Home › Forums › Infant Reflux Information › Medicines › caracream
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April 16, 2007 at 11:27 pm #30730
Anonymous
InactiveDoes the caracream work with any PPI?
Does it taste good? Where do you get it from & how much does it cost??
Just wondering because I am really fighting Owen to take the medicine and it is the compound so if it becomes unstable so quickly, does this help??
Erica
April 16, 2007 at 11:43 pm #30737Anonymous
Inactivecaracream can be mixed with prevacid capusles to make a stable compound-its made by dr phillips, its the original zegerid. it tastes like caramel. we order it from marci-kids.
as for the compounding, if you are getting it made by the pharmacy then they have to make it a very specific way otherwise it will become unstable. this is how it needs to be made, every 2 weeks.
“
Proton Pump Inhibitors – or PPIs – are probably the safest and most effective drugs that are currently available for treating GERD in infants. Usually pediatricians and pediatric gastroenterologists will prescribe PPIs such as Prevacid or Prilosec in the form of a compounded liquid suspension made by a pharmacy. This form is advantageous because it is generally easier to administer to infants, who cannot easily swallow pills, capsules or granular forms of medicine.
However, for a number of reasons, Dr Phillips and the MARCI-Kids team at the University of Missouri do not generally recommend the use of such compounds. We have done very extensive research on the stability of these compounds in an effort to find a liquid form of PPI that would keep its stability for a greater length of time. In the course of our research, we have found that an overwhelming majority of the PPI compounds made by pharmacies lose their stability within 5 to 7 days.
The main reason that these compounds lose stability is that a flavoring is added to them. There are very few flavoring agents that can be added to a PPI compound that will not cause a loss in stability over time. For this reason, if you are getting a PPI compounded at your pharmacy, we strongly recommend that you ask your pharmacist not to add any sort of flavoring agent to the mixture.
In response to this problem of stability, Dr Phillips developed a flavored, immediate-release form of omeprazole (the same drug that is in Prilosec), which forms a true liquid suspension that is very easy to mix and administer to infants, and which will remain stable in refrigeration for up to 21 days after it is mixed. This drug is called Zegerid, and it now sold by Santarus Inc. For more information on dosing and mixing Zegerid for infants, visit http://www.marci-kids.com.
If you are either unable to get a prescription for Zegerid for your child or you would like to continue using the compounded PPI that you are currently using, here are some recommendations for how you should ask that your pharmacist make the compound so that it will remain stable for longer.
- Make sure that your pharmacist does not put any kind of flavoring agent in the compound.
- Make sure that the concentration is between 2 mg/mL and 4 mg/mL. This means that for every milliliter of suspension, you are giving between 2 and 4 milligrams of drug.
- Ask that your pharmacist make the compound with 16.8% sodium bicarbonate if the total volume of each dose is less than 7 mL. If the total volume of each dose is greater than 7 mL, ask that your pharmacist make the compound with at least 8.4% sodium bicarbonate. We also do not recommend that you give less than 3.5 mL of a PPI suspension at any concentration. This is because doses smaller than 3.5 mL do not provide enough buffer to adequately protect the drug from being destroyed by the acid that is present in the stomach.
It is important that the pharmacy does not add flavoring to the compound as it will almost certainly cause it to lose its stability much more quickly. It tastes pretty aweful this way, I know, but it’s better than the alternative.
Remember, Dr Phillips and the MARCI-Kids team do not recommend the use of compounded PPIs of any kind for infants or children. We do recommend the use of immediate-release Zegerid Powder for Oral Suspension. The makers of Zegerid currently hold a patent which covers any combination of a buffer (such as sodium bicarbonate) with a PPI (such as Prevacid or Prilosec), and it is a violation of this patent for pharmacy to make such a compound.
In addition to this, there are no studies that have been done to show that such compounds made by pharmacies are effective or even safe. This is another reason why we cannot and do not recommend them.
If you have any questions, please contact the MARCI-Kids team: info@marci-kids.com. “
April 17, 2007 at 12:08 am #30742Anonymous
InactiveThank you also for the info. Just what I was looking for!
April 17, 2007 at 11:10 am #30770Anonymous
InactiveWe have been using CaraCream for Hailey for some time now. It works well for her, but she doesn’t much like the taste. She is fussy, though.
April 17, 2007 at 12:32 pm #30781hellbennt
KeymasterApril 17, 2007 at 1:10 pm #30786Anonymous
InactiveThanks for the info! My doc kind of laughed at me when I asked to have the prescription written for 2 weeks at a time! He said well your insurance will make you pay for the med twice… Isn’t there a way to write it that it could be half the total amount and just have it filled more often?
I was just sick of talking to him because I just really don’t think he has educated himself very much on this subject!! Another reason why I want to change docs, but I don’t think now is the right time because Owen is doing so well!
So what I’m understanding from your post the caracream can only be used with the capsules?
Also, is your son considered MSPI? Owen is 6 1/2 months so we are doing cereal and all fruits and veggies. I have tried the oatmeal, mixed grain and rice cereal and he seems to do well with them all, I haven’t noticed any changes in fussiness or skin, etc. What problems did you have with Trace that he is wheat free?
I also started mixing his Neocate with goats milk simply because I could hardly get him to take the Neocate. He would take about 2-3 oz. and just get himself satisfied and then he would refuse the rest. When I mixed the two, he sucked down 5 oz. no problem!! We have been doing this for almost 3 weeks and he is sleeping much better and is taking 25-30 oz per day compared with 18-20 oz on a good day before. So does this mean that he is maybe less intolerant to the milk proteins than before??
We were officially diagnosed MSPI in the hospital, but we were working with so many different docs and had so many different tests, I don’t know which one made them finally decide this is what he had. I was such a mess too and getting no sleep and they gave me this answer and at the time that’s all I wanted was an answer as to what was going on! I’m wondering if he really had an extreme case of reflux and the MSPI was just something they added in??? Is there a definate test that diagnoses MSPI? I guess it really doesn’t matter except that I would like to try a different formula sometime in the future if I could and I also have a bunch of BM that is in my freezer that I really could mix in with it! I hate to waste that stuff!!
Sorry so long! I guess now that I have a chance to sit and think about what we have been through to where we are now, I am just amazed!
Erica
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