Medications For Treating Infant Reflux and Pediatric GERD Print

 

If lifestyle modifications alone are unsuccessful in controlling reflux then medication will likely be the next step. Listed below are the different types of medication used to treat reflux or GERD, (where possible the generic name will be listed in brackets).

 

Antacids
Simply put, these neutralize acid in the stomach. Antacids do not decrease acid production, rather work by temporarily neutralizing the acid that is in the stomach at the time they are taken.  They work quickly but do not have long lasting effects.

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Cytoprotective Agents
These medications work by protecting the esophagus and stomach lining. There are two medications in this class of drug and each work in different ways.

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Acid Blockers (Histamine Receptor Antagonists)
Also called H2 blockers, this class of drug works to block acid production by stopping histamine from binding to H2 receptors.

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Proton Pump Inhibitors (PPI's)
Proton pump inhibitors or PPI's are thought to be the most effective medication for treating acid reflux and GERD. They work by almost completely shutting down acid pumps in the stomach.

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Motility Agents (Prokinetics)
Prokinetics work by moving food through digestive system faster. The rationale behind using prokinetics for treating reflux is simply that the faster food travels out of the stomach, the less chance there is for it to be refluxed.

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Antispasmodics
They are prescribed assuming that colic is due to abdominal cramps or spasms due to an overactive gastro-colic reflex, which has yet to be proven.

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Final Comments

Very few of the drugs used on babies and children for treating GERD have been FDA approved to do so.  When a drug is used for something other than it's FDA approved usage, it's referred to as "off-label".

References

  • Prilosec (omeprazole ) package insert. Wayne, PA: Astra Merck Inc; 2000 April.

  • Prevacid (lansoprazole) package insert. Deerfield, IL: TAP Pharmaceuticals, Inc; 2000 Nov.

  • Nexium (esomeprazole) packet insert Wilmington DE: AstraZeneca; 2002, Feb.

  • Zegerid prescribing information: Santarus, Inc., San Diego, CA 92130
    by OSG Norwich Pharmaceuticals, Inc., North Norwich, NY 13814.

  • Trissel, Lawrence A. Trissel's Stability of Compounded Formulations. 2nd ed. Washington, D.C.: American Pharmaceutical Association; 2000 pp279-80.

  • Sharma VK. Comparison of 24-hour intragastric pH using four liquid formulations of lansoprazole and omeprazole. Am J Health-Syst Pharm 1999;56(Suppl 4):S18-21.

  • McAndrews KL and Eastham JH. Omeprazole and lansoprazole suspensions for nasogastric administration. Am J Health-Syst Pharm 1999;56:81.

  • Phillips JO, Metzler MH, Palmieri TL, Huckfeldt RE, Dahl NG. A prospective study of simplified omeprazole suspension for the prophylaxis of stress-related mucosal damage. Crit Care Med 1996;24:1793-800.

  • Howden CW. Update on the use of proton-pump inhibitors in the hospital setting. Am J of Health-Syst Pharm 1999;56(Suppl 4):S3-4.

  • DiGiacinto JL, Olsen KM, Bergman KL, Hoie EB. Stability of suspension formulations of lansoprazole and omeprazole stored in amber colored plastic oral syringes. Ann of Pharmacother 2000;34:600-5.

  • Phillips J. Dynamic medical information system for flavored lansoprazole suspension. www.surgery.missouri.edu/tops/lansoflav.html . Accessed on: 1/10/2001.

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