Wednesday, July 24, 2013

What is the dose of Nexpro Junior (Esomeprazole) for infants with Reflux ?

For infants (less than 1 year old) with repeated vomiting & lack of weigth gain due to reflux (GERD), there are very limited medicines that are available for effective treatment in India.
A relatively new molecule is Esomeprazole marketed in the form of Nexpro Junior Satchets. I was trying to search for the effective dose in a 3 month old in my care who has significant reflux (vomiting, decresed weight gain, opisthotonic posturing etc.)
Here is what I found

Usual Pediatric Dose for Erosive Esophagitis

Healing:
12 to 17 year olds: 20 or 40 mg once daily
Duration of therapy: 4 to 8 weeks
1 to 11 year olds:
-weight less than 20 kg: 10 mg once daily
-weight greater than or equal to 20 kg: 10 or 20 mg once daily
Duration of therapy: 8 weeks
Comments: Doses over 1 mg/kg/day have not been studied.

Due to acid-mediated GERD:
1 month to less than 1 year old:
-weight 3 kg to 5 kg: 2.5 mg once daily-weight greater than 5 kg to 7.5 kg: 5 mg once daily
-weight greater than 7.5 kg to 12 kg: 10 mg once daily
Duration of therapy: For up to 6 weeks
Comments: Doses over 1.33 mg/kg/day have not been studied.

Read more at http://www.drugs.com/dosage/esomeprazole.html#iukblX6mMgSAPTLx.99 

Each satchet contains 10 mg of Esomeprazole and hence I have started the baby on 5 mg (1/2 satchets) once a day for the same.
Previously I have been using Junior Lanzol (Lansaprazole) tablets by Cipla, but they are a little difficult to dissolve in water to feed an infant. Hopefully this would be a more acceptable solution for an infant.

13 comments:

PR84 said...

Hi.. wanted to check if this medicine worked for your baby and also was it okay to reuse the other half of the sachet once opened.. ?

PR84 said...

Hi.. wanted to check if this medicine worked for your baby and also is it advisable to reuse the other half contents of the opened sachet. Thanks !

Dr. Gaurav Gupta M.D. said...

I am not sure, but I believe that reusing the sachet within 24 hours should be alright,

Ray said...

Hi, how is your baby patient doing on the medication? My baby has severe acid reflux issues as well. Thanks.

Ray said...

Hi, How is your baby patient doing on the new medication? My baby has severe reflux issues as well. Thanks.

Dr. Gaurav Gupta M.D. said...

Dear Ray,
If you are asking regarding the baby in my care, he has done well, with reduced irritability, posturing and vomiting,
Thanks for asking :)

Unknown said...

Is this medicine advisable for treating silent/mild reflux too?My baby is 4 mths old and makes vomit sounds but doesn't throw up.

Dr. Gaurav Gupta M.D. said...

I would ONLY recommend it if your pediatrician suggests it, especially in kids less than 1 year old.
Warm regards

visali nadipudi said...

My doc suggested to use this for 3 months for my 8 month old baby .Is it ok to use for such a long period

Dr. Gaurav Gupta M.D. said...

Yes,
It is safe and is recommended for long periods of time in cases of GERD

Anil singh said...

Sir My doc suggested to use this for 3 months for my 3.2 year old son,sir we have completed 3 month course,after completing 3 months we have closed doase ,but again vomiting is on.sir what should I do.

Dr. Gaurav Gupta M.D. said...

Hi,
You can continue this medicine for much longer if the symptoms are persisting,
Warm regards

Anil singh said...

Thanks sir