COMMON PRESCRIBING NAMES
US: prevacid, prevacid solutabs
CAN: prevacid, prevacid fastabs
UK: zoton, fastabs
AUS: zoton
GER: zoton, agopton, lanzor
PREPARATIONS
Capsules: 15 and 30 mg. Generally opened and placed in a small amount
of apple juice or water and syringed to the child. Can also be sprinkled
on food with a teaspoon of applesauce, cottage cheese, yogurt and strained
pears only.
Powder for oral suspension: in 15 and 30 mg. Made into a liquid at home by
adding water and then given via bottle, syringe or spoon.
Soluble tablet (solutab or fastab): 15 and 30mg tablets, which dissolve
when placed under the tongue or held in the side of the cheek. Can be
broken and given in smaller pieces, or dissolved with water in a syringe
and given that way with water.
Compound: Made into a liquid form by a compounding pharmacy, which must
then be stored in the refrigerator.
THINGS TO BE AWARE OF
- If you split the solutab (with fingers is best to avoid crumbling)
keep it in an airtight container and away from the sun and use this for
the next dose. Break the solutab into quarters or smaller for younger
children and make sure fully dissolved bit at a time to avoid choking.
- 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.
- Like all PPI’s 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 PPI’s 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 prevacid, 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, 15-30°C (59-86°F). Keep away from moisture.
Compound should be refrigerated.
PEDIATRIC DOSING
Lansoprazole is approved by the US Food and Drug Administration for
pediatric use in children 12 months and over at a dose of: 15mg if under
30kg and 30mg if over 30kg.
In general though doctors tend to prescribe an initial dose of 15mg and
this is upped to 30mg if need be. PPI’s are less weight sensitive then
other meds, so doses will depend on symptoms. A few Drs will prescribe
lower doses, especially in babies, but 30mg is generally a ‘max’ dose for
children without further testing.
OTHER USES
Lansoprazole is used for treating ulcers of the stomach and duodenum,
and Zollinger-Ellison Syndrome.
DRUG INTERACTIONS
The absorption of certain drugs may be affected by stomach acidity. It
has been found that PPI’s 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.
SIDE EFFECTS
Lansoprazole, like other PPI’s is well-tolerated. The most common side
effects are diarrhea, nausea, vomiting, constipation, rash and headaches.
Dizziness, nervousness, abnormal heartbeat, muscle pain, weakness, leg
cramps and water retention rarely occur. |
