Home › Forums › Infant Reflux Information › Medicines › The 30 minute rule
- This topic has 41 replies, 23 voices, and was last updated 7 years, 1 month ago by Anonymous.
October 3, 2005 at 8:16 pm #127AnonymousInactive
Thanks to Pooka, I was able to find some of the posts that I lost due
to the stupid hacker, and I am going to repost a few after doing a
little editing and updating. Here’s the first:
To help clear up the confusion, I thought I would give you
all a more scientific explanation behind why, when taking an enteric-coated PPI
such as Prevacid Solutabs, Prevacid capsules, Prilosec capsules or Prilosec OTC
tablets, it is best to take them on an empty stomach and then have a meal 30
minutes or so later. Some of this I have explained elsewhere as well, so
forgive me for repeating myself.
PPIs or Proton Pump Inhibitors work to reduce acid production in the stomach by
blocking (or “inhibiting”) the proton pumps which make the
acid. However, they are only able to block those pumps that are in an active
(acid producing) state. So the best way to block the most pumps and best
reduce the acid level is to have as many of these pumps in the active state as
possible when the drug reaches them. The primary means of activating the pumps
is by raising the pH level in the stomach (ie, making the fluids less acidic
and more alkaline). The primary means of raising the pH level in the stomach is
by eating a meal, since most foods are much less acidic than the stomach’s
Now here’s the tricky part with PPIs. They are what is known as a pro-drug
which means that they need to be chemically modified in order to become active.
The way that PPIs are activated is by being placed in an acidic environment
(such as found in the stomach). However, they also have a very very short
half-life (1-2 hours), which means that once they are activated, they only stay
activated for a very short period of time. The other trick is that they only
work by reaching the proton pumps through the blood stream. So they must be
taken orally, then absorbed into the blood stream, then come to the proton
pumps though the blood in the stomach lining in order to do their job.
The problem is, if they are exposed to the stomach acid right away, they will
be degraded by the acid and never be absorbed or passed on to the proton pumps,
thereby being completely ineffective. In order to get around this problem, most
PPIs are given an enteric coating that will only be
dissolved in a high pH environment. This coating protects the drug from the
acid while it is in the stomach until it can pass into the first section of the
small intestine known as the duodenum. In the more alkaline environment
of the duodenum, the enteric coating is dissolved and the drug is absorbed into
the blood stream and is carried to the proton pumps in the stomach lining where
it begins to block the proton pumps.
This whole process takes approximately 30 minutes. As you can see, with
this form of PPI, timing is everything. What you are aiming for is to
have the medicing reach the pumps right about the time that the meal is turning
them all on, so the maximum number can be turned off. That is why you must have
the meal as close as you can to 30 minutes after having taken the enteric-coated
PPI on an empty stomach. The reason
that it must be taken on an empty stomach is that taking it along with food dramatically
reduces the absorption of the drug into the blood stream, which means that
less drug gets to the proton pumps.
Even more detailed explanations and illustrations of this process can be found
at the PPIKnow website on this page.
As I have explained elsewhere, Zegerid is the only FDA approved form of PPI
which is not enteric-coated and which is absorbed immediately in the stomach
and you do not have to wait 30
minutes after taking it before eating a meal – it can be given without
regard to a meal.
If you have any questions about this post or other related topics, please
email: [email protected]October 3, 2005 at 9:06 pm #128October 4, 2005 at 12:31 pm #129AnonymousInactive
Thanks for the info
I just spoke to our Gi yesterday and she said you need to wait 1/3hr with
prevacid but prilosec/nexium 1 hr
I’ve never heard this before?
I wish all the docs would get on the same page…
KimOctober 4, 2005 at 12:40 pm #130AnonymousInactive
Kim, I’m afraid your GI is smoking something. I asked Dr Phillips and
he said that there is absolutely no evidence in the literature or
anywhere else to support this claim. I would ask her where she heard
this.October 4, 2005 at 12:42 pm #131
I’m cracking up here, LMAO!October 4, 2005 at 12:43 pm #132AnonymousInactive
Hilarious!October 4, 2005 at 12:51 pm #133AnonymousInactive
It makes me so mad that so many doctors out there are just talking out
of their you-know-whats and telling folks these things so confidently
when they just aren’t true! It really makes me wonder just how much
they really do know sometimes.October 4, 2005 at 12:54 pm #134
that’s exactly why I can’t seem to leave this place…September 24, 2006 at 8:08 pm #14190AnonymousInactive
bumpSeptember 25, 2006 at 6:30 am #14199AnonymousInactive
Thanks for bumping this. For some reason when I first saw this thread, I was so excited thinking that Joel had come back to visit! Then I looked at the date, and realized it was an old thread. He had a funny sense of humor.
s&h’s mum2006-9-25 6:38:56September 25, 2006 at 9:33 am #14209AnonymousInactive
lol this was hilariousOctober 13, 2006 at 9:09 pm #15650AnonymousInactive
just wanted to bump this
andreaOctober 13, 2006 at 11:43 pm #15672AnonymousInactive
okay what does bump mean???October 29, 2006 at 3:57 pm #16759AnonymousInactive
bump! I was waiting 20 minutes too! I think I need more Joel humor-anybody got any other posts of his? just kidding…October 29, 2006 at 11:14 pm #16775AnonymousInactive
Good info about the bump, I was wondering what it meant…
Anyway in Aus there are only Losec tablets. I contacted the company who makes them re the 30 minute rule and this is what the said ( I have added the bold for emphaisis.)
“Dear ThereseThank you
for contacting AstraZeneca today, when you requested information on the above product. The reason we suggest to people to dissolve in water for babies is that if you break the tablet up you are destroying some of the medication. Also the multiple little pellets need to stay whole so that they reach the right part of the digestive system before they are absorbed. You are correct that it can also be given with something acidic like fruit juice or stewed apple. It does not matter whether you take with or without food.
Thank you for your interest in AstraZeneca’s products and services. Please don’t hesitate to contact me if I can be of any further assistance.
I don’t think she is getting enough of it (10mg a day and she is 61/2 kilos) to make a difference anyway.
- You must be logged in to reply to this topic.