Omeprazole
Well, the omeprazole (generic form of Pr1losec) is a confirmed cause of reactions.
Almost an hour to the minute after giving it to her tonight, the same reaction happened as an hour or 90 minutes after giving it to her this morning.
Over a 5-minute period we watched her go from almost no rash and normal behavior to bright red, inflamed, itching cheeks, itchy eyes and nose, lots of tantrums, repeatedly saying "ow," and full-fledged fussy, clingy behavior.
I wouldn't have said her face swelled at all, but now that I'm comparing photos I wonder if there was some slight swelling or if it was just her facial expressions that make it look that way.
9:01PM (the yellow is food on her cheeks, which makes the rash look slightly worse than it is in the first couple of pictures):
#########
9:02PM:
9:26PM:
9:32PM:
9:49PM:
The onset was so fast once the reaction started, which seems strange an hour after taking the medicine. The timeline tonight matched what I noticed this morning, but possibly a little shorter. I think the reactions were happening closer to when I gave her the medicine before I took her off it; I expect that if we had her back on the medicine for a while again the reactions would gradually get faster and more severe.
We finally got our compounded Benadryl today. The pharmacist at this new pharmacy had to order the raw ingredients, so it took a while. I was glad to have the Benadryl tonight.
Once her reaction got bad enough to take pictures, we gave E the antihistamine. It did seem to make the reaction shorter and less intense. Still, she's squirming uncomfortably and banging her head with her fist (typical allergy behavior) while nursing at the moment. The medicine most certainly didn't make her groggy or sleepy--if anything it made her hyper.
When I told the pharmacist about E's omeprazole reaction, he reminded me that there are two different formulations of the drug. One is plain omeprazole powder, which is combined with sodium bicarbonate as a buffer, and the other which is granules that are enteric-coated to make them delayed-release. A compounding pharmacy would have both the enteric-coated granules and the powder. The enteric coating, of course, contains corn-derived ingredients.
I had called the other pharmacy a day or two ago to ask if there was anything different about this batch of omeprazole. If E was going to develop an allergy, it seems odd that it would just perfectly coincide with getting a new bottle, when she'd been fine with it for a couple of months before then.
I asked the compounding pharmacist if there was anything done differently, and had her check the ingredients on the sodium bicarbonate suspension. But I didn't think to ask if there was any possibility the enteric-coated omeprazole was used. I also didn't ask about the possibility of cross-contamination or of traces of something else getting into her medicine, although that seems unlikely.
Needless to say, I'll be calling the pharmacy again tomorrow to ask some questions. I think I'll ask them to mix up just 2 or 3 doses worth fresh for us to try, just to make sure it's not some kind of cross-contamination issue or an accident with using the wrong omeprazole formulation.
BTW, neither of these pharmacies is the one that lied to me about the ingredients in the Nystatin some time ago. Both of these pharmacies seem to take E's allergies quite seriously, tend to err on the side of caution when choosing ingredients, and are quite willing to check and double-check things for me.
Since the omeprazole reactions seem to be short-lived, I'm going to skip the omeprazole tomorrow and try giving Baby E a small amount of pure unrefined cane sugar to see what happens.
I'll be standing by, camera and notebook in hand.
Almost an hour to the minute after giving it to her tonight, the same reaction happened as an hour or 90 minutes after giving it to her this morning.
Over a 5-minute period we watched her go from almost no rash and normal behavior to bright red, inflamed, itching cheeks, itchy eyes and nose, lots of tantrums, repeatedly saying "ow," and full-fledged fussy, clingy behavior.
I wouldn't have said her face swelled at all, but now that I'm comparing photos I wonder if there was some slight swelling or if it was just her facial expressions that make it look that way.
9:01PM (the yellow is food on her cheeks, which makes the rash look slightly worse than it is in the first couple of pictures):
#########
9:02PM:
9:26PM:
9:32PM:
9:49PM:
The onset was so fast once the reaction started, which seems strange an hour after taking the medicine. The timeline tonight matched what I noticed this morning, but possibly a little shorter. I think the reactions were happening closer to when I gave her the medicine before I took her off it; I expect that if we had her back on the medicine for a while again the reactions would gradually get faster and more severe.
We finally got our compounded Benadryl today. The pharmacist at this new pharmacy had to order the raw ingredients, so it took a while. I was glad to have the Benadryl tonight.
Once her reaction got bad enough to take pictures, we gave E the antihistamine. It did seem to make the reaction shorter and less intense. Still, she's squirming uncomfortably and banging her head with her fist (typical allergy behavior) while nursing at the moment. The medicine most certainly didn't make her groggy or sleepy--if anything it made her hyper.
