Prevacid and zantac taken together? - Mothering Forums

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#1 of 21 Old 01-25-2009, 08:47 PM - Thread Starter
 
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Hi ladies,

Prevacid worked for our 4 month old DD great for about a month and 12/29 she started getting miserable and is on the verge of inconsoable most of the time now. We doubled her dose of prevacid with no change (at $400 a month). Plus, the doubled dose really messed up her gut. So, now I'm wondering if I should try using Prevacid and Zantac together?

I took her to the ped a couple days ago and she looks fine ears, nose and throat wise. She said her belly is soft. She's been "teething" for two months with no sign of breakthrough.

Gosh, I just don't know what to do. She's barely sleeping, isn't big on eating and cries, whines or screams when she's awake.

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#2 of 21 Old 01-25-2009, 10:04 PM
 
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You're using a sling or using Hylands teething tablets by chance?
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#3 of 21 Old 01-25-2009, 10:20 PM
 
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We have had great success with the drug Reglan for reflux. It has been around a long time and has very little side effects. Our NP was very wary of Prevacid - its a pretty hardcore drug... Maybe switching to something else entirely might be better than adding to the mix.

Good luck - I know how hard having a reflux baby can be!
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#4 of 21 Old 01-25-2009, 10:34 PM
 
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We've tried Prevacid & Zantac - and both together.

YMMV, but when we did both together, we did see a marked improvement... before it stopped working.

Then we tried Nexium.

Now we're onto Losec.

So far, only the Losec is really working to combat her GERD issues.

Everything works for a time, then starts to be ineffective. Then we tweak the dose and get a bit more out of it. Then if stops working altogether!

My LO is thirteen months and spends just about every waking minute moaning, whining, crying or screaming.

I'm at a loss for what to do when the Losec stops working; I'm in Canada, so my options are a bit narrower (I think - need to do more research!)

Having said that, our paed also thinks she may have SPD, so who knows at this point!

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#5 of 21 Old 01-25-2009, 11:38 PM
 
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I am so sorry you guys are still going through this!!!! Luckily our days have gotten a lot better reflux-wise (with the prevacid), but our nights are awful awful. Hugs Kari!! You are in my prayers!!

I have heard that mixing the two sort of cancels eachother out. I would try something different, like the PP's have mentioned. A friend of mine has had great luck with Prilosec.

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#6 of 21 Old 01-25-2009, 11:47 PM
 
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I have a reflux baby as well, but we didn't put her on meds for several reasons. I'm really wary of Prevacid. It shuts down the acid pumps in the stomach, so food cannot be very well digested and can lead to serious IBS problems. The baby still has reflux, it's just not acidic anymore and therefore doesn't burn which is why it works for a while.

I've found that the only thing that works for us is for me to be on a very strict diet (no dairy, caffeine, sweeteners - artificial or natural, or most grains) and taking her to the chiropractor. We tried the chiropractor first and it was really helpful, but the diet was the icing on the cake - particularly the no dairy part.

I hope you are able to find some relief for her and you!

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#7 of 21 Old 01-26-2009, 12:05 AM
 
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You can't use zantac with the prevacid at the same time. It will prevent the prevacid from working. You can do prevacid night, zantac morning. However, the acid reducers are famous for building tolerance and not working long.

What is your daughter's prevacid dose and how frequently is she getting dosed. I would tend to assume she's metabolizing fast (many infants do, especially as they age) and she needs to be dosed three times per day. That did it for my kid. We also used Zegerid which I prefer because it can be taken without regard to food...the others you're really supposed to give away from eating and that is difficult to impossible with an infant.
http://www.marci-kids.com/dosing.html They have a dosing calculator too. Make sure she's at the right dose and taking it three times per day.
Prilosec has issues because when it is compounded by the pharmacy it only stays potent for two weeks. So if you try that one have it refilled every two weeks. The Marci kids site referenced above describes why this is an issue with prilosec. So I'd stay with prevacid or try Zegerid. We loved Zegerid.
If all that is fine and she's still in pain you need to see a pediatric GI in my opinion. But I suspect proper dosing will help her and most pediatricians dose poorly.

