Posted By Posting
Aug 05, 2013
rubysdad
Prevacid - conflicting and dated information
Today is my daughter's fifth day of Prevacid. Her reflux is definitely getting worse. I've been doing all the reading I can on Prevacid, and part of our struggle is that there is a lot of conflicting and/or dated information out there. Here I try to summarize my questions and the (conflicting) answers I've found:

How long to give before feeding? The most common answer, for the Solutabs, is 30 minutes before feeding, or two hours after a feeding. My understanding is that this is common for all PPIs. (As a side note, we were doing this with Axid, but some of my research suggests it's not necessary for H2-class drugs?)

How long before it starts working? Our pediatrician said 24-48 hours, a recent post on this forum said two weeks is typical, and I've seen reports of it taking longer still. My wife and I decided to try and wait 14 days, unless there are too many nights of inconsolable screaming.

How to best administer it? Clearly, the Solutabs were designed for adults. This is consistent with the lack of FDA approval of Prevacid for kids under 1 year of age. But if the drug cannot be correctly and efficiently administered to the baby, how do we know whether or not it's working? I.e., if the baby isn't getting enough, it will never work.

It seems that most people, including our pediatrician, said to use a syringe with water and the dissolved solutab. So far this has resulted in my daughter ending up with a chin/neck/bib full of the granules (she mostly spits out the water). I suspect she's getting 50% of the dose at most. Other people suggested putting the tab directly in the baby's mouth. Our doctor advised against this, and we're worried about the choking risk. I've seen people talk about using a tiny amount of water to make more of a "mush", then spoon-feeding the baby. Our doctor even said that we can mix it with formula! But this is inconsistent with the "wait 30 minutes before feeding rule".

Then there's the whole sub-discussion of liquid-form, i.e. compounds. It looks like, at one point, you could basically create your own compound from the solutabs using something like Buffer Babies, ChocoBase, or CaraCream. But for one, are these "DIY" compounding solutions still available? I can't seem to find any website that sells them. And two, my informal research suggests that they change the nature of the drug, from time-release to immediate absorption (likewise for liquid-based Prevacid sourced from a compounding pharmacy). Some of what I read suggested that if you use a suspension form of the drug, then the dosing becomes dynamic and weight-dependent (like H2-style drugs such as Axid and Zantac). The whole point of Prevacid is to avoid the roller-coaster of always playing catch-up with the dosing.

The confusion of getting reliable and consistent answers only makes the frustration of dealing with reflux worse. Maybe it's because of the off-label nature of using PPIs for babies---feels we're all part of a big living trial.

Thanks again for the help and responses I've received. If anyone has anything to add, we're thrilled to hear it!

Aug 05, 2013
rubysdad
two more things...
Two more topics I forgot to add:

Can Prevacid be taken at the same time as an H2 med? Our doctor said no. But our close friend's son struggled with reflux, and his pediatrician said yes. In particular, they were directed to continue the H2 (Zantec I think) for two weeks while they waited for the PPI to take effect (Prilosec or Prevacid, can't remember which). I've seen several anecdotal stories on the Internet suggesting the same.

Prevacid once or twice per day? Our doc prescribed a single 15 mg solutab per day. But, again, there is plenty of talk on the Internet of dividing the tab in half, and giving half a tab twice per day. I am thinking about doing this myself, given how much we struggle to get the full dose at once. Maybe we'd have better luck getting her to take half the dose (and doing that twice a day).

Aug 09, 2013
babsil037
Prevacid
It took a full two weeks for the Prevacid to start working on our son. He was never prescribed Zantac so I am not sure if you can take both at the same time. In regards to the solutab, we just cut it in half and put it in our little guys mouth with no water. He refused syringes of any kind so that was the only way we could get him to take it. It dissolves really quickly in their mouths so we were not concerned about him choking on it. Our ped also suggested dissolving it in a tiny bit of applesauce but our guy woulnd't take that either. We tried giving him it to him an night which I believe is what was prescribed but his nights would be even worse than before (if that was possible) so we just give him the whole dose in the morning. We also tried giving him half a dose in the morning and half at night but that didn't work for him either. Every baby is different about this so it may take a few days of testing to find what works for Ruby. The Buffer Babies and other compounds are hard to find - there used to be a website called marcikids which is now defunct that would prescribe dosing for this. If you google that you may be able to find dosing and the buffers but we never tried those.
Aug 09, 2013
rubysdad
Hi babsil037, thanks for your reply!

