Ask the expert


GI Medications


What is the maximum acceptable dosage of Prilosec. Does it depend on the age and weight of the person? What are your feelings on the long-term use of Prilosec? Have you seen adverse side effects?

Answer of our experts

Prilosec (omeprazole) and Prevacid are proton pump inhibitors. They are the most potent acid blockers available. They are much more effective than Tagamet, Zantac, and Pepcid. There is no known "correct" dosage for kids. In adults, you would use 20 or 40 mg omeprazole per day. This is about up to 1/2 mg per kg per day for an adult. Some infants and children are on over 2 mg, 1kg per day, and some authors have suggested higher doses. This is a medicine that must be studied in children. The pharmacokinetics are just not known. But it is very potent, and we use it, even in infants. It has a second problem for many children, particularly the ones with CdLS. It is designed to be administered in the capsule, and it is destroyed by stomach acid. It is a complicated delivery system. The capsule can be opened, and put on acidy food, but the granules cannot be chewed, and they cannot be dissolved. Some pharmacies have taken to putting the chemical in a basic solution, which should possibly protect it. But we believe there commonly is destruction when it is delivered this way, unless it is tubed into the duodenum or jejunum. When we think Prilosec is not working, we do a pH probe on the medicine, with one of the probes in the stomach. If it shows too much acid (too many hours per day of acid) we go up on the dose, or add a second medicine. This is not national standard practice, but it is for us. We feel this is the only way to justify "high doses." So, dosed by age, weight, indication and response. It is very complicated, and needs to be individualized by someone familiar with the medication. We have very rarely seen any reactions we thought we could attribute to Prilosec in children, but there are a number of theoretical problems, listed on the insert with every prescription. We have used it very long term in many patients, very safely. But we only use it when we MUST. It is not a first line reflux or esophagitis medication

Propulsid bears no relationship whatsoever to Prilosec. Propulsid is a "prokinetic" which means that it helps to move the stomach contents in a forward direction. Reglan is another medication in the same style of medication, but chemically unrelated. Propulsid does not block stomach acid at all, and it clearly does have warnings about cardiac arrythmias and death associated with its inappropriate use. There are MANY medication reactions with Propulsid and other medications, including some routine antibiotics

DP /TK 7-13-10

Answer is checked and valid for
Find other pages that share the same topic as this page Reflux9 Reflux3 Reflux38



Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

Legal Disclaimer

Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

Do you have a question you would like to ask?

Ask a Question

Do You urgently need help? Contact the CdLS Foundation USA, Our Staff!