonate rather than Mylanta.
July 6, 2006 at 4:02 pm #11112InactiveInteresting! We finally got a pharmacy to order and make the caracream, and Isaac was vomiting that as well, and he didn’t like the taste!!!! I thought it would be our lifesaver with taste, and because it wasn’t, we just went back to the Zegerid b/c it was much easier since he didn’t lke the caracream anyways.
But, he does still often vomit it too…. Joel- do you know if Zegerid has anything in it (ie dairy, soy etc..) that are high on the allergen lists? Do you know if Mylanta Cherry Supreme does? I’m on an elimination diet, and am currently eating now even less than what is on the diet b/c I cut brown rice out (eating free range turkey, potato, squash, pear), and Isaac is still having blood in his stool. I’m starting to wonder if it could be something in the Zegerid?
I would love to try to make it taste better and cause less vomiting- I can’t take advantage of teh fact that it can go with a meal b/c if he gets it too close to a meal he vomits- but I’m nervous about adding the Mylanta if there is dairy/soy etc.. in that.
thanks!!!
July 6, 2006 at 4:12 pm #11113hellbennt
Keymasterrobyn,
I don’t want to hijack here- so email me via the link( i lost your email & it’s not via yor profile)- but I want to tell you more about your diet…I rather doubt it’s the meds
…~laura
July 7, 2006 at 1:43 pm #11147InactiveRobyn,
Allergies are a response to proteins, and neither Mylanta CS or Zegerid contain any proteins. I would try the 40 mg Zegerid with Mylanta and see if lowering the sodium content helps with the vomiting.
October 31, 2006 at 2:15 pm #16931Inactivebump
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