Home › Forums › Infant Reflux Information › Medicines › Timing of dosage
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hellbennt.
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January 25, 2007 at 10:58 am #23088
Anonymous
InactiveWe are on day 8 of a 10-14 day trial of correctly dosing DD (18 months) with Prevacid Solutabs. We learned 8 days ago that we were not dosing it correctly and were told we needed to start dosing 15-30 min before a meal or nursing session (we were dosing immediately before a meal or nursing session).
My question is that my daughter nightwakes 3-8+ times per night and often her last waking before waking for the morning is at 6AM and I nurse at this waking. If she then wakes at 7:00 AM for the day and we dose prevacid at 7:00, wait 30 min until breakfast, are we defeating the purpose by dosing then because she has nursed at 6:00?
Based on our visit to the ped GI, if she is not markedly better after 10-14 day trial, then the doctor wants to schedule a pH probe and/or endoscopy.
DD’s is on 30 mg of Prevacid (15mg BID) and her main symptoms are the frequent night wakings where she screams and arches her back, calmed only by nursing, and prior to a dosage increase of Prevacid 3 weeks ago, she was visibly refluxing at night prior to vomiting (1x on two different nights in 4 day period).
Christa
Sarah (18 months)
Joshua (3 years)January 25, 2007 at 12:32 pm #23096InactiveIt really would be better to give it to her on an empty stomach. Does she take a nuk? I used to sneak into Myles room and give him his prevacid while he was still sleeping and then stick the nuk in his mouth. He’d go right back to sleep and then I’d wake him in 30 minutes and feed him. He was a lot younger, so I don’t know if that would work at her age.
The only other thing I can think of is to delay her next feeding until 8:30 so you can give her the Prevacid on an empty stomach (at 8am). Prevacid is tricky that way. It drove me nuts but it worked so well that I stuck with it.
Or, you could try another form of Prevacid. The compounded version doesn’t have to be timed around meals but it has it’s own problems. If it’s not compounded correctly (which evidently is common from reading these posts) then it loses its effectiveness.
Or, you can try Zegerid. This doesn’t have to be timed around meals.
For the 10-14 day trial period it would probably be best to stick with the Prevacid and try to time it the best you can.
Good luck. I hope she’s feeling better soon.
January 25, 2007 at 12:47 pm #23097Inactiveits actually 30 min to 60 min before eating:
How Delayed Release PPIs
WorkIn
their pure and unprotected form, PPIs are very vulnerable to degradation when
exposed directly to the acid in the stomach. For this reason, DR PPIs are given
an enteric coating. This protective
coating is specifically designed not to dissolve while the drug is in the acidic
fluids in the stomach, but instead it dissolves when the tablet or granules
reach the higher pH (less acidic) environment of the duodenum (the first
section of the small intestine). Here the coating dissolves and the drug is
absorbed into the blood stream, where it is carried to the parietal cells,
where it does its job of blocking proton pumps. This whole process takes 30
minutes to 1 hour.DR
PPIs should be given on an empty stomach because food in the stomach can both lower
the level of absorption and raise the pH in the stomach, causing the enteric
coating on the drug to dissolve, which then leaves the drug vulnerable to
exposure to pockets of acid in the stomach which could destroy the drug.DR
PPIs should be given 30 minutes to 1 hour before a full meal (6 oz or
more for infants). As I already mentioned, in order for PPIs to work their best
you want as many proton pumps to be in an active state as possible, and the
primary way of achieving this is by eating a full meal. The timing is important
because you want the meal to be activating lots of proton pumps right at the
same time that the drug is reaching peak levels in the blood stream.DR
PPIs should taken with water or sprinkled over an acidic food such as apple
sauce or yogurt.You
should never break or crumble a tablet form of DR PPI, as this will compromise
the protective enteric coating. (Prevacid Solutabs contain enteric-coated
granules within the tablet, and it is ok to break a Solutab in half, as this
should not harm the individual granules)You
should never give a DR with a non-acidic food (such as milk, formula or
cereal), as this will dissolve the enteric coating and leave the drug
unprotected.DR
PPIs should never be chewed or crushed, as this will compromise the protective
enteric coating.For
infants, MARCI-Kids recommends the use of the IR PPI Zegerid over DR forms of
PPIs, as infants can easily spit out, chew or even choke on the granules of DR
PPIs. Of the DR PPIs, Prevacid Solutabs seem to be the easiest to administer
for most parents.January 25, 2007 at 2:46 pm #23103InactiveSo I suppose my follow up question is, does it need to be dosed in equally timed doses (aka 12 hours apart) or could it be dosed at 10:30 AM and 5:00 PM for instance, which would be 1 hour before lunch and 1 hour before dinner.
Currently I dose my DD at 7:00 before breakfast at 7:30 and at 6:30 before nursing to sleep at 7:00. But she eats dinner at 6:00, so I wonder if I am still not dosing it optimally.
Thoughts?
Christa
Sarah (18 mos), Prevacid Solutabs, 15mg BID
Joshua (3.5 years)January 25, 2007 at 3:22 pm #23106hellbennt
Keymaster10:30 AM and 5:00 PM sounds fine
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