Need advice about upping Prevacid and removing Zantac

[BethL]

One of my good friends is a pediatrician and mentioned to me today that she thinks I should take Brandon off the Zantac. He has problems with the volumes of medication that I have syringe into him three times a day and Zantac has the highest volume. She said that Zantac is an anti-histamine as is his new medication Periactin. She asked me if I've seen an improvement since he's been on the Zantac and we haven't. So she thinks that since he's already on the Prevacid which controls acid, and he's on the Peractin which is another anti-histamine, the Zantac is unnecessary over kill. After I spoke with her about the MARCI Kids recommended dose for Prevacid and how Brandon is still slightly below the range they recommend, she suggested that I ask the GI to remove the Zantac and up the Prevacid to the low end of the MARCI Kids dosage range. What do you guys think?

Also, for those of you whose kids are on higher doses of Prevacid solutab, how often do you administer it and are all the doses equal? Brandon currently takes 15 mg first thing in the morning and then 7.5 mg in the evening. The Zantac is given in the afternoon. So if Brandon is upped to say 24-30 mg for the day and the Zantac is removed, how should it be spaced out for the optimum results? MARCI Kids recommends dosing 3 times a day but I don’t know how I would do that with 15 mg solutabs. I know that I can cut them in half and I’ve even been successful at cutting them in quarters. Your experience and suggestions with this are welcome.

Thanks!
Beth

[EllaGracesMom]

Ella was on 15mg of Prevacid in the am and Zantac in the evening. Zantac did nothing for her - even her paed. admitted that it is a somewhat useless drug for most. We then tried giving her the Prevacid at night, but that didn't help. Now she has 15mg in the morning and 15mg at night. It's helped much more than the Zantac. Also, we changed her diet which has helped tremendously - she's quite content when we're avoiding bad foods...so much so, that I'm hoping a wean is on the horizon. I give the prevacid doses usually every 12 hours which seems to work well. Breaking the solutab wasn't working for us (we also tried 7.5 in morning and 7.5 in the evening - just not enough). My nephew, who is 6.5 mos. younger than Ella, is on 22.5 mg of prevacid/day. My SIL will likely up to 30 as she thinks he may need it (he is about 2-3 lbs lighter than Ella). Zantac did nothing for him either. She too finds administering 2 x per day is fine (not doing 3) - i heard that the dose lasts 12 hours anyway. Hope that helps!!!

[amy5045]

We were on 7.5 mg in the AM and 7.5 in the PM for a very long time. But just recently at around 14 months old I was noticing what I *thought* was a return of symptoms in the afternoon (it was hard to tell for sure) so her GI upped her dose to almost a whole 30 mg solutab in the AM and PM. I dissolve it in a syringe and give it to her that way. It's only been a week or so on the higher dose but I think I do see a difference. If I hadn't seen improvement we probably would have tried 7.5 mg three times a day.

I never found that Zantac helped Katelyn either.

[erinsmom1964]

We like alot of people didnt find Zantac helpful at all. Erin is now up to 22.5mg of Prevacid. We were doing the 15mg in morning then 7.5(half of solutab give or take) in the evening. She was still getting problems in late afternoon so I have switched it around. It has only been 2 days so I am not sure but I am thinking "on paper" this should work better because of her schedule. She wakes up at 7am and eats dinner early about 5 so its only 9 1/2 hours between that dose and 14 1/2 until morning dose. hoping this works so we dont have to go to 30 mg yet. I dont really want to give 3 doses if I can help it. I would hate to have to wake her up in the night if she actually sleeps the whole time. 3 nights last week!!!!

As far as how I give it I gave up on putting it in syringe because all of beads were basically in first squirt and if you missed you basically lost the whole dose. I read here someone say they just put it in LO's mouth. I tried it and low and behold it works great for Erin. She likes the taste. I only go the syringe route when I have had a solutab crumble when trying to split.

