My daughter is on 20mg losec per day and 1.8ml zantac 3 times a day. She is also on 0.5ml erythromycin 4 times a day and 20ml lactulose a day. She has slow gut motility due to a redundant bowel loop and severe reflux as a result. She is 9.5 months and weighs 8kg.

My question is, is the zantac necessary? I have been told that it will help the losec "kick in" when given for a few weeks intermittently with the losec. Is this true, or should just the losec be sufficient. Also, what is the max dose that she could have of the losec for her weight. Also, just a thought, could the zantac contribute to constipation at all as she suffers this alot too (although, I think this is mainly due to her bowel problems). Also, is erythromycin ok to take for a long period. She has been on a similar dose for 5 1/2 months now. Thanks in advance.

Hi Nicole, I always say the fewest number of drugs that do the job the better. Although the omeprazole might get a little more effective over a week of continuous dosing, I don't think the zantac is needed just for that reason. Having said that, the 2 drugs work well together esp when zantac is at bed and omeprazole is 30 min before breakfast. The max omeprazole would be about 10 mg for her weight. It is generally kids over 20 kg that get the 20 mg once daily. Zantac can cause constipation. Also the erythro is safe when given indefinitely but keep an eye on liver function tests every 6 months or so. There are a few previous threads that go into more detail on erythro and the PPI/zantac question
Thanks Graham Ph.C.