This is a baby in pain. No meds isn't an option. My kid ended up failure to thrive and spitting up blood....and his reflux was not impacted by a strict allergen free diet. If a child moves along happily spitting up that's one thing but this baby isn't. My son's only long term issues from his reflux were oral aversion due to the pain when he went untreated. No IBS or issues at all related to being on PPI medication. It's nearly impossible to completely surprise a baby/infant/toddler so they'll still have acid even on a PPI. But beyond that no child should be in pain.

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#8 of 21 Old 01-26-2009, 10:26 AM
 
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I so understand where you are coming from. DD had the same problem - everything that we tried worked for a little while and then her reflux was as bad as ever. We tried zantac and then prevacid. Both helped a little. We also started her on nutramagen, a hypoallergenic formula without milk protein which also helped a little. (I couldn't breast feed for health reasons). We finally had to add erythromycin three times a day, which was our silver bullet. Not only does she have reflux, she also has delayed emptying of her stomach. The erythromycin helps to move the food along so it doesn't stay in her belly. It may be worth asking your ped about. DD is the worst case of reflux that my ped has ever seen. She was in so much pain she would cry nonstop from 8am until she fell asleep exhausted at 10pm.
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#9 of 21 Old 01-26-2009, 05:44 PM - Thread Starter
 
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Hi all,

Thank you for your replies!

Ok, I guess I should preface by saying that DD's reflux created an aversion to eating (nursing) and therefore (as much as I HATE it), she needs to be on meds for now. She's in ECI to work with feeding issues and other sensory stuff that started when she started refusing to eat.

Formula is not an option I'll consider. Antibiotics are also notI have taken her to a chiro with little improvement. I'm starting an ED Friday to see if that will help things. If it does, then I'll revisit the chiro and see if maybe it can be helped or managed that way.

We had an appointment with Cooks GI in early Feb., but my hubby's insurance that was supposed to be effective 2/1, isn't effective until 3/1. So, we're stuck there too.

She's was on 7.5 broken into twice a day and we went to 15mg with absolutely NO change. According to marci kids, she should be on like 27-36mg a day, but we can't afford that. We're already strapped at $200 a month at 7.5mg a day. Going to 15mg cost us $400/month and that made no difference. We certainly don't have $900 a month for this. You know what I mean? So, meds wise, we're in a jam until sometime after March when we reach the deductible.

I gave her ped a call about Zengerid. Her nurse hadn't heard of it, so she'll be calling me back. It sounds like either we're going to go broke or constantly changing meds to get her to feel better. There's got to be a better way. Lord willing, we can at least keep her on 7.5mg a day with a strict diet and homeopathy. Gosh, this sucks.

Nursemummy I'm sorry, that is just awful!

Hi Catie, I'm glad that y'all are doing well in the daytime, but having nights be awful sure will put a drain on you both. I'm sorry

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#10 of 21 Old 01-26-2009, 05:53 PM
 
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Hi all,


She's was on 7.5 broken into twice a day and we went to 15mg with absolutely NO change. According to marci kids, she should be on like 27-36mg a day, but we can't afford that. We're already strapped at $200 a month at 7.5mg a day. Going to 15mg cost us $400/month and that made no difference. We certainly don't have $900 a month for this. You know what I mean? So, meds wise, we're in a jam until sometime after March when we reach the deductible.
How absolutely horrible. The issue is that you can get in a royal mess (as you know) with feeding issues the longer she's in pain. My son got an eroded esophagus. It took us 1.5 years before we made headway in fear of swallowing. It took three years to really improve. So somehow we've got to figure out a way for you to afford the proper dosage. The dose is the problem here with her continued/recurring pain. Have the pharmacist figure out if zegerid or prevacid (at Marci kids doses) is less expensive or if there is another PPI other than prilosec for kids. Don't use prilosec even if it is cheaper. $900 a month seems crazy to me though I honestly don't know what we spent. We were so incredibly desperate to help him. But you can also check with the prevacid and zegerid makers. See if they have a prescription assistance program. See if your physician can get samples. We got lots of prevacid samples. Maybe they can sample you enough to make it manageable until you get to March. Another thing you might be able to do is get the pain under control (give it a month at high doses) then try a two week max dose, one week under dose, two week max dose schedule. That would be a last resort for me. But in my experience it took us 1 to 2 weeks before we saw major symptoms when we would try to step down doses.

