PPI’s – a question for Joel or Lori…

[Anonymous]

I have a bit of a dilemma…my daughter Paige is now on day 17 of Prevacid Solutabs at the marci-kids recommended dose of 7.5 mg 3x/day. While she has shown some improvement, I don’t think she is doing as well as she could be because I’m having a very hard time getting it to her on an empty stomach. You see, she is a good sleep feeder (and Lori I’ve noticed you menion that Hailey is too, and also takes Prevacid, that’s why I’m curious to see what worked for you) and feeds very poorly when awake. She fusses terribly and often only takes in about 2 ounces over a period of an hour or so, then takes a long time to burp and settle so that she can sleep. If she does sleep, she often wakes after only 20-30 minutes, and is hungry again and the cycle repeats itself. If she does somehow manage to have a good nap, by the time she wakes she is extremely hungry, and it is impossible to then give her the Prevacid and make her wait 30 minutes before eating. And it is impossible to give her the Prevacid on an empty stomach if I try to feed her in her sleep so that she actually has a somewhat decent feed. Any suggestions? For now, I figure it is better for her to at leaset get the 3 doses each day, even if it’s not on an empty stomach, than how she was before on the Zantac.

I know Zegerid is available in the U.S. and can be taken without regard to meals/empty stomach, but I am in Canada and I don’t think it is on the market here.

Any suggestions would be greatly appreciated! Thanks!

[Anonymous]

Sheri,

I’m typing really quickly while Hailey is fussing to wake up so I’m going to have to run in about 10 seconds.

You can get CaraCream here. It’s the original zegerid, and you order it directly from marci-kids. You mix it yourself at home. We were never able to time the prevacid b/c of the feeding aversion, and the solutabs weren’t even available here until recently.

The CaraCream has worked well for her, but doesn’t taste fabulous, but that’s also a thing where each baby is different.

If you contact marci-kids directly they can give you more info.

Have to run, I’ll post more later.

[hellbennt]

we loved caracream here

[Anonymous]

we also do caracream, after switching from zegerid. i cant handle the timing with meals thing….it gives me anxiety!

[Anonymous]

Sheri, about the sleep feeding, it wasn’t something that I would really advocate for. We kind of fell into it, b/c Hailey literally wouldn’t eat while awake at all, and it was that or a tube. Even with the sleep feeding we had a feeding battle on our hands.

My feeling is that if she’s still having feeding trouble, I would try for an even higher dose of prevacid if you can. It’s amazing though that you’ve actually found someone who will go along with Marci-kids here. I’ve seen many many docs and none will do it. Who do you see, if you don’t mind me asking (you’re in TO right)?

I would try the CaraCream, they’ll send you free samples. My understanding is that they’re developing a new product, so I don’t know how much longer it will be on the market.

[Anonymous]

Lori,

Thanks so much for the tips – I hadn’t really read up about caracream so I didn’t realize how it worked. I’m going to see if I can get some! Hopefully it will be our answer. As for the sleep feeds, I have heard that they aren’t recommended. We try not to do it very often, usually only at night. What kind of long-term reprocussions (sp?) do you think came from Hailey’s sleep feeding?

We are in Brandon, Manitoba and thankfully we have a friend who is a doctor and was willing to prescribe the marci-kids recommended dose for us. We see the pediatrician in 2 weeks, and he doesn’t know that we’ve started Prevacid, so I wonder what his respose will be to the dose. I didn’t even bother to go to him for the prescription because he hasn’t been very helpful when it comes to the reflux, or the MFPI.

Thanks again!

[Anonymous]

Hailey wouldn’t eat any other way, so in terms of repercussions, I don’t know choice we had- either feed her asleep or get the tube. For us the tube would have been the better choice probably. The consequences were that no one took our situation seriously b/c Hailey was gaining weight. We were trapped in the house trying to get her to sleep and it would take hours to get a few ounces in her with difficulty. Now we’re in a position where we have a child who finally will take a bottle awake, but it’s a very rare occurence, and she doesn’t understand that you can drink a bottle awake in a place other than her bedroom. We’re dealing with her feeding aversion, and having a lot of anxiety around weaning her off her night feeds as she doesn’t eat any other way. Your situation sounds a bit different in that she will take other feeds while awake, so hopefully you wouldn’t end up in the same position.

[Anonymous]

Well, I got a shock this afternoon when the ped GI’s nurse called and said they have an opening on Monday to see the doc if I would like it! Wow – I’ve been trying to get an appointment with him for weeks and just kept getting stonewalled!

So, how should I ask him to prescribe the Prevacid in caracream? Should the strength be between 2mg/mL and 4mg/mL like the pharmacy compounded Prevacid? As well, does the dose need to be at least 3.5 mL in order to ensure enough buffer, like the pharmacy compounded Prevacid? Then should I ask him to write the prescription for “Prevacid in caracream” or just as “Prevacid capsules”? I know, so many questions, but I want to get it right. Thanks for all your help!

MFPIx22007-3-22 20:39:2

[Anonymous]

you get an Rx for prevacid capsules. i got an rx for 30 mg based on my sons weight. you get caracream from marci kids and they give you directions to mix in 8 capsules at a time. this will make a 3 mg/ml concentration. Dr Phillips suggest giving a minimum of 4.5 ML, otherwise use mylanta to equal that. since my son is older now, i do two doses a day, at about 4.5-5 ML at a time. then i give pepcid complete at bedtime. personally, i wouldnt even mention to the pharamcy that you are getting caracream and compounding yourself…they will most likely try to argue with you or advise against it because they dont realize what they are talking about

[Anonymous]

I agree with Natalia about not mentioning the CaraCream. Just ask for the prevacid capsules, not the solutabs. Then call and get some samples from marci-kids. Tell them the overall dose that you’ve been prescribed and how many doses you want to give a day, and they’ll tell you how to make it. We found that more docs here would prescribe the 15mg capsules, so if that’s the case, make sure to specify that to marci-kids so they know the right number of capsules to tell you to add.

We see a GI at Sick kids in TO, and when I recently told them that we were using CaraCream to compound the meds, they started arguing with me about stability. I knew that I knew more then they did on the issue, so I refused to talk about it any more, at which point the doctor actually said there was nothing more he could do for us.

[Anonymous]

What if he askes me how I plan to administer the capsules to a baby? I guess I’m just not sure how to ask him for capsules without him wondering why I wouldn’t rather have the solutabs.

Thanks for all the input Lori and Natalia!

[Anonymous]

Some people use the capsules and administer them using applesauce. So you could say you are doing that.

[Author]

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