- This topic has 5 replies, 1 voice, and was last updated 14 years, 9 months ago by
.
-
the compound DOES make it so that baby can take meds & not have to time it around meals. HOWEVER, they are notoriously made INCORRECTLY.
TELL your doctor to TELL the pharmacist EXACTLY how to make the solution. TELL your doctor to PLEASE oh PLEASE just humour you…
A Word About Pharmacy Compounded PPIsMost PPIs can be compounded extemporaneously by a pharmacy into a buffered liquid suspension, and many pediatricians prescribe and recommend such suspensions.
However, MARCI-Kids [this is the research team of the University of Missouri]does not recommend the use of these suspensions, as our research and the research of others has shown that the vast majority of such suspensions become unstable within a very short period of time (usually a week or less). This loss of stability is related to the use of flavorings and other agents in the suspension.
In addition, most pharmacies do not add enough buffer to their suspensions to adequately protect the drug from degradation by the stomach acid. This is particularly a problem if a child is receiving a very low dose.
For these reasons, MARCI-Kids recommends the use of FDA Approved Zegerid Powder for Oral Suspension over the use of pharmacy compounded suspensions, which are not FDA approved.
~~~~~~~~~~~~~~~~~~~~~~~~~
As
Ask for a printout of all the ingredients and amounts put into compound. If you see any flavourings (simple syrup, sweet syrup, sweetener, bitter stop, stevia powder, oraplus, flavouring) then you know it’s not being made correctly. Then look for the amounts of bicarb and mg/ml as per the description in Natalia’s link[the information found in the previous/above posts]. I’ve yet to find a pharmacy who makes it correctly. It works for some…~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~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.
~~~~~~~~~~~~~~~~~~~SO:1) figure out PROPER DOSEhave you readPrevacid 101:
scroll to the last page of this post, (it’s actually also about other PPIs like prilosec, too)
https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1 yet?2) TELL doctor to TELL pharmacist. TEll don’t ask.
FAX FAX FAX the dr
stick to the FACTS (no emotions and ramblings)
state current meds, doses & symptoms
make request- flat out- short & sweet
provide pharmacist name & contact info
follow up by calling office to tell them fax was sent
call again later to discuss requests made in fax, ie:
is RX w/ instructions called in yet?
sample fax: https://www.infantreflux.org/forum/forum_posts.asp?TID=10633&PID=90325#90325
About faxing the doctor (& more): https://www.infantreflux.org/forum/forum_posts.asp?TID=2841&TPN=1
- You must be logged in to reply to this topic.
