ZEGERID (Omeprazole + Sodium BiCarbonate)
Prescribing Information »
PREPARATIONS (for infant and children)
Oral suspension packets: 20 and 40mg sachets.
Directions to make 2mg/ml solution
20mg sachet: Add 6.5ml water, to a 10ml syringe, add the 20mg sachet and
shake.
40mg sachet: Add 16.5ml water, to a 20ml syringe, add the 40mg sachet and
shake.
If your child tends to spit up the solution, use the 40mg sachet, add
8.25ml water, and 8.25ml Mylanta cherry supreme, add the 40mg sachet and
shake.
THINGS TO BE AWARE OF
- It is an immediate release formulation of omeprazole. When mixed
with water, the powder dissolves to form a true, homogeneous liquid
suspension. It has a peach/mint flavor.
- Unlike enteric-coated PPI’s (beads), which must be taken 30 minutes
before a meal, the makers of Zegerid claim it can be given without
regard to mealtime. Zegerid is stable for up to three weeks in the
refrigerator; un-refrigerated it is stable for up to 24 hours. The
prescribing information provided with Zegerid however, states it should
be given at least an hour before a meal.
- Some children find the taste unappealing, and if administered the
way the packet says it should, it requires large volumes of medicine to
be administered which the child doesn’t always like. Please use the
dosing instructions above for infants and children.
- Supersedes the ChocoBase and CaraCream that also makes a true at
home suspension. The rights to these products 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.
- 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.
STORAGE
Store in the refrigerator for up to three weeks, un-refrigerated, it is
stable for up to 24 hours.
PEDIATRIC DOSING
Omeprazole is approved by the US Food and Drug Administration for
pediatric use in children 2 years and over at a dose of: 10mg if under
20kg and 20mg if over 20kg.
In general though Drs tend to prescribe an initial dose of 10mg and this
is upped to 20mg 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 20mg is generally a ‘max’ dose for
children without further testing.
OTHER USES
Not common, but can be 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.
Also omeprazole potentially can increase the concentrations in blood of
diazepam (Valium), warfarin (Coumadin), and phenytoin (Dilantin) by
decreasing the elimination of these drugs by the liver.
SIDE EFFECTS
Omeprazole 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.
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