My original post was half venting, because it's frustrating when you can't get a consistent story on a medication, particularly one for a three-month-old who is suffering. But at the same time I had hoped a lot of people would contribute and it would ultimately evolve into a "FAQ" of sorts on infant Prevacid.

Anyway, just to give an update: we gave on the syringe. For the last few days, we have been breaking the pill in half, and administering twice a day (morning and night) directly in her mouth. We try to push the pill back in her mouth, between her lower gum and cheek. Then we give her a nipple with a little water in it to wash it down. So far, it's gone so much better, with minimal "grains" ending up outside her mouth. In fact, this morning, my wife said she gave the whole pill, and that also went well. So we'll probably just do the full dose once a day now.

As to the question, "is it working?" August 1 was her first dose, so today make nine days. The first few days it definitely wasn't doing anything, but as I mentioned before, I wasn't sure if she was getting enough, since with the syringe method, so much of the medicine ended up on her chin, neck and bib. We've only been doing the directly-in-the-mouth method for a few days now. Unfortunately, the new delivery method coincided with her catching a cold from her sister! She's fussy and unhappy, but we can't tell if it's reflux or the cold. Hopefully she gets over the cold quickly, and then maybe we can assess the effectiveness of Prevacid.

Aug 12, 2013
onion
My 6mo son is on prevacid. I think it is helping some. I think we started almost 2 wks ago. I'm curious about conflicting info on side effects. When I asked our GI doc, he said there were virtually none. But reading all over the internet, one sees accounts of sleeping problems. And boy do we have issues now. Our son seems wired at nap time and can't fall asleep. Some days we get NO naps. At night bedtime, it now takes an hour or more sometimes, with a couple of wakeups soon after. Then he'll wake up every 1.5 hr after that. Thing is, this may happen even on nights when reflux isn't bad. So whats the word? Is this a side effect? If so seems barely worth it.
Aug 13, 2013
rubysdad
Hi Onion,

Tomorrow will make exactly two weeks that our 3.5 month old daughter has been on Prevacid. We have not seen any side-effects so far. She has always slept poorly (or not at all) during the day, but reasonably well at night (all things considered). We are hoping the poor day-time sleeping is due the reflux, and if Prevacid does in fact work for her, she might be able to sleep during the day.

That said, I too have seen the anecdotal evidence about Prevacid causing sleep problems. I read about it before we actually started using it, and it almost made me re-consider. I of course want her to get lots of high-quality sleep, but if I have to give up a little sleep to ease her suffering, maybe that's the right way to go. Sadly, there are rarely easy black-and-white answers when it comes to raising children. Many times I think all you can do is to simply educate yourselves as much as possible and make decisions you believe are in your child's best interests.

Is your son happy when he's awake? My completely-speculative, non-medical idea is that if kids are miserable before the meds, and completely transformed with the meds, then maybe they want to stay awake more and enjoy life. Or perhaps more simply, perhaps if your son was truly suffering, he never learned how to fall asleep on his own, and only slept when he was completely fatigued from crying or suffering from the pain of reflux? And now that he has no pain, he "realizes" he never learned to go to sleep without being completely drained and exhausted.

I think if I were in your situation, I would of course consult with the pediatrician. Depending on what the doctor says, I'd might give it another week or two, and see if sleeping patterns improve at all. I suggest keeping a sleep log, so you can accurately keep track of how much your son really sleeps per 24 hour period. It can be hard to make a call based on gut feel, particularly if you are going on minimal sleep! But with the log, you'll have hard numbers on which to base your decision. The doctor might also find the sleep log helpful.

Sep 22, 2013
jaclyn0519
I second that...
I second everything that rubysdad posted... we are in the same boat with our 9 week old son and i have all the same questions and concerns. we are doing zantac .9 ml 7am and 7pm, prevacid (7.5 1/2 tab in cheek) mid-day 1.5 hrs after the start of a feeding and 30 mins before the next feeding. we are on say 12 of this and not seeing much improvement. we dont know what else to do and our pedi doesnt seem to know anything about when to give, how much, how, etc. help!!!!
Check with your
doctor first!