Choice of PPI |
|
Under 1 year old |
1 year old and over |
ORAL ROUTE |
|
First line: Omeprazole orodispersible tablets or capsules
|
First line: Omeprazole orodispersible tablets or capsules
|
Second Line: Omeprazole suspension
|
Second line: Esomeprazole granules
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(If suspension not tolerated)
|
Third line: Lansoprazole orodispersible tablets, capsules
|
ENTERAL TUBE (6Fr gauge or larger) includes NG and PEG tubes
|
|
First line: Omeprazole suspension
|
First line: Esomeprazole granules
|
Second line: Lansoprazole orodispersible tablets (Zoton Fastabs®)
|
|
Third line: Omeprazole solution
|
|
ENTERAL TUBE (less than 6Fr gauge) includes gastro-jejunal, naso-jejunal, or if suspension is problematic |
|
First line: Omeprazole solution
|
For dosing and licensing information, see: BNFC, the Manufacturer's Summary of Product Characteristics (emc) and/or pharmacy.
Notes:
- Omeprazole suspension is the only PPI licensed for use in children under 1 year of age. It is available in two strengths and the most cost-effective strength should be prescribed (consider dose, pack size and in-use expiry). Parents/carers should be counselled of any change of dose/strength.
- Other omeprazole preparations are licensed for children over 1 year of age and 10kg or more. These may be used off-label, if they are deemed to be more appropriate, depending on individual circumstances.
- Where there is a need for continued PPI use, preparation choice should be reviewed once the child reaches 1 year of age and weighs 10kg or more, or sooner if clinically indicated. If long-term use is anticipated, the need for review should be discussed with parent/carer at initial prescribing of suspension.
- Esomeprazole granules are the first line option for enteral tube administration in children 1 year of age or older unless there are repeated problems with administration via enteral feeding tube using the method described in the administration leaflet (below), or an option involving a smaller volume is required. It may be used off-label in some children under 1 year of age, depending on individual circumstances.