Guest guest Posted August 16, 2008 Report Share Posted August 16, 2008 Hy Glynis, Maximum recommended dose of omeprazole in children is 3mg/kg/day, with a maximum single dose of 40mg. This tends to be given once daily. How old is your child and how much does she weigh? Watch for giving activated charcoal at the same time as drugs, there is a risk of adsorption of the drug by the charcoal, with reduced bioavailability of the omeprazole. Regards Hi Everyone,Well, Jazzie has had a return of gulping at night problems. The gastro has put her on Omeprazole, 10mgs once a day, which has helped a bit. I also give her activated charcoal, which also helped at first, but last night she was gulping pretty loudly. The gastro has said she is on maximum therapy (she takes metoclopramide too) and the next step would be a Nissen Fundo op, where they wrap the top part of the stomach round the oesophagus to tighten things up. She had a hiatus hernia but an upper barium showed this has healed. I am wondering if anyone is doing a higher dose of Omeprazole, perhaps twice per day, as obviously I do not want her to have the fundo op. TIAGlynis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2008 Report Share Posted August 17, 2008 ---Thanks for your reply, Jazzie weighs 40 kgs and will be 9 in October. She takes 10 mgs Omeprazole in the morning and I give her the charcoal at night. I was hoping that I could give her another dose of Omeprazole at night instead of the charcoal. I recently had a course of PPI's and was told to take it twice per day. Initially I tried once per day but still had problems at night, so took it as directed and immediately improved. That was when I wondered whether the same would be effective for Jasmine, for a short time anyway, to get on top of the problem. I know a lot of kids with Kabuki Syndrome have had the Nissen Fundo op, and for some they have to have it repeated, so it's not something I want for her. As Dr Fell seems to be prescribing PPI's for long term in some cases, I have argued this point for Jazzie, and asked our GI to speak to Dr Fell, but I am not expecting her to. Thanks again for your guidance. Glynis In Autism-Biomedical-Europe , " OMONEFE BOLTON " wrote: > > Hy Glynis, > > Maximum recommended dose of omeprazole in children is 3mg/kg/day, with a > maximum single dose of 40mg. This tends to be given once daily. > How old is your child and how much does she weigh? Watch for giving > activated charcoal at the same time as drugs, there is a risk of adsorption > of the drug by the charcoal, with reduced bioavailability of the omeprazole. > > > Regards > > > > > > > Hi Everyone, > > > > Well, Jazzie has had a return of gulping at night problems. The gastro > > has put her on Omeprazole, 10mgs once a day, which has helped a bit. I > > also give her activated charcoal, which also helped at first, but last > > night she was gulping pretty loudly. The gastro has said she is on > > maximum therapy (she takes metoclopramide too) and the next step would > > be a Nissen Fundo op, where they wrap the top part of the stomach round > > the oesophagus to tighten things up. She had a hiatus hernia but an > > upper barium showed this has healed. I am wondering if anyone is doing > > a higher dose of Omeprazole, perhaps twice per day, as obviously I do > > not want her to have the fundo op. > > > > TIA > > > > Glynis > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2008 Report Share Posted August 17, 2008 -----Thanks Efe. I will phone the GI and ask for her dose to be increased tomorrow. I tried 2 doses yesterday am and pm and she slept much better. Jazzie is on metoclopramide as when she was NG tube fed, she vomited frequently and it was prescribed years ago for this. The GI has recently increased it to its maximum dose, which I was disappointed with as I had been reducing it to try and get her off it. She did mention domperidone as an alternative, but didn't explain anything about it. I have just found out through various searches that this can also aid in the pressure of the valve at the top of the stomach which I am sure will also help with her reflux, so I will ask to swap over. You sound extremely knowledgeable by the way :-)). Glynis In Autism-Biomedical-Europe , " OMONEFE BOLTON " wrote: > > Hi Glynis, > > There is room to increase her dose because you are no where near maximum > dose for Jazzie. And it is not unreasonable to split the dose into twice > daily if that is what works for you, it tends to be okay as once daily > dosing in the general populace including children. But sometimes due to > differences in metabolism or tolerance in the paed population twice daily > dosing is used to good effect. You may find that increasing the dose and > giving once daily may be as effective as giving it twice daily. > As Jazzie is not getting complete resolution of symptoms on her current dose > it only rational to increase her dose. A nissen's should only be done only > when oral therapy has been maximised, as you are aware they can fail. > > You need to push this with your doctor, to get it sorted. > You say she's on metoclopramide, has she ever had domperidone (standard > therapy rather than metoclopramide), it's also a motility agent. > > Efe > > > > On Sun, Aug 17, 2008 at 12:02 PM, Glynis Steele wrote: > > > ---Thanks for your reply, Jazzie weighs 40 kgs and will be 9 in > > October. She takes 10 mgs Omeprazole in the morning and I give her > > the charcoal at night. I was hoping that I could give her another > > dose of Omeprazole at night instead of the charcoal. > > > > I recently had a course of PPI's and was told to take it twice per > > day. Initially I tried once per day but still had problems at night, > > so took it as directed and immediately improved. That was when I > > wondered whether the same would be effective for Jasmine, for a short > > time anyway, to get on top of the problem. I know a lot of kids with > > Kabuki Syndrome have had the Nissen Fundo op, and for some they have > > to have it repeated, so it's not something I want for her. As Dr > > Fell seems to be prescribing PPI's for long term in some cases, I > > have argued this point for Jazzie, and asked our GI to speak to Dr > > Fell, but I am not expecting her to. > > > > Thanks again for your guidance. > > > > Glynis > > > > In Autism-Biomedical-Europe <Autism-Biomedical- Europe%40yahoogroups.com>, > > " OMONEFE BOLTON " > > <nigerbolton@> wrote: > > > > > > Hy Glynis, > > > > > > Maximum recommended dose of omeprazole in children is 3mg/kg/day, > > with a > > > maximum single dose of 40mg. This tends to be given once daily. > > > How old is your child and how much does she weigh? Watch for giving > > > activated charcoal at the same time as drugs, there is a risk of > > adsorption > > > of the drug by the charcoal, with reduced bioavailability of the > > omeprazole. > > > > > > > > > Regards > > > > > > > > > > > > > > > > > Hi Everyone, > > > > > > > > Well, Jazzie has had a return of gulping at night problems. The > > gastro > > > > has put her on Omeprazole, 10mgs once a day, which has helped a > > bit. I > > > > also give her activated charcoal, which also helped at first, but > > last > > > > night she was gulping pretty loudly. The gastro has said she is on > > > > maximum therapy (she takes metoclopramide too) and the next step > > would > > > > be a Nissen Fundo op, where they wrap the top part of the stomach > > round > > > > the oesophagus to tighten things up. She had a hiatus hernia but > > an > > > > upper barium showed this has healed. I am wondering if anyone is > > doing > > > > a higher dose of Omeprazole, perhaps twice per day, as obviously > > I do > > > > not want her to have the fundo op. > > > > > > > > TIA > > > > > > > > Glynis > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2008 Report Share Posted August 18, 2008 --- Hi Everyone, Well I phoned the doctor today and spoke to the receptionist who then spoke to the dr. I managed to get Jazzie swapped over to domperidone, but they refused to put the omeprazole up. The GI is on holiday so I will have to wait 'til next week to speak to her. I find it gob-smackingly awful that the dr. is willing to let her suffer 'cos they don't want to do anything without the GI's say so. I just hope the domperidone will help in the meantime. Glynis In Autism-Biomedical-Europe , " Glynis Steele " wrote: > > -----Thanks Efe. I will phone the GI and ask for her dose to be > increased tomorrow. I tried 2 doses yesterday am and pm and she > slept much better. Jazzie is on metoclopramide as when she was NG > tube fed, she vomited frequently and it was prescribed years ago for > this. The GI has recently increased it to its maximum dose, which