Cortef Question (December 2006)

We recently started my 6 year-old daughter Halle (severe non-classic/borderline simple-virilizing) on Cortef, but are running into a real issue. She has had GERD and laryngotracheobronchial reflux ever since she was a baby, and has been on Prevacid twice daily for quite some time. The Prevacid has worked well for her in terms of heartburn and bellyaches, but now that she’s started the Cortef, she’s back to severe belly pain again...I am not sure what we’re going to do. The NIH had recommended a total daily dose of 10mg...She is not able to tolerate this amount. In fact, all I can give her is 1.25mg at a time, or her stomach hurts her so bad she is down on the couch, crying. She has also been very nauseated with any dose at or over 3.75mg too--pukes a bit about a half-hour after, even with food in her belly and Prevacid on board. I called the NIH and left a message for them...At this point I think we’re going to have to stay with what she can tolerate and see what labs show. There’s no sense in ripping the heck out of her stomach and/or causing a GI bleed just to get the dose in her. Hopefully they will have some thoughts on this...If Halle can’t take any more than a small dose at a time, I don’t know what we’ll do when she needs stress dosing...We’ll see I guess. I don’t want to have to give her an IM injection every single time she needs stress dosing. Any other folks have any thoughts on this? We have tried everything--making sure Halle eats a full meal before her dose , (which is difficult, as she’s not a big eater,) and making sure she has had her Prevacid at least a half-hour before-hand...We can also see what her GI doc thinks, but I don’t see much hope for this situation.