When I told the pharmacist about E's omeprazole reaction, he reminded me that there are two different formulations of the drug. One is plain omeprazole powder, which is combined with sodium bicarbonate as a buffer, and the other which is granules that are enteric-coated to make them delayed-release. A compounding pharmacy would have both the enteric-coated granules and the powder. The enteric coating, of course, contains corn-derived ingredients.
I had called the other pharmacy a day or two ago to ask if there was anything different about this batch of omeprazole. If E was going to develop an allergy, it seems odd that it would just perfectly coincide with getting a new bottle, when she'd been fine with it for a couple of months before then.
I asked the compounding pharmacist if there was anything done differently, and had her check the ingredients on the sodium bicarbonate suspension. But I didn't think to ask if there was any possibility the enteric-coated omeprazole was used. I also didn't ask about the possibility of cross-contamination or of traces of something else getting into her medicine, although that seems unlikely.
Needless to say, I'll be calling the pharmacy again tomorrow to ask some questions. I think I'll ask them to mix up just 2 or 3 doses worth fresh for us to try, just to make sure it's not some kind of cross-contamination issue or an accident with using the wrong omeprazole formulation.
BTW, neither of these pharmacies is the one that lied to me about the ingredients in the Nystatin some time ago. Both of these pharmacies seem to take E's allergies quite seriously, tend to err on the side of caution when choosing ingredients, and are quite willing to check and double-check things for me.
Since the omeprazole reactions seem to be short-lived, I'm going to skip the omeprazole tomorrow and try giving Baby E a small amount of pure unrefined cane sugar to see what happens.
I'll be standing by, camera and notebook in hand.
Labels: allergies
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Posted by purple_kangaroo at 10:07 PM[Permanent link]
4 Comments:
You, armed with camera and notebook, are the Allergy Mom of the Universe!
Sorry to hear Benadryl made Baby E hyper. That's the problem with Benadryl, it can go either way. Then again, if she'll need it as she gets older you won't want her conking out every time. It makes me so tired I'm loopy within about 20 minutes.
But at least you have it when you need it. I hope you are able to identify a safe way to get the reflux med prepared, so you can safely treat Baby E.
PK- thanks for stopping by. I was thinking about E and started brainstorming, take it for whatever it's worth.
It is a myth that heartburn is caused by too much acid in the stomach. In actuality it is caused by to LITTLE ACID. That is why the old wives tale of drinking vinegar works. (I know I've tried it) Constant and habitual use of antacids such as tums or mylanta can lead to several health problems including Vitamin B12 defieceny. Which in turn causes other severe problems. When I read this in a health magazine I thought of my mom who has experienced this. I say all this because even though I know reflux also has to do with the muscle opening of the stomach, the medicine given for it is only for the acid of the stomach, not the muscle. If heartburn is caused by too little acid, could the lack of acid also contribute to relfux? and if so could giving E some white wine vinegar in her thickened water help? It would only taste sour, like lemon. I mention vinegar becuase I don't know if she is allergic to citrus. Does using her reflux medicine long term prohibit the absorption of vitamins like OTC drugs? My gut reaction would be that the answer is yes, but I have no experience with reflux or the meds associated with it. Perhaps this might be a solution to the med that she is now allergic too. Perhaps not....
MD
madeleine, that's a good point. It could make school and such more difficult if the Benadryl made Baby E too sleepy, since it's probably something she'll be taking fairly frequently.
mama duck, thanks for the thoughts. I've heard the thing about heartburn being caused by too little acid. With reflux, though, it's not an issue with acid or lack of acid at all, as far as I understand. There's a problem with the flap between Baby E's stomach and esophagus that is allowing stomach acid to go up into her throat. The stomach acid would be fine in her stomach environment, but the esophagus is not desiged to tolerate that kind of acid. If the acid is not neutralized, it can cause a lot of pain and permanent damage to the esophagus, along with other problems.
The medicine she is taking actually blocks production of the acid rather than just neutralizing acid that's already there. The idea is not to stop the reflux, but to stop the acid in the reflux from damaging the esophagus and causing problems with breathing, etc.
The drug Baby E is taking is a proton pump inhibitor (PPI) which can affect absorption of minerals, and can have other side effects. It's a matter of choosing the lesser evil at this point.
Since both food allergies and sucrose intolerance can cause problems with the valve resulting in reflux, I'm really hoping that once we get those things under control Baby E may not need reflux medicine.
Oh, and she can't tolerate any kind of vinegar because of the mold/yeast issue, but it was a good thought. She seems to be able to tolerate citrus in moderate amounts at this point (she loves orange juice), but because her problems are caused by a structural issue and not an acidity issue I doubt that would help.
What madeleine said. You are doing such a good job of being a symptoms recorder for your daughter
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