prevacid compound vs. solutabs

[Sweet Harrison's mommy]

Harrison had his ENT scope yesterday and the only thing that the doctor found was irritation in the upper airway. He seems to think it could be that Harrison is refluxing past his fundo, which is causing redness and irritation. A few weeks ago, Harrison stopped wanting to swallow...normally, he handles his own secretions just fine, so this theory seems to make sense to me. Currently, he is making an active effort to gather his saliva and spit it out rather than just swallowing it! So, the irritation must really be bothering him.

From reading previous threads, it seems that there are 2 types of Prevacid? Harrison was put on the compounded form. He is getting 2 1/2 ML's, twice daily, and I read to give it on an empty stomach. I also read that there are prevacid solutabs? Could someone let me know what the difference is between the 2? Which have you found to be more successful? how do the solutabs work?

Harrison was on zantac for a while and I never noticed a difference, but he has never been on prevacid.

Thanks for your help!

[aseda]

The major difference between the two is that the compound only lasts 2wks after it is prepared. The tabs are easy enough to dilute, but it's never really exact how much of the tablet you are drawing up becuase it doesn't dissolve compeltely. My daughter has g-tube and we opted for the compound - easier for nurses and mommy:-) We do have the tablets as a backup for those times when I cant make it to the pharmacy in exactly 2 wks.

Good luck:-)

Amy

[jarner79]

2 weeks? I get a 30 day refill each time... The tabs do not break donw completely. They stay in little balls. We switched to compound due to 3 clogs with his G/J Tube. I don;t see a difference although some swear by the tabs. I think it all depends on which one works better for you/your child. But yes, give on empty stomach. My son is J fed, but he doesn't get the previcid during a feeding. Even through a J port, the stomach muscles and fluids are still at work. Derrick does just fine with compound. No difference here with our experience.

[Ainsley's Mom]

We got our compound at Children's. I grilled them and they insist that the compound is effective. They say that it IS best to get it from an experienced pharmacy since it can be done wrong. That being said they weren't labeling it to be given on an empty stomach "because they didn't have a sticker for that". I made a big fuss and now they have the sticker. I saw the biggest change going to an empty tummy. A month later I also switched to Solutabs. Previously had clogs but haven't since using Destinyandmiracles method please see prior posts. I like the Solutabs better because they don't have to be refrigerated, are more portable and I know for sure she is getting the right dose (eliminates any question about the compounding). Ainsley has been doing better and eating more. I can't say that we've seen a huge difference between the compound and the Solutabs (generic BTW) but I would still go that way just to be sure. The granules don't disolve completely because they aren't supposed to. Those beads are supposed to make their way into the small intentine I've heard (why it's best given on an empty stomach). That is why kids who take it orally are NOT supposed to chew. This is one instance when having a G-tube is an advantage. As I said, I've had no clogs.

[Sweet Harrison's mommy]

Thanks everyone! It seems that the compound will be much easier, so I guess we'll give it a try and see how it goes.

Susan, I remember reading in an earlier post that your ENT found slight irritation in Ainsley's upper airway during a scope. Am I remembering this correctly? If so, what did he attribute the swelling to? Reflux?

[Ainsley's Mom]

Thanks everyone! It seems that the compound will be much easier, so I guess we'll give it a try and see how it goes.

Susan, I remember reading in an earlier post that your ENT found slight irritation in Ainsley's upper airway during a scope. Am I remembering this correctly? If so, what did he attribute the swelling to? Reflux?

The ENT said he knows people often attribute this redness to reflux but he's not so sure. There is no way to know for sure. Even when we had all those tests in Cincinnati Dr. Cotton said essentially the same thing. Some kids have swelling that never goes away and they can't say for sure what the cause is.

My opinion after years of analysis, scopes, surgery, meds etc. is that there is some degree of reflux still causing irritation, that is getting past the fundo. The reason I think this is that she is tolerating her cap better after the Prevacid changes and the airway is less inflamed. Though she doesn't show any outward symptoms of reflux and since the fundo has never vomited once. I think the reflux in her case has to do with low muscle tone and the esophageal sphincter not being tight enough to hold the content in when she coughs from the trach. I also thing that in Ainsley's case there is something going on with her vocal cords that causes them to rub on each other and the remaining redness is from irritation when she cries. Ainsley's body forms keloid scars and she scars very easily. I believe that her airway was damaged from intubations. Her vocal cords looked great on the initial scopes when she was first born. But then became increasingly swollen and have never recovered completely.

[Niff]

The problem with all compounded medicines is that you are not 100% guaranteed the correct dose. Some of the med almost always forms sediment at the bottom. This means that even if you shake up the bottle, you're not guaranteed to get 15 mg worth of Prevacid in your syringe. Therein lies the benefit of a SoluTab. With a SoluTab, you are guaranteed 15 mg of Prevacid. Obviously, the downside is that the granules can easily get stuck in the G tube. Flushing with a tiny amount of pop (less than 5 mL) can dislodge that clog, though. We've only had to change a G tube once because of a clog, and that's simply because the nurse was... not very smart.

But! Some kids can take a compounded med and be perfectly fine. :) If you're not seeing a difference with the compound, it might be worthwhile to switch to the SoluTab to see if it makes a difference. If it doesn't, then you can switch right back to the compounded solution without any harm done.

