Administration of Proton Pump Inhibitors to Children

Administration of Proton Pump Inhibitors to Children

Your child has been prescribed a medicine called a Proton Pump Inhibitor (PPI) to help treat a range of conditions affecting the tummy such as gastro-oesophageal reflux.

There are different brands and formulations of this medicine. Your doctor will choose the one that is most suitable and easiest for your child to take.

This leaflet explains how to give PPIs to babies, children and young people, either with or without a feeding tube (enteral tube).

For Children Taking Medicines by Mouth

Omeprazole oral suspension

• Shake the bottle well before use.
• Use an oral syringe or medicine spoon to measure the right dose. These can be obtained from your pharmacist.
• Do not use a kitchen teaspoon as it will not give the correct amount.

Omeprazole dispersible tablets (Losec MUPS®)

(Note: 10mg tablets can be halved to give 5mg using a tablet cutter, but must not be cut into smaller pieces)

• Place the tablet (whole or half) in 10mL of water (about two medicine spoons).
• Do not crush the tablets. Stir gently until a very cloudy mixture forms – this may take 5–10 minutes.

• You may add a small amount of fruit juice, apple sauce or yogurt to this mixture, but do not use milk or fizzy drinks.
• Make sure your child takes the full amount straight away.

Omeprazole capsules

• Swallow the capsule whole with water, juice, or squash.
• Do not chew the capsule.
• If your child cannot swallow the capsule:
• You can open the capsule and mix the contents with a small amount of soft food such as yogurt, honey [not to be given if less than 1 year old], or jam.
• Make sure your child swallows the mixture straight away without chewing.

Lansoprazole orodispersible tablets

(Note: 15mg tablets can be halved to give 7.5mg or quartered to give 3.75mg using a tablet cutter, but must not be divided further)

• Place the tablet (whole, half or quarter) or on your child’s tongue and let it melt (about 1 minute) or allow them to gently suck it.
• Alternatively, the tablet can also be swallowed whole with water – but not chewed.
• If needed, dissolve the tablet in a small amount of water (it dissolves slowly). Stir the mixture well and give it with a spoon or oral syringe. The full dose should be taken immediately.

For Children With an Enteral Feeding Tube

Omeprazole oral suspension

1. Shake the medicine well.
2. Draw up the correct amount using a syringe.
3. Give the dose through the feeding tube.
4. Flush the tube with 10mL of water afterwards.

Omeprazole dispersible tablets (Losec MUPS®)

(Note: 10mg tablets can be halved to give 5mg using a tablet cutter, but must not be cut into smaller pieces)

1. Pull the plunger out of the barrel of a 20mL syringe and place the tablet (whole or half) inside.

• Replace the plunger and draw up 10mL water with the tip of the syringe (use cooled boiled water if your child is under 6 months old).
• Hold the syringe upright. Draw up about 5mL of air and shake the syringe for 1-2 minutes to disperse the granules.

• Keep the syringe tip upright and then push out the air.
• Attach the syringe to the feeding tube and administer using a push-pull technique to keep the granules suspended.
• Refill the syringe with the same amount of water, shake and flush the remaining contents down the enteral tube.
• Rinse the syringe and flush the tube with water (use cooled boiled water if under 6 months).

Note: This medication can block feeding tubes if not flushed properly.

Lansoprazole orodispersible tablets (Zoton FasTabs®)

(Note: 15mg tablets can be halved to give 7.5mg or quartered to give 3.75mg using a tablet cutter, but must not be divided further)

1. Pull the plunger out of the barrel of a 20mL syringe and place the tablet (whole, half or quarter) inside.

• Replace the plunger and draw up 10mL water with the tip of the syringe (use cooled boiled water if your child is under 6 months old).
• Hold the syringe upright. Draw up about 5mL of air and shake the syringe for 30- 60 seconds to disperse the granules.

• Keep the syringe tip upright and then push out the air.
• Attach the syringe to the feeding tube and administer using a push-pull technique to keep the granules suspended.
• Refill the syringe with the same amount of water, shake and flush the remaining contents down the enteral tube.
• Rinse the syringe and flush the tube with water (use cooled boiled water if under 6 months).

Note: This medication can block feeding tubes if not flushed properly.

Esomeprazole granules sachets (Nexium®)

1. Add the contents of the 10mg sachet to 15mL of water (use 30mL of water for 20mg dose and 60mL of water for 40mg dose).

• Stir and allow the mixture to thicken for a few minutes (do not leave it unattended).
• Stir again and draw the mixture into a syringe.

• Attach the syringe to the tube and administer immediately.
• Refill the syringe with the same amount of water, shake and flush the remaining contents down the enteral tube.
• Rinse the syringe and flush the tube with water.

Who to contact for more information

If you have any questions, speak to your doctor, pharmacist or nurse.

You can also get useful information from: Medicines for Children Website – https://www.medicinesforchildren.org.uk

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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