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. 2023 Mar 16;15(3):84–102. doi: 10.4253/wjge.v15.i3.84

Table 4.

Summarizes the drugs used in infants and children with gastroesophageal reflux disease[1-5] (for guidance only, prior to use please refer to local formulary and guidelines for accuracy and appropriate doses)

Medication
Dose
Adverse effect
Approved age (FDA indicated)
PPI1
Omeprazole 1-4 mg/kg/d od Diarrhea, abdominal pain, flatulence, headache, enteric infection, respiratory infection, rebound hypersecretion > 1 yr old
Lansoprazole 0.7-2 mg/kg/d od 1Esomeprazole: Tarry stool, darkened urine > 1 yr old
Esomeprazole 3-5 kg: 2.5 mg od 1Rabeprazole: Light-colored stool > 1 mo old
> 5-7 kg: 5 mg od
> 7.5 kg, < 20 kg: 10 mg od
20 kg: 20 mg od
Pantoprazole 1-2 mg/kg/d od > 5 yr old
Rabeprazole 0.5-1.0 mg/kg/d od > 1 yr old
Pro-motility
Metoclopramide 0.4-0.9 mg/kg/d tid Extrapyramidal side effect (1%), diarrhea, drowsiness > 1 yr old
Domperidone 0.8-0.9 mg/kg/d tid Dry mouth, QT prolongation (rare) Abdominal pain, diarrhea, (rare) HPS in infants, QT prolongation (rare) > 12 yr old
Erythromycin 5 mg/kg/dose qid Dizziness, diarrhea, dry mouth All ages
Baclofen 0.5 mg/kg/d tid All ages
Esophageal mucosal protection
Alginate antacid Flatulence, diarrhea, nausea and vomiting Younger than 12 yr of age is not generally recommended
Magnesium alginate plus simethicone Infant: 1-2 mL/kg/dose after feeding
Sodium alginate (225.00 mg sodium alginate, 87.25 mg magnesium alginate per sachet) Child: 2.5-5.0 mL oral tid after meal
Sucralfate (sucrose, polyaluminium hydroxide) 40-80 mg/kg/d qid Constipation, aluminum toxicity in long-term use In adult
Esoxx (sodium hyaluronate, sodium chondroitin sulfate, poloxamer 407, povidone K30, xylitol, potassium sorbate, sodium benzoate, red grape aroma, purified water) (10 mL/sachet) 1-2 sachet/d after main meal and bedtime No serious adverse effect because of the poor absorption, however, no data of long-term adverse effect In Italy, it is approval for adolescents age > 12 yr old
Probiotics
Lactobacillus reuteri DSM 17938 > 1 × 108 colony-forming units/d od None All ages
1

Dose depend on metabolizer via cytochrome P2C19. FDA; od; bid; tid; qid.

PPI: Proton pump inhibitor.