I > was disappointed with as I had been reducing it to try and get her > off it. She did mention domperidone as an alternative, but didn't > explain anything about it. I have just found out through various > searches that this can also aid in the pressure of the valve at the > top of the stomach which I am sure will also help with her reflux, so > I will ask to swap over. > > You sound extremely knowledgeable by the way :-)). > > Glynis > > In Autism-Biomedical-Europe , " OMONEFE BOLTON " > <nigerbolton@> wrote: > > > > Hi Glynis, > > > > There is room to increase her dose because you are no where near > maximum > > dose for Jazzie. And it is not unreasonable to split the dose into > twice > > daily if that is what works for you, it tends to be okay as once > daily > > dosing in the general populace including children. But sometimes > due to > > differences in metabolism or tolerance in the paed population twice > daily > > dosing is used to good effect. You may find that increasing the > dose and > > giving once daily may be as effective as giving it twice daily. > > As Jazzie is not getting complete resolution of symptoms on her > current dose > > it only rational to increase her dose. A nissen's should only be > done only > > when oral therapy has been maximised, as you are aware they can > fail. > > > > You need to push this with your doctor, to get it sorted. > > You say she's on metoclopramide, has she ever had domperidone > (standard > > therapy rather than metoclopramide), it's also a motility agent. > > > > Efe > > > > > > > > On Sun, Aug 17, 2008 at 12:02 PM, Glynis Steele <pyn1pyn1@>wrote: > > > > > ---Thanks for your reply, Jazzie weighs 40 kgs and will be 9 in > > > October. She takes 10 mgs Omeprazole in the morning and I give her > > > the charcoal at night. I was hoping that I could give her another > > > dose of Omeprazole at night instead of the charcoal. > > > > > > I recently had a course of PPI's and was told to take it twice per > > > day. Initially I tried once per day but still had problems at > night, > > > so took it as directed and immediately improved. That was when I > > > wondered whether the same would be effective for Jasmine, for a > short > > > time anyway, to get on top of the problem. I know a lot of kids > with > > > Kabuki Syndrome have had the Nissen Fundo op, and for some they > have > > > to have it repeated, so it's not something I want for her. As Dr > > > Fell seems to be prescribing PPI's for long term in some cases, I > > > have argued this point for Jazzie, and asked our GI to speak to Dr > > > Fell, but I am not expecting her to. > > > > > > Thanks again for your guidance. > > > > > > Glynis > > > > > > In Autism-Biomedical-Europe <Autism-Biomedical- > Europe%40yahoogroups.com>, > > > " OMONEFE BOLTON " > > > <nigerbolton@> wrote: > > > > > > > > Hy Glynis, > > > > > > > > Maximum recommended dose of omeprazole in children is > 3mg/kg/day, > > > with a > > > > maximum single dose of 40mg. This tends to be given once daily. > > > > How old is your child and how much does she weigh? Watch for > giving > > > > activated charcoal at the same time as drugs, there is a risk of > > > adsorption > > > > of the drug by the charcoal, with reduced bioavailability of the > > > omeprazole. > > > > > > > > > > > > Regards > > > > > > > > > > > > > > > > > > > > > > Hi Everyone, > > > > > > > > > > Well, Jazzie has had a return of gulping at night problems. > The > > > gastro > > > > > has put her on Omeprazole, 10mgs once a day, which has helped > a > > > bit. I > > > > > also give her activated charcoal, which also helped at first, > but > > > last > > > > > night she was gulping pretty loudly. The gastro has said she > is on > > > > > maximum therapy (she takes metoclopramide too) and the next > step > > > would > > > > > be a Nissen Fundo op, where they wrap the top part of the > stomach > > > round > > > > > the oesophagus to tighten things up. She had a hiatus hernia > but > > > an > > > > > upper barium showed this has healed. I am wondering if anyone > is > > > doing > > > > > a higher dose of Omeprazole, perhaps twice per day, as > obviously > > > I do > > > > > not want her to have the fundo op. > > > > > > > > > > TIA > > > > > > > > > > Glynis > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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