Joel’s Out of the Office!

[Anonymous]

FYI, I will be out of the office from Wednesday, March 23 until Wednesday, March 29. So I will not be able to respond to posts, emails or calls during that time. If you have any urgent needs or questions, please ask me today or tomorrow!

[Anonymous]

YIKES!! I guess you deserve a vacation, but what will everyone do without you???

I do have a question about Prevacid. When you say it should be given on a empty stomach and 30 minutes before a full meal, do you mean the baby has to eat 30 minutes after if is given? Or, can he eat anytime after the 30 minutes is up? Someone posted that the baby needs to eat 30 minutes later to activate the drug. True?

Thanks.

[hellbennt]

from here (prevacid 101- last purple post on the page): https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&a mp;PN=0&TPN=1

there’s: How long before/after eating to administer: https://www.infantreflux.org/forum/forum_posts.asp?TID=2789

HTH (hope this helps)

~laura

[Anonymous]

Yes, true. Any enteric-coated form of PPI (Prevacid capsules, solutabs, powder packets, Prilosec capsules, or Losec tablets/capsules) are not absorbed in the stomach, but must pass through it and be absorbed in the small intestine. The coating is designed not to dissolve in an acidic environment, which protects the drug that is inside from being degraded by the stomach acid.

You need to give it on an empty stomach because 1) any non-acidic food could cause the coating to come off and expose the drug to pockets of acid, and 2) because giving it with food reduces the amount of drug that can be absorbed.

You need to give a full meal (6 oz or more) at about 30 minutes (not necessarily exact) after the dose. The reason for this is that the drug can only block the acid secreting proton pumps that are in an active state, and the primary means of activating these pumps is by raising the pH in the stomach with a meal. The more pumps that are activated, the more pumps can be blocked by the drug.

Now for babies with delayed gastric emptying, an enteric-coated PPI may not work well, as the drug may stay in the stomach for too long and the coating will eventually come off of the granules, leaving the drug unprotected. This is why many babies on these forms of PPI will sometimes spit up purple or brown flecks or granules, which is the color that PPIs turn when they have been degraded by the acid. This is another reason why we recommend Zegerid, which is absorbed both in the stomach and small intestine, does not require a special wait time, and can be given regardless of mealtime.

Does that all make sense? Let me know if you have any other questions.

[Anonymous]

O.k. but my son rarely eats more than 4 ounces at a time. His first feeding is usually only 3 ounces. After his next two doses he typically will eat 4 – 5 ounces, but that’s it. That’s the best I can do with him – he’s not a big eater. Do you think this is o.k.? He does seem to doing better.

Thanks, Joel.

[Anonymous]

Christine,

If that amount of food is doing the trick, then I would stick with it. I’m just passing on what has been told to me about the best way to make these drugs work effectively. The reason that you just mentioned (having a hard time giving these kids a “full” meal) is just another reason why our group does not recommend the use of enteric-coated PPIs as much as an immediate release form like Zegerid. But, as they say, “if it ain’t broke, don’t fix it”.

[Anonymous]

Yeah, I know what you mean. I tried to switch to Zegrid thinking it’d be easier, but my son hated it and there’s no way to get him to take 5 ml’s of something he hates. He’s stubborn! I may try it again in the future. With him on Prevacid I have to plan my entire day around his meals and his medication. It’s frustrating, but it’s working so I shouldn’t complain.

Thanks so much for your help.

[Author]

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