I'm so sorry for you and your baby.

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#11 of 21 Old 01-26-2009, 06:37 PM - Thread Starter
 
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How absolutely horrible. The issue is that you can get in a royal mess (as you know) with feeding issues the longer she's in pain. My son got an eroded esophagus. It took us 1.5 years before we made headway in fear of swallowing. It took three years to really improve. So somehow we've got to figure out a way for you to afford the proper dosage. The dose is the problem here with her continued/recurring pain. Have the pharmacist figure out if zegerid or prevacid (at Marci kids doses) is less expensive or if there is another PPI other than prilosec for kids. Don't use prilosec even if it is cheaper. $900 a month seems crazy to me though I honestly don't know what we spent. We were so incredibly desperate to help him. But you can also check with the prevacid and zegerid makers. See if they have a prescription assistance program. See if your physician can get samples. We got lots of prevacid samples. Maybe they can sample you enough to make it manageable until you get to March. Another thing you might be able to do is get the pain under control (give it a month at high doses) then try a two week max dose, one week under dose, two week max dose schedule. That would be a last resort for me. But in my experience it took us 1 to 2 weeks before we saw major symptoms when we would try to step down doses.
We buy the RX bi-weekly and I realized that I was getting it messed up. We paid $45/bi-week for 7.5mg a day and $45/a week for 15mg. So, at 30mg/day it would be $400 a month. I think I'm figuring that right. That's a whole lot better than I was thinking, but still really tough for us.

Since we have a 90 day RX for Prevacid, I think I'll try the Zegerid to see if that helps more. The alternating max/lower sounds like a good plan.

Now, how on earth do I convince a doc to give her 30mg a day? We switched her doc recently and she was fine with giving her 15mg a day, but said that with Prevacid, they don't increase past 15mg/day until they are 60 some odd pounds. Since we're cash for now, continuing to visit other docs isn't possible. Should I give her the Marci Kids site?

Finally, with doubling her dose, should we not have seen *some* type of improvement? This is what makes me wonder if staying with prevacid (vs. trying another kind) is a good idea.

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#12 of 21 Old 01-26-2009, 06:45 PM
 
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I realize money is tight. Have you had her allergy tested? My dd2 had terrible reflux and later diagnosed as terrible food allergies. (She was "okay" with the meds when I was EBF. But once she was eating it by mouth at 11 months she got way worse.)

I wonder why they won't give you more Prevacid, my DD2 is back on it at 30 mg day.

I'm sorry you guys are going through this. It's the worst when they are in pain.
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#13 of 21 Old 01-26-2009, 06:57 PM - Thread Starter
 
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I realize money is tight. Have you had her allergy tested? My dd2 had terrible reflux and later diagnosed as terrible food allergies. (She was "okay" with the meds when I was EBF. But once she was eating it by mouth at 11 months she got way worse.)

I wonder why they won't give you more Prevacid, my DD2 is back on it at 30 mg day.

I'm sorry you guys are going through this. It's the worst when they are in pain.
Nope, no allergy testing. I'm doing an elimination diet on Friday to see if this is at all food related. I've been off obvious dairy for 3 months, but she seems super sensitive to what I eat. She won't be on solids until sometime after 9 months, so that's not an issue yet.

Gosh, I don't know. Her first ped didn't want to increase her from the 7.5mg a day she was on, which is why we switched to a different one. The new one I really like for many different reasons and I'd like to stay with her if possible. She was fine doubling her dose. I guess in another week on the higher dose, I can push the issue and she where I get. I'm still hoping that a new medicine would help in a lower dose.

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#14 of 21 Old 01-26-2009, 07:02 PM
 
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As the Mom of 2 reflux/motility kids, I would suggest you aggressively try an elimination diet(take dairy, garlic, caffeine, onion, tomatoes, fatty foods & coffee out of your diet).

