yes that is true, unfortunately.
How Delayed Release PPIs Work
In their pure and unprotected form, PPIs are very vulnerable to degradation when exposed directly to the acid in the stomach. For this reason, DR PPIs are given an enteric coating. This protective coating is specifically designed not to dissolve while the drug is in the acidic fluids in the stomach, but instead it dissolves when the tablet or granules reach the higher pH (less acidic) environment of the duodenum (the first section of the small intestine). Here the coating dissolves and the drug is absorbed into the blood stream, where it is carried to the parietal cells, where it does its job of blocking proton pumps. This whole process takes 30 minutes to 1 hour.
DR PPIs should be given on an empty stomach because food in the stomach can both lower the level of absorption and raise the pH in the stomach, causing the enteric coating on the drug to dissolve, which then leaves the drug vulnerable to exposure to pockets of acid in the stomach which could destroy the drug.
DR PPIs should be given 30 minutes to 1 hour before a full meal (6 oz or more for infants). As I already mentioned, in order for PPIs to work their best you want as many proton pumps to be in an active state as possible, and the primary way of achieving this is by eating a full meal. The timing is important because you want the meal to be activating lots of proton pumps right at the same time that the drug is reaching peak levels in the blood stream.
DR PPIs should taken with water or sprinkled over an acidic food such as apple sauce or yogurt.
You should never break or crumble a tablet form of DR PPI, as this will compromise the protective enteric coating. (Prevacid Solutabs contain enteric-coated granules within the tablet, and it is ok to break a Solutab in half, as this should not harm the individual granules)
You should never give a DR with a non-acidic food (such as milk, formula or cereal), as this will dissolve the enteric coating and leave the drug unprotected.
DR PPIs should never be chewed or crushed, as this will compromise the protective enteric coating.
For infants, MARCI-Kids recommends the use of the IR PPI Zegerid over DR forms of PPIs, as infants can easily spit out, chew or even choke on the granules of DR PPIs. Of the DR PPIs, Prevacid Solutabs seem to be the easiest to administer for most parents.
https://www.infantreflux.org/forum/forum_posts.asp?TID=6026&a mp;a mp;KW=treating+gerd+with+PPI
good luck!
nataliachick72007-5-24 17:31:29
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