Question on Zegerid dosing with 40 mg

[Anonymous]

My BIL is a regular (adult) GI. He is going to give me some samples of Zegerid to supplement our prescription. However they are mostly 40mg packets.

Could someone tell me how I would dose a nearly 4 month old 18 lb baby on the 40mg packets? I have been giving him 30 mg (10 mg 3x day) in 5ml doses. How would that change?

Help a dummy out please!

[Anonymous]

Hello. You might want to email Joel on this one b/c according the marci kids website they do not recommend using 40mg packets if you are giving 30mg. Here’s the reason from the website.

Why should only the 20 mg Zegerid packet be used for doses of less than 7 mL?

Even though the 20 and 40 mg Zegerid packets contain different amounts of omeprazole, both packets contain the same amount of buffer. To make the recommended 2 mg/mL omeprazole suspension using the 40 mg packet, more water is added, which means that the buffer concentration will be half as strong as a suspension prepared from the 20 mg packet.

When the volume of a dose is less than 7 mL, the concentration of buffer in a suspension prepared from the 40 mg packet is not enough to protect the omeprazole from degradation by stomach acid. However, the concentration of buffer in a 2mg/mL omeprazole suspension prepared from the 20 mg packet is high enough to protect the drug if the volume per dose is less than 7 mL but greater than or equal to 3.5 mL. Dose volumes less than 3.5 mL from 20 mg packet preparation do not contain enough buffer to protect the omeprazole. The buffer concentration in suspensions prepared from the 40 mg packet is sufficient to protect the PPI only if the volume per dose is 7 mL or greater.

[Anonymous]

I’m not sure how you mix the 40 mg packets- I think you have to give more than 7 mls at a time though. I’m sure Joel will answer.

Just wondering how your little one is doing? Have you noticed any improvements?

[Anonymous]

Huh, what a shame that I couldn’t use these free 40mg packets. But if that’s not recommended than I guess we can’t. I hope Joel sees this and responds.

Truman is doing better! His alter ego Fussy McFusserton doesn’t make the regular appearances he used to. He’s much happier and smiley during the day, and we saw that change immediately. We started the Zegerid Friday night btw, and that night he slept better than he’s ever slept which isn’t saying much as he still woke up 4 times, but not the usual 6-7!

Unfortunately that little improvement hasn’t lasted as he was back to his 6-7 wakings Saturday and Sunday nights–despite having good days. So I don’t know what to make of it. I’m really hoping that his sleeping will improve with a little more time. I really dread going through sleep training but I also can’t continue to get up with him every 1-2 hours either!

Please tell me they do sleep more as the PPI takes full effect!

[Anonymous]

I’m not sure what meds you were on (sorry) but 30mg is a good dosage so he should start sleeping better soon. They say it can take up to 2 weeks but some that are on proper dosages at first do notice a difference before that, just give it a little bit longer it is to soon. I love zegerid, it changed our lives so much I don’t know what I would have done without it so I hope it helps you too!!

[Anonymous]

Saucy,

As it says on our website, you should only use the 40 mg packets if you are going to be giving 7 mL or more per dose (14 mg when mixed at a 2mg/mL concentration). If you give less than this, you will not be giving enough buffer to adequately protect the drug.

If you do decide to use the 40 mg packets, you would add 16.5 mL of water to each packet to make a 2 mg/mL concentration.

Just out of curiosity, has your BIL changed over to the new Zegerid capsules?

[Anonymous]

Thanks Joel. So how many mL would I give him per dose to be 30mg/day? Is it safe to do it this way? Obviously this would be a great savings to us, but not worth it if its going to compromise safety/effectiveness.

Yes, he has been using the capsules because he asked me if wanted the packets or the capsules. I know he’s said that he prescribes it to his patients.

[Anonymous]

Well, given what I stated earlier and the info on our website, I cannot recommend that you use the 40 mg packets unless you are going to give 7 mL (14 mg) or more per dose. The only way you could do that with your current dosing of 30 mg per day would be to give two doses of 7.5 mL (15 mg), but according to Dr Phillips, the frequency is just as important as the dose, so I wouldn’t recommend that either. Sorry, I wish I could be more helpful.

Does your BIL like the Zegerid capsules? I wish we could afford them for my wife. They’re supposed to work great and you don’t have to put up with the taste of the powder!

[Anonymous]

I don’t know if he likes the capsules, but I will ask him next time I speak to him!

[Author]

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