How we do it: Compounding Zegerid

Lulu has reflux and after trying several meds, we have found success with a Zegerid/Omeprazole mixture.  Actually, Zegerid is Omeprazole just with sodium bicarbonate added as a buffer to make it immediate release but anyway...
I am going to go over how I compound (mix) her meds.  The items that I use are:
     -Medicine bottle
     -Tums 1000- I use berry flavor but any flavor is fine
     -Omepraloze tablets- I have tried using the capsules but I have found that getting the super tiny beads into the bottle is far more difficult that crushing the tablets and pouring it in.
     -Zegerid capsules
     -A pill crusher (bought at Walmart)
     -A funnel (not pictured)- I have Hubby make me one out of paper.

I start by putting 95mL of water into a medicine bottle.  I like the medicine bottles from Target best.  I just go up to the pharmacy and ask for a few empty medicine bottles with the plugy top thingy and a few syringes.  The ones from Target have a plug that goes into the top once you are done making it and this feature  makes it much easier to administer the meds.  I have found that it's easiest to get the 95 mL by filling the medicine bottle to 100 mL and then removing 5 mL with a syringe. 

I add 5 1000 strength Tums to the water.  I break each Tums into 4 pieces and plop them right in.

Once they are all added to the water, I shake, shake, shake!  I then place the bottle into the fridge and leave it over night so that the Tums can dissolve.  Every time I open the fridge, I shake the bottle to speed up the dissolving process.

The next morning...

I get out 5 20mg Omeprazole tablets and crush each one individually in the pill crusher.  I have found that crushing them individually is far more effective than trying to crush all 5 pills at once in the pill crusher (actually, trying to crush all 5 at once did not work).

 This is a pic of the pill crusher.  You put the tablet in and turn the top until the tablet crumbles.

 They break apart into powder and chunks.  I just tilt the pill crusher to the side and tap it until all the material is gathered on one side.  Then I place the very awesome and scientific funnel (made of a small piece of paper :) into the top of the medicine bottle.

 Our funnel

 I then pour the Omeprazole powder/chunks into the water/Tums mixture and shake.

 Next, I get out 5 Zegerid capsules. 

 I use these little scissors (also purchased at Walmart) to poke a hole into the Zegerid.  I think they are actually cuticle scissors or something.  I found them in the nail polish section.

 I poke a small hole into one side of the Zegerid capsule.

 I squeeze the Zegerid powder into the bottle until it's all out.

 This is the size of the hole and what the empty capsule looks like.

 Once I've done this with all 5 Zegerid pills, I put the pluggy thing in the top.

 Then I put the lid on and shake, shake, shake.  The compound is then placed in the fridge, usually for another 24 hours before I use it.  Just be sure everything's dissolved before administering. 

 When the compound (mixture) has settled in the fridge, it looks like this and has distinct layers.  That is normal and is why you must shake it very well before dosing.

Once it's time to give medicine, I just insert the syringe and pull out the appropriate dose.

The first time that I made it, I was a bit intimidated but have found that it's actually very easy and since the Omeprazole is mixed with the Zegerid it can be given any time (no timing around meals!).  This is very important and is one of the main reasons I switched Lulu to Zegerid.  She pretty much eats all day and never has a long period of time in which she has an empty stomach- especially since starting solids.