[davidsmom]

So I got a prescription for prevacid from the doctor. Ofcourse she didn't agree with me to get the solutabs so she prescribed compund. And medicaid didn't cover it so they gave us generic. Anyone else using generic?

[Niff]

When we had it compounded in the early days, we used lansoprazole (generic of Prevacid). I really don't think, it terms of efficacy, brand name makes a difference. I'm sure it does to highly sensitive people, but on average, I've never heard of there being a huge difference.

Ironically, with our primary insurance, we can ask for brand name. We just have a significantly higher copay. I bet the issue on coverage is because they sell over-the-counter 15 mg Prevacid.

I know the FDA released a statement that any SoluTabs administered through a G tube can only be name brand because of the high rate of generic granules clogging tubes. It was discussed on the board not too long ago. That doesn't apply to you but is a tidbit of knowledge for potential future use. ;)

[Ainsley's Mom]

I think most insurance companies work that way, that you pay a higher co-pay for non-generic. And Medicaid will not pay for non-generic. I would guess most of us use Lansoprazole which is generic for Prevacid.

Sometimes it can be difficult to find a pharmacy that compounds, so I'm a little surprised that the doc was insistent about that, Davidsmom. Just make sure you shake the bottle until ALL the sediment is off the bottom of the bottle each time before dosing. And just in case it doesn't say, give it on an empty stomach. Good luck. I hope the med helps.

[davidsmom]

Thanks, it does say give on emty stomach. We have an appointment with the doctor in two weeks and I will discuss the solutabs more than. With the first dose I already saw that there is a lot of residue on the bottom of the bottle so I had to shake it a couple more times to really mix it. Thanks for the great tips!

[davidsmom]

Ok, so I dug up this thread but I don't see the info on here that I need. Even since we started David on Prevacid, we currently use the compund, he has constipation issues. I called the GI and they told me that prevacide can cause constipation in some kids. His stools are not as soft and watery as they used to be and I guess it's hard for him to pass them. He is still on breastmilk and we have been adding about 15 mls of baby food to it. That's how his feedings were for a while, we haven't really introduced anything new except the prevacid. Any of your kids experience constipation issues? Thanks.

[Sweet Harrison's mommy]

yes, Harrison often needs a little "help" getting things moving:) It is definitely worse on prevacid. I give him warm 100% prune juice every other day or so if he seems to need it. 1-2 ounces at a time. For us, it completely does the trick!

[destinyandmiracles]

Yes. Ashton gets prunes everyday in his blend of food as well as bran buds :)

[Ainsley's Mom]

When we starting giving the dose on an empty stomach we saw her stools firm up. A few people said they saw the same. But I guess most people didn't want to talk about it. ;) The first days were the worst. Ainsley's BM's were always a little loose, since she got a lot of fruits and veggies. So for her the change is welcome and not a problem.

[davidsmom]

I have tried prunes, and prune juice and extra water and he still goes without poop for sometimes 4 days..... his poop is not hard, more like a paste.... sorry if that's too much info.... before prevacid he used to go every day.... I add fruits and veggies to his breastmilk but not a lot..... only 15 mls.....
I was just wandering if anyone has tried probiotics for constipation or other issues....

[Niff]

Probiotics are great for virtually everyone. We typically only give it while on antibiotics, although I know several parents do it routinely every day.

You can talk with your pediatrician about MiraLAX. It's a very safe drug, and you can play with the dose to get it right for son.

[lovemy3]

davidsmom, we are dealing with the same thing. We just started MiraLax. I was anti any medicines but we had tried everything and our GI stressed that a baby with respiratory & reflux issues does not need to be constipated.

We were doing prune juice before she suggested pear juice. I could only find it in the baby food section made by Gerber. Pear juice got him going for awhile but that stopped. Also she wrote an order for extra water throughout the day especially if he was spending time outside. 20ml anytime he has doing anything that makes him sweaty.

[davidsmom]

That's another thing, David is on antibiotics all the time (since he was 3 months old) due to his urine reflux, so I thought that probiotics may be a good thing for him. I have to do a little more reserch because I see that there are many different kinds even for kids. And if probiotics will help him with the constipation then we wouldn't have to do Miralax. Although that's another option.

I will try the pear juice. I have given him pears but not pear juice. We have been doing extra water and get more wet diaper but didn't seem to improve the poop situation.

Thank you!

[Big Al]

Fluids are essential, especially if you are trying miralax as it is a bulk forming laxative and taking it without enough water leads to an obstruction.

[Niff]

If you go the probiotic route, make sure it is the kind that requires refrigeration. The "good" bacteria keeps longer this way. If you're concerned about brands, call your pediatrician! I'm sure he/she can give you information on what to look for. Our ped gets fielded with crazy questions all the time. :) It's their job, and most are happy to help in any way.

[kharmasmama]

Kharma takes a chewable probiotic every day and a liquid, refridgerated one when we go on antibiotics. The liquid one we use is fantastic - it's called Bio-K and comes in a 2 oz bottle. Most health foods stores carry it, I know that Whole Foods does. Its a little spendy but it helps soooo much. Augmenten used to just kill her stomach and now that we give the Bio-K she doesn't have the same GI issues with antibiotics. And her BMs are like clockwork :p

[Niff]

Ugh... Augmentin is a really hard antibiotic.