You should also keep your daughter upright after feeding and prop the head of her bed. I used a sling with my dd but I had to be careful with positioning to make sure there wasn't any pressure on her stomach. Also make sure her diapers aren't too tight around the stomach. Another thing I did was try different positions when feeding. It did help to use a football hold while bf and smaller frequent feeds are easier on her tummy.

There are other med options but you should talk to the GI about that. Although, I would be careful with Reglan because it does have some pretty nasty side effects(speaking from personal experience). It is pretty typical for babies to need higher doses of meds that need to be adjusted frequently.

I hope your dd is feeling better quickly!
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Originally Posted by sbgrace View Post
You can't use zantac with the prevacid at the same time. It will prevent the prevacid from working. You can do prevacid night, zantac morning. However, the acid reducers are famous for building tolerance and not working long.

What is your daughter's prevacid dose and how frequently is she getting dosed. I would tend to assume she's metabolizing fast (many infants do, especially as they age) and she needs to be dosed three times per day. That did it for my kid. We also used Zegerid which I prefer because it can be taken without regard to food...the others you're really supposed to give away from eating and that is difficult to impossible with an infant.
http://www.marci-kids.com/dosing.html They have a dosing calculator too. Make sure she's at the right dose and taking it three times per day.
Prilosec has issues because when it is compounded by the pharmacy it only stays potent for two weeks. So if you try that one have it refilled every two weeks. The Marci kids site referenced above describes why this is an issue with prilosec. So I'd stay with prevacid or try Zegerid. We loved Zegerid.
If all that is fine and she's still in pain you need to see a pediatric GI in my opinion. But I suspect proper dosing will help her and most pediatricians dose poorly.

This is a baby in pain. No meds isn't an option. My kid ended up failure to thrive and spitting up blood....and his reflux was not impacted by a strict allergen free diet. If a child moves along happily spitting up that's one thing but this baby isn't. My son's only long term issues from his reflux were oral aversion due to the pain when he went untreated. No IBS or issues at all related to being on PPI medication. It's nearly impossible to completely surprise a baby/infant/toddler so they'll still have acid even on a PPI. But beyond that no child should be in pain.
Bolding mine - I should have mentioned that! We did space it out when we were giving it.

Has anyone here tried Losec or Nexium?

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#16 of 21 Old 01-26-2009, 11:08 PM
 
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How absolutely horrible. The issue is that you can get in a royal mess (as you know) with feeding issues the longer she's in pain. My son got an eroded esophagus. It took us 1.5 years before we made headway in fear of swallowing. It took three years to really improve. So somehow we've got to figure out a way for you to afford the proper dosage. The dose is the problem here with her continued/recurring pain. Have the pharmacist figure out if zegerid or prevacid (at Marci kids doses) is less expensive or if there is another PPI other than prilosec for kids. Don't use prilosec even if it is cheaper. $900 a month seems crazy to me though I honestly don't know what we spent. We were so incredibly desperate to help him. But you can also check with the prevacid and zegerid makers. See if they have a prescription assistance program. See if your physician can get samples. We got lots of prevacid samples. Maybe they can sample you enough to make it manageable until you get to March. Another thing you might be able to do is get the pain under control (give it a month at high doses) then try a two week max dose, one week under dose, two week max dose schedule. That would be a last resort for me. But in my experience it took us 1 to 2 weeks before we saw major symptoms when we would try to step down doses.

I'm so sorry for you and your baby.
Not to quote stalk you sbgrace - but we're getting special services for my one year old now now because of eating aversions linked to pain. She won't tolerate any solids by mouth, and requires thickened feeds for some feedings. Hers isn't an allergy, because we've tried every hypoallergenic formula out there and saw no change at all (we're not bf'ing).

You really have to play around with the dosing. It's critical to have an up to date, open minded paed and a fantastic compounding pharmacy - it makes all the difference in the world!

Has anyone tried Maxeran? We also tried that, with limited success.

