Home Infant Reflux Main Treating Infant Reflux and Pediatric GERD Medications Omeprazole or Prilosec for Infant Reflux and GERD

Omeprazole (Prilosec) for Treating Infant Reflux and GERD

   
Rachel McMahon, B.Sc. Chem. Min. Sc.
January 2007
 

  
 

COMMON PRESCRIBING NAME

US: prilosec, rapinex
CAN: losec, losec MUPS
UK: losec, losec MUPS
AUS: losec, acimax
GER: losec, antra, ome-netron, gastroacid, omelind

PREPARATIONS

Capsules: 10, 20 and 40 mg. Generally opened and sprinkled on apple sauce (not hot) or placed in a small amount of apple juice or water and syringed to the child.

Tablets/MUPS: 10, 20 & 40 mg tablet either dissolved in water and given or slightly crushed (do not chew or crush the beads)

Over the Counter: 20 mg tablet.

Powder for oral suspension: This is rapidly absorbed, is available in 20 mg packets for dilution with water. It is combined with sodium bicarbonate to neutralize stomach acid that would destroy the omeprazole.

Compound: Made into a liquid by a compounding pharmacy. Must be stored in the refrigerator.

THINGS TO BE AWARE OF

  • With syringing a dissolved solution the beads may get stuck in a small syringe, so the larger the syringe (i.e. 20ml) the better to get the beads out, which is the active ingredient.
  • Compound generally only lasts 14 days, though some Drs and pharmacists will say 30 days, what is noticed that around the 14 day mark an increase of symptoms occur due to the product becoming unstable. Generally this is related to the effect of the flavorings added by pharmacies. Flavorings cause the PPI to become unstable and break down. Also many pharmacies do not add enough buffer to protect the drug from being eaten up by the stomach acid on the way down, especially in low doses.
  • Compound must be refrigerated, and for best results go to a proper compounding pharmacy.
  • MUPS stands for multiple unit pellet system
  • Like all PPIs administer 30mins before food for maximum efficiency. The beads are the ingredient these should be swallowed whole and should not be crushed, split or chewed.
  • Never stop taking or administering a PPI abruptly always consult your doctor and note that in most cases, results are not immediate, on average it takes 10-14 days to notice a definite change, this depends on how severe the reflux and how much damage it is healing.
  • It has been found that children metabolize PPIs two to three times faster than middle age adults, and thus splitting the dose over 2 to 3 times a day gives better results.
  • In the past CaraCream and ChocoBase have been used to make a true at home suspension of prilosec, but it has since been taken off the market. The rights to the product were sold and they are no longer allowed to distribute and produce the CaraCream and ChocoBase commercially due to a non-compete agreement of Santarus Inc, which now makes zegerid. Both the CaraCream and ChocoBase, is still made in small quantities for children unable to take zegerid. Please contact the manufacturers.

STORAGE

Store at room temperature, 15-30C (59-86F). Keep away from moisture and light. Compound should be refrigerated.

OTHER USES

Omeprazole is used for treating acid-induced inflammation and ulcers of the stomach and duodenum, gastro esophageal reflux disease (GERD) and Zollinger-Ellison Syndrome. It also is used in combination with antibiotics for eradicating H. pylori infection of the stomach.

PEDIATRIC DOSING

Omeprazole is approved by the US Food and Drug Administration for pediatric use in children 2 years and over at a dose of: 10mg if under 20kg and 20mg if over 20kg.

In general though Drs tend to prescribe an initial dose of 10mg and this is upped to 20mg if need be. PPIs are less weight sensitive then other meds, so doses will depend on symptoms. A few Drs will prescribe lower doses, especially in babies, but 20mg is generally a max dose for children without further testing.

DRUG INTERACTIONS

The absorption of certain drugs may be affected by stomach acidity. It has been found that PPIs reduce stomach acid also reduce the absorption and concentration in blood of ketoconazole (Nizoral) so it has a reduced effectiveness and increase the absorption. It has also been found to and concentration in blood of digoxin (Lanoxin) hence an increased toxicity.

Also omeprazole potentially can increase the concentrations in blood of diazepam (Valium), warfarin (Coumadin), and phenytoin (Dilantin) by decreasing the elimination of these drugs by the liver.

SIDE EFFECTS

Omeprazole like other PPIs is well-tolerated. The most common side effects are diarrhea, nausea, vomiting, headaches, rash and dizziness. Nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps and water retention occur infrequently.

Each dose of omeprazole powder for oral suspension contains 460 mg of sodium, and this should be taken into consideration in patients who need a sodium restricted diet.
 

 

 


 

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Site Last Modified: March 29, 2007
*Disclaimer: The information available on this website should not be used as a substitute for professional medical care for the prevention, diagnosis, or treatment of your child's reflux. Please consult with your child's doctor or pharmacist before trying any medication (prescription or OTC) or following any treatment plan mentioned. This information is provided only to help you be as informed as possible about your child's condition.
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