Pedi says all reflux meds are the same??

cooker71

I don't get this.

Our new pedi for Miles told us last week that basically all reflux medications are the same and that switching to a different medication (i.e. from Zantac to Prevacid) wouldn't really help relieve his reflux symptoms any better.

Well we're going back to see him tomorrow and Miles' symptoms don't appear to be getting a whole lot better. He's arching his back during and after most feedings and is now crying out in pain as well. He also has breathing issues while he's eating, which freaks me out. Like he's wheezing for breath or something.

Should I press the issue again tomorrow?? Ask for another medication? Would something else really possibly make a difference? I thought I had seen responses from moms on here that said Zantac didn't work but other medications did....?

Temp374386125003286

Okay, maybe an ignorant question but do you switch to a ped that has more experience with DS or any is fine?  Just curious.  I've never heard that about those meds but I would just ask what you are supposed to do if it isn't working then.  It seems that your only choice it to try something else.  GL!

cooker71

We've switched to one with a lot of Down syndrome patients actually. We really like his personality and expertise with DS but I was just surprised to hear him say that about reflux meds. I had heard differently.

We'll definitely be asking him what to do now that Zantac isn't working!?

DandelionMom

I have no personal experience but my niece did much better on one of the meds than she did on the other (and I'm sorry but I can't remember which one worked for her).  She also had to switch to one of those special formulas (Nutrigamin, I think). 

If the one you're using isn't working, I'd insist on at least doing a trial with the other one.  What harm could it do?

JOEBunny

I don't think they are all the same.  I can't see my doctor perscribing 3 different ones if that were the case.  Zantac is the one they started with because it has the lowest volume of medicine and if you try to give a baby some other ones, which require you to give more liquid, you know that the least amount is the easiest to administer.  DD was on 3 and Zantac worked the best.  None made much difference though and I stopped giving it to her after a month.

BubblyToes

Um, wrong, wrong, wrong. 

Zantac and Prevacid work in entirely different ways.  They produce the same effect, but there are two different pathways to getting that effect.  Zantac blocks the histamine/acid receptors in the stomach.  Prevacid stops the acid production altogether. 

There are several big issues with Zantac.  The first, and the reason Will failed on it, is the taste/smell.  He wouldn't take it.  It's awful.  Second is that the dosing is weight based.  As he grows, his dosage is going to have increase for it to work.  That can be a pain. 

I would be concerned about that particular pedi's apparant lack of knowledge or lack of concern/ability to change the medication.

cooker71

BubblyToes:

Um, wrong, wrong, wrong.?

Zantac and Prevacid work in entirely different ways.? They produce the same effect, but there are two different pathways to getting that effect.? Zantac blocks the histamine/acid receptors in the stomach.? Prevacid stops the acid production altogether.?

There are several big issues with Zantac.? The first, and the reason Will failed on it, is the taste/smell.? He wouldn't take it.? It's awful.? Second is that the dosing is weight based.? As he grows, his dosage is going to have increase for it to work.? That can be a pain.?

I would be concerned about that particular pedi's apparant lack of knowledge or lack of concern/ability to change the medication.

Thanks Bubs. I am definitely bringing this up tomorrow. Like pp have said, it can't hurt to try something different. This clearly isn't working.?

JenniC1135

Wrong, wrong, WRONG!  The way zantac works is different from Prevacid.  Without googling, one is a proton pump inhibitor and the other isn't I believe. 

 

My experience was that Zantac took almost a week to start working for DS1, worked for week, and then stopped. We say a pedi GI for him and she mentioned that with Zantac, the body finds a way to produce the acid once it's stopped by the meds, so it only works for a limited timespan for anyone, though many babies outgrow the reflux before that happens. Prevacid solutabs made him a new baby.  With DS2, I could never get the Zantac into him because he was EBF and hated the taste.  I had a hard time getting solutabs into him as well bc of trying to dissolve them in liquid and squirt it in his mouth, but then I tried just putting the tablet in his mouth and immediately nursing, and it worked like a charm. 