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#17 of 21 Old 01-26-2009, 11:25 PM
 
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nak - have you tried probiotics?
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#18 of 21 Old 01-26-2009, 11:55 PM - Thread Starter
 
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As the Mom of 2 reflux/motility kids, I would suggest you aggressively try an elimination diet(take dairy, garlic, caffeine, onion, tomatoes, fatty foods & coffee out of your diet).
I'll be doing the total elimination diet on Dr. Sears' site. Gosh, it would be wonderful if it makes a big difference!

Quote:
You should also keep your daughter upright after feeding and prop the head of her bed. I used a sling with my dd but I had to be careful with positioning to make sure there wasn't any pressure on her stomach. Also make sure her diapers aren't too tight around the stomach. Another thing I did was try different positions when feeding. It did help to use a football hold while bf and smaller frequent feeds are easier on her tummy.
I have a sleepy wrap and maya and I tend to use the sleepy wrap mostly. With my big boobs, any carrier really makes the tummy pressure difficult.

We co-sleep, so raising her up isn't really possible. Raising our bed up on wood floors I can't imagine would be safe either. Suggestions?

Quote:
There are other med options but you should talk to the GI about that. Although, I would be careful with Reglan because it does have some pretty nasty side effects(speaking from personal experience). It is pretty typical for babies to need higher doses of meds that need to be adjusted frequently.
I've heard about that stuff and I'll avoid it like the plague.

I talked to the nurse from her ped office and she said that the doc will research the zegerid, as she doesn't know enough about it to give an RX. I tried to tell the nurse about the marci kids site and she didn't much listen to me. She assumed that it was just some "website" that didn't have any real sound stuff. I told her that it was legit and she said she's pass it on.

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#19 of 21 Old 01-27-2009, 12:09 AM
 
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Kari, the dosing guidelines in the guidebook for pharmacy/doctors whatever that all the peds have do have the higher doses. I'm pretty sure they recommend the three times per day dosing too. It's not like it's that hard for them...it drives me nuts when doctors don't bother to do their own research.

But my suggestion is if they won't do it fax in the official guidelines and also the research. Then request, again, that she be dosed properly. Suggest they consult with a pediatric GI themselves if they question the dosing. In other words, be aggressive to get what she needs.

You don't want more feeding issues.

FWIW, my kid still refluxed with all allergens taken out. Sometimes it is a structural/maturity issue or something else. It isn't always diet and sometimes when it is it is quite serious. Meds won't help.

If she sleeps on her left side that may help. We did elevate my son's bed but I can see why you're hesitant with wood floors and a large bed without sides.

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#20 of 21 Old 01-28-2009, 10:37 AM
 
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"We co-sleep, so raising her up isn't really possible. Raising our bed up on wood floors I can't imagine would be safe either. Suggestions?"

There are risers that you can purchase that are designed for this purpose.

Regarding the ellimination diet, there may be foods that your daughter reacts to that aren't typical reflux causing foods. It can take some time to figure out what works best for your daughter...good luck!
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#21 of 21 Old 01-28-2009, 12:56 PM
 
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If the meds aren't working, more than likely you're facing allergy issues as well. Now for some kids, getting rid of the allergens will get rid of the reflux, isn't the case for all. Eliminating the allergens is what made the meds work for Evan (he was on meds till 21 mos). I did the Sears elimination diet (w/ some changes b/c we knew some things that already bothered him) and the meds worked like a charm finally. I had a happy baby who was gaining weight etc. He was 11 mos old then and was only allowed bm, Neocate formula (I have supply issues and we had to supplement) and plain white rice. I weaned him at 12 mos and he stayed on the formula and rice till 15 mos and we started food all over again w/ him, one at a time. It took a long time, but he was a new child. He did great on the Prevacid. Prevacid does have medical grade lactose in it though and Ilana reacted to it. She did great on Axid though and it's cheaper than Prevacid. Also be sure you're asking your DR for samples when you go in. Ours was great when we tried Ilana on it since we were still waiting for insurance stuff to kick in etc, they really stocked us up (or was that Evan, either way). Ilana was only on meds for 6 mos, but I had to be dairy, soy, and egg free and should've been wheat free too but she wasn't having visible sx, hind sight is 20/20. Good luck.

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