Prilosec issues

[Anonymous]

Hi everyone, couple of questions about prilosec……

My son is on 5mls per day and it is compounded in a chocolate suspension. Do the concerns about stability of a suspension apply to the chocolate form? It says it needs to be refrigerated, not sure if that fact helps you answer the question. I saw the posts about suspensions not being effective after a week or two but they mostly talked about cherry/grape etc and I’m wondering if what we have is more like chocobase I’ve seen posted about on here. Is chocobase more stable?

My other question is tips for administering. My son HATES taking it. I’ve tried droppers, syringes, putting it in a bottle and no luck. He chokes and gags and often spits it up, and then I don’t know how much he received. Today my peds office said I could mix it with milk which I did And he took it!!!!! However…..then I saw that it might be important to give it on an empty stomach and wait some time before feeding for certain forms of PPIs. Is this true of the type that I get compounded and has to be refrigerated? Would love to keep giving to him in some formula bc he took it without a fight and got the whole dose, but obviously I want to make sure he is getting maximum benefits of the meds

Thanks!

[hellbennt]

I would say that the compound may not be made correctly- even if it is chocolate- there is more to look at- if you do have the suspension you should get it NEW every two weeks- if you find it’s helping then yes maybe it’s stable- and then yes you can give at any time, even w/ formula- I might ask for the flavoring on the side? also read below

1. Make sure that your pharmacist does not put any kind of flavoring agent in the compound.

2. 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.

3. 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.

If you have any questions, please contact the MARCI-Kids team: info@marci-kids.com

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