I need help! Medicine Dosing

[Anonymous]

I am desperately looking for help in treating my infant daughter with severe acid reflux.

I have gone to one pediatric GI specialist and am scheduled for a second opinion this week. I am trying to determine if the amount of medication, type of medication (brand and liquid vs. powder) and frequency are correct for her condition so I may bring the information to the doctor. I saw the ‘dosing chart’ on marci-kids.com, but I am not sure I am calculating it correctly. (Not sure what the conversion of ml to mg’s is either?)

Here is more information regarding my daughter and her treatment:

She is 10 weeks old this week (she was 4 weeks early…not sure if her prematurity makes a difference when dosing?)
9 lbs 4 ounces in weight and takes the following medicines every day:

4 ml of Prevacid <LIQUID form with a STRAWBERRY flavor – ONCE (morning) per day – I give it in a little formula just before feeding>

Pepcid – .6 ml two times per day (should this be spaced out from the Prevacid?)

Mylanta – .5 with every feeding (is this interfering with the other medicines I am giving – Prevacid and Pepcid?)

Thank you very much in advance for your assistance!

[Anonymous]

how many mg/ml is the suspension? im guessing its between 2-4 mg/ml?

your compound is being made incorrectly. it should be made with NO FLavorings of any kind, 16.8% sodium bicarb, and made every 14 days. if this is not done, the compound will become unstable in a matter of a few days, or may not even work at all.

please read this information:

pharmacy compounded PPI’s.

PPI’s also work best if given 2-3 times per day as babies metabolize PPI’s very rapidly. if given in one dose-it “wears off” by the end of the day.

H2 blockers need to be given 4 hours apart from a PPI.

this is the dosing recommended from marci-kids for your baby:

Your child, who is 3 months old and weighs 4.3 kg, should receive a dose of 5 to 7 mg of Prevacid delivered 3 times per day for a total of 15 to 21 mg per day.

is your baby in a lot of pain? and is she breasted/formula fed? MSPI?

nataliachick72007-5-28 20:19:57

[Anonymous]

First of all, thanks for your response.

how many mg/ml is the suspension? im guessing its between 2-4 mg/ml? – Ok, dumb question…by suspension do you mean liquid Prevacid?

Also, can you tell me the conversion of ml to mg? I saw you said “Your child, who is 3 months old and weighs 8.8 kg, should receive a dose of 10 to 14 mg of Prevacid delivered 3 times per day for a total of 30 to 42 mg per day. ” – but how much mg’s is she being given today? What is the equivalent of 4 ml in mg’s? I did the conversion and it seems that she is 9 lbs 4 ounces – so 4.3 kgs?

Yes, she is in a lot of pain. She has a milk allergy as well and is on Neocate formula. (I was breastfeeding and I am still pumping in case I can breastfeed in the future…but for now the doctor wants to rule out the allergy as the cause for her continued pain.)

She was also given a PH probe last week while on lower dosages of medications and was still refluxing.

[Anonymous]

in order to tell you how many mgs, i need to know how many mg/ml your prevacid compound is. in each ml, there is a certain amoutn of mg’s. its usually 2-4 mg’s in each ml. it should tell you right on the bottle.

[Anonymous]

The bottle says Prevacid 3MG/M – is this the information you need?

Thanks.

[Anonymous]

ok. so….that means she is getting 12 mg a day.

perhaps you can fax the doctor the marci-kids.com research, particularly this page:

http://marci-kids.com/dosingppis.html

[hellbennt]

how does dr know it’s a milk allergy?

sorry for the questions- just trying to help you…

in the meantime, are you eliminating all dairy (including ‘hidden’) from your diet so that your milk is free of milk proteins and then you can try to breastfeed again (sounds like you would like to return to itas you said you’re pumping)

[Anonymous]

oh yes i was going to say that…have you eliminated all milk and soy from your diet. cause that way you can breastfeed

[Anonymous]

is 12 mg too much or too little? it sounds like too much since the chart says “<3 months 1.5 to 1.75 mg/kg three times per day”

[Anonymous]

its too low. i pasted the wrong info for you earlier. this is based on 3 months and 9.4 lbs

Your child, who is 3 months old and weighs 4.3 kg, should receive a dose of 5 to 7 mg of Prevacid delivered 3 times per day for a total of 15 to 21 mg per day.

[Anonymous]

if you want to use that chart:

1.5 times 4.3 is 6.45

6.45 times 3 is about 19 mg

the high end:

1.75 times 4.3 is about 7.5

7.5 times 3 is about 22 mg

[Anonymous]

Thank you, this is so helpful. I am going to fax this to the doctor.

Also, I see in the dosing pdf for the doctors – that he said he starts on the high end – 4 X0.5 mg/kg = 2 mg/kg per dose…so…is the following correct?

2 times 4.3 is about 8.6

8.6 times 4 is about 34.4 mg

[Anonymous]

Hello!! As I was reading through this, I’m not sure if anyone mentioned that I *think* the prevacid is supposed to be given on an empty stomach followed by a meal 30 minutes later. Maybe it doesn’t matter with the compounded prevacid, but I know I’ve read the empty stomach thing on here a lot. Good luck and I hope the doctor increases your dose!!!!!!

[hellbennt]

compounded (compounded CORRECTLY) can be given anytime

[Anonymous]

yes you dont have to time compounds with meals. i would work on getting it made properly though! good luck!

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