Question about Reflux Meds

So I posted a little over week ago regarding my LO's reflux issues. I ended up switching doctors, and last Tuesday the new doctor prescribe Prevacid (one 15mg solutab a day) and increased the Zantac to 1ml twice a day. My DS is a little over 14 pounds. He started doing great after this. The problem is, this past Tuesday we went back to the same office for their 4 month checkup, but we saw a different doctor because the other wasn't available. This doctor questioned why he was on BOTH Zantac and Prevacid. He said they don't go together. He talked about putting him on Reglan with the Prevacid. I mentioned I had heard of bad side effects from Reglan, and he didn't know what I was talking about. He suggested I stop the Zantac and he ALSO said the dose of Prevacid was too much for his weight. He prescribed 7.5mg once a day (actually in oral form - but that shouldn't make a difference). The problem is yesterday my DS gradually throughout the day went back to HORRIBLE. Last night I gave him the other half of the dose of Prevacid and the Zantac because I know Zantac acts quickly. I called the doctors office 3 hours ago and they said they would figure it out and call me back. I just wanted to see what those of you who have had your LO's on reflux meds have experienced. I want to keep him on the meds/doses that are working but I want to make sure it is ok.

 

that is so frustrating!

zantac and prevacid are FINE to be taken together, they work on different mechanisms of acid production and there is no danger with taking both. my DD was on both for quite a while with no adverse effects. additionally, i think that the 15 mg dose of prevacid is fine too. my DD was on the lower 7.5 mg dose and it did nothing for her symptoms, she didn't get any relief until the GI upper her dose to the 15 mg solutab.

i think that becky(moderator) had her LOs on reglan and had no side effects but i think is more for motility of the stomach contents, not necessarily acid reduction, so if you aren't having a problem with motility and are having good results with the prevacid and zantac, i would probably avoid reglan. just my .02

in the future, if possible, i would demand to see only one doctor in the practice so you can avoid this type of hassle.

and i hope they can get their act together at the docs office!

 

At that age--- we did a compound of previcaid because it is hard to break the solutabs if you need less than the tab is--we did that until my DD was 18lbs and then switched to the solutabs. She also took Reglan for 3 months, but we stopped it right away due to side effects.

Now she is 30lbs and takes 15mg solutabs.

She sees a Gastroenterologist---that specilizes in reflux so I totally trusted her choices.

KC

 

Thank you. Thank you. Thank you!! I feel better now. I agree on only seeing one doctor, but I really didn't have a choice if I didn't want to go back to my old doctor (the one that wouldn't give me the prevacid... I got in an argument with his office manager :BDH: ). They needed to get their 4 month shots and I was making the appointment less than a week in advance. I feel better knowing he is taking the same as your DD, as I went back to higher doses this AM, and it has been 5 hours and the doctor still hasn't called me back.

 

THe new prescription is a compound, which I thought would be easier... but he spits it out. This is weird because he takes every other med. fine??? When she was on the compound was it 15mg?

 

I never had refluxers so I have no advice but wanted to offer :hug: 's for the frustration factor! I hate it when doctors give conflicting advice!!

 

if you can, i would probably go back to the solutab. we never used the compound but from what i understand it is fairly unstable and only maintains its potency for 2 weeks or so, so if you stay on the compound and notice a return of symptoms that may be why.

just putting it out there....

 

remember that pedis are general health practitioners. they're great for normal health issues but may not always be experts when you start getting into specialized problems. this would be a great time to get a referral to a GI specialist.

the second doctor shouldn't be unaware of reglan's side effects. that's your first red flag that you should perhaps take his opinion with a grain of salt. additionally zantac is a class of drugs called H2 blockers (H2 receptor antagonists, if i remember correctly). prevacid is a PPI (proton pump inhibitor). they are a different class of drugs so they certainly can be taken together to try to treat two mechanical causes of reflux.

however it may be that you could get by on a proper dosage of prevacid alone. tough to say unless a GI specialist has a look an puts some expertise into the conversation.

i will say that our boys are on a much higher dosage than is typically recommended for their weight. the fact that we needed to up their dosage so much is what made us see a GI specialist, just to make sure there wasn't any better way to treat it. he told us that regardless of weight, some babies are born acid producers and you do what you need to do to treat it. and yes, we've had general practitioner pedis question the dosage, but we go by the GI specialist's recommendations because this is what his specialty is.

 

This topic is of great interest to me too as my 9-wk-old was son was just this afternoon prescribed 15 mg Prevacid (solutab) to be administered in two divided doses each day. I wasn't aware there is a compounded version. Boy I sure do hope all our reflux kiddos get some relief soon.

 

Definately stick with your first doctor. If your LO does better with 15mg prevacid and zantac...keep doing it and dont let anyone tell you not to!
So so many GI's do prevacid with zantac, its perfectly fine and even often reccomended.
About the compound of prevacid-its highly known for its short shelf life-it becomes unstable within about 10 days, so the effects would wear off. I think its also harder to give because it doesnt taste good and adding flavoring just hurts the stability more. The solutabs are easy and taste good.
Reglan now has a black box warning-I definately dont reccomend trying it, but if you do you need to inform yourself about s/e so you know what to watch for. There are other drugs out there that work like reglan; erythromyacin when givin in low doses works just as well.

 

Oy, I don't know what is worse, the reflux or the doctors! Sorry they are giving you different stories. I had a lot of issues with doctors when we were fighting reflux. :hug: If the Zantac/Prevacid combo is working, I would definitely stick to that. Like PP said, they work in different ways on acid production, and are fine together. I would stick to the Solutab though, if you can, because you don't want to have to worry about it losing it's potency in the compounded form. My babies were on Reglan for about 5 months, and it worked wonders for us.

 

E-myacin works too? Wow, I didn't know that!!

 

Didn't know that. Thank you.

SO TRUE!

UPDATE: Nurse called me this afternoon and said she spoke with first doctor and she said Zantac and Prevacid aren't a common duo to take together, but they are safe to take together. She said to continue if it works and the 15mg of Prevacid is fine. My DS is SLOWLY getting better, but I am kicking myself for changing it up on him. Thank you for all of your replies and support! :wub:

 

I hope he continues to do well!!

And again, zantac and prevacid together is very common...silly nurse!