 If you do go to Prevacid, please PM me if you'd like my supply of extra tablets, all still sealed in original blister packs.  It can be expensive even with insurance, and my DS doesn't need it anymore.

MediaBride

BubblyToes:

Um, wrong, wrong, wrong. 

Zantac and Prevacid work in entirely different ways.  They produce the same effect, but there are two different pathways to getting that effect.  Zantac blocks the histamine/acid receptors in the stomach.  Prevacid stops the acid production altogether. 

There are several big issues with Zantac.  The first, and the reason Will failed on it, is the taste/smell.  He wouldn't take it.  It's awful.  Second is that the dosing is weight based.  As he grows, his dosage is going to have increase for it to work.  That can be a pain. 

I would be concerned about that particular pedi's apparant lack of knowledge or lack of concern/ability to change the medication.

Ditto this.  I am not a doc, but I had HORRIBLE reflux until I had surgery when I was 20.  I can tell you first hand that the meds are NOT the same at all.  Sure... their goal is to help eliminate or at least aleviate the pain that reflux causes, but they do it in totally different ways.

I agree... I'd be a bit concerned at his lack of knowledge in this arena...

Temp159135562506975

I used to sell prevacid and can tell you that they are NOT all the same.  not b/c I sold it... but b/c i had parents tell me all the time while i was in the waiting room things like "prevacid saved our family's sanity! - nothing else worked until we tried it and our child suddenly was happy and calm!" etc.

If you want the nitty gritty about how they actually DO differ.... Pepcid/Zantac are H2RAs... they slow the production of acid by blocking the histamine receptor on the pump that creates acid (the proton pump).  There are still 2 other receptors that are active- so acid is still produced, just not as much.

Prevacid is a proton pump inhibitor (a PPI)- it STOPS the pump all together... and shuts down most of the pumps when a dose is given - for 24 hours.  This means MUCH less acid is produced compared to an H2RA... PPIs are MUCH better.

while some babies have issues that are not truly acid related- and in these situations a change in meds might not really help b/c acid is not the real cause of the problem..... if acid IS the problem- Prevacid is going to work much better than Zantac or pepcid- period.

Is this a regular ped or a pediatric GI?  I would see a GI specialist... and hopefully you can find one familiar with DS.

Maybe i'm missing something in what you wrote- but this pedi you mention either is a jerk or has no idea how these meds work... and does not have much experience with reflux in babies.

Some pedis are hesitant to Rx Prevacid in babies under 1 y/o - because it is not approved under 1 y/o yet... and it has a fairly new approval for peds all together (the pediatric approval was given to Prevacid approx 6.5 years ago).  Ped docs can be VERY conservative and want to see years and years of data before they will use certain meds --- but I can tell you- prevaicd is considered to be VERY safe - i have given it to my own son... i take it while pg.... it's given to many babies under 1 y/o all the time.

Reflux can cause wheezing, chronic cough, sinus problems, asthma, etc.... but again- some peds don't really believe this yet.

page or PM me if you have specific questions about Prevacid.  I hope you can find something to work for him.

 

r9stedt

No, no, no, no, no. L was on zantac for about 3-4 weeks after his pyloric stenosis surgery. We finally got on the prevacid solutabs. I warn you-- My insurance didn't cover squat. 117 for two weeks. Ask for samples! Enfamil AR also made a world of difference for us after his surgery. Hope miles starts to feel better!

akimbo

Thank goodness for Bubbly!!

I can tell you that Zantac didn't do squat for DS - it was a happier life for ALL of us when he switched to Prevacid.

I think I may have said before, but I've come to look at DS's pedi (and I LOVE her) as more of a well visit, regular schedule doc and rely heavily on the specialists (geneticist, GI, developmental pedi). 

 

Bellisimo

Just asked MH and he said that he disagrees with the pedi.  Even GI patients that are on PPIs like Protonics or Nexium, etc. seem to respond differently to the different meds even though they're supposed to be the same.   It is worth it to switch to a different med if what you're trying isn't helping.  So sorry you're having to deal with reflux!!