HTH

[Litterbox]

Zantac wasn't helpful for us at all. Your friend sounds fairly knowledgeable. Too bad you can't just see her as patients KWIM? Anyway, Denver was never on a really super high dose of Prevacid but it seems like the way you have it split up would work. Some people try and split up the timing based on when the kiddo has the hardest time, ie. bedtime.

[andrea]

Just to add to what everyone else has said... Zantac is also a med that "times out". Even if it does work well in the beginning for someone, after time the effect does wear off. Realistically, I doubt if it is doing much for Brandon. I definitely agree on upping the Prevacid - his dose certainly has room to move up. You may see a big difference in him once he is properly medicated as well. Back when my son was his age, I would have sworn he was properly medicated, but oh was I wrong.

Anyway, certainly doesnt hurt anything to try to increase the Prevacid dose. If you dont notice a positive difference you could always try adding Zantac back in (the only time Zantac did ANYTHING for us was when we were on 30mg of Prilosec --which is equivalent to 45mg of Prevacid-- AND had Zantac in there as well. It worked great for a med to control the little bit of breakthru acid that there was, but alone - and even with lower doses of Prilosec - it did absolutely nothing for this kid).

Good luck.

[amy5045]

Hey Andrea, just wondering, what was Hunter like when he was not properly medicated but you thought he was? How did you eventually find out he needed a higher dose? I just ask because I'm starting to suspect that Katelyn's dose is not enough for her (and maybe hasn't been all this time but it's only now becoming more obvious because I switched her from BM to formula). If you want I can post this in a different thread, I just wanted you to see it. Thanks, I'm really interested to know.

[andrea]

I dont really even know how to answer that. He was "okay". He acted like he was fine, etc, but he didnt eat. At all. Ever. He was cranky and had tantrums a lot. Yeah, all kids have tantrums, and I thought it was just him... except the minute he was properly medicated he was a different kid. Totally happy, not aggressive at all, etc. There's no real answer other than to follow your mommy instinct (well, and trial and error). If you suspect her dose isnt high enough, I'd say push to try a higher dose (or just do it and then get approval from the doc afterwards if it works), and see what happens. You'll know if it works for sure

[amy5045]

Ok thank you! It's so hard to tell. Katelyn does eat but VERY little and she's starting to refuse her bottles too. It reminds me of when she started to refuse the breast at 2 months only now she doesn't arch/cry, she just pushes it away. She is also pretty happy for the most part but has trouble falling asleep for naps and they are almost always short. Used to be she'd take hour or hour and a half naps.

I called the GI last week and we are playing around with her meds to see what helps. We upped her dose to almost a whole solutab AM and PM but no improvement so today I called again and got it changed to 7.5 mg 3 times a day. We'll see if that helps (crossing fingers).

I can just tell that something isn't right since I switched her to formula. I kept pumping for two weeks and she seemed ok as long as I thickened it a bit. But now problems are really starting to show up and my milk is almost gone.

Anyways, this really belongs in another thread. Sorry to hijack Beth!!! And thank you for the information Andrea.

[BethL]

Hey guys! OK, so I've succumb Andrea- we upped his Prevacid today to 30 mg (15 in the am and pm). I know that you've been a strong proponent of this for a long time. I pray that Brandon responds like Hunter did. I'm glad that Amy asked what Hunter was like before he was properly medicated because I think that's something I needed to know too. You see, Brandon's GERD symptoms don't seem to be very bad. I do see him silent refluxing from time to time and he smells pukey sometimes even when he hasn't puked (that I can find) but in general his GERD symptoms are far less now than 5 months ago. However, his consumption levels are worse and worse. In general he's a very happy baby but he does get very fussy too. (Of course what baby doesn't?)

Anyway, we changed all his meds today. We dropped the Zantac and the Erythro and upped the Prevacid, Reglan and Periactin. Please put in some good vibes and/or prayers that this new meds change helps him.

-Beth