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Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
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Experience:  U.S. Surgeon / Neurological Surgery
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Can Prograf and Cellcept be given per G-tube for a child who

Resolved Question:

Can Prograf and Cellcept be given per G-tube for a child who has had a kidney transplant. This child get many meds. which are G-tube but these are written as po is there any harm if given per G-tube?
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. Mark replied 7 years ago.
If the medication is written as "PO" -- essentially it is the same as "NG" or "per-G-tube".

The medications all end up in the same place -- the stomach. From there, they get dissolved and absorbed in the stomach and small intestine.

So medications that are designed to be taken orally can also be given via G-tube.

The concerns with some types of medications is that they can "clog" up the G-tube, and if so, will need to be "unclogged" with soda, for example.

The other issue is -- can the medication be crushed? If the medication is available in liquid form, this is not an issue. But if the medication is a sustained release, or cannot be crushed for some other reason, then administration via G-tube may not be possible.
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Customer: replied 7 years ago.
He is 3 yrs old dx with polycystic disease received new kidney at age of 3 he takes many meds. but parents say he needs Prograf, Cellcept and Nystantin oral with the rest being given per G-tube.
Expert:  Dr. Mark replied 7 years ago.
The nystatin oral -- is probably given oral, because the medication is designed to help fight yeast infection in the mouth and pharynx and esophagus.

So instilling it directly into the stomach may not make sense, since you are bypassing the areas where you intended it to work.

The cellcept has a delayed release formulation -- and this would prevent it from being crushed. So that would be required to be swallowed.

The Prograf medication has specific instructions not to open the capsule, or crush the capsule, so this too would have to be swallowed. I believe this is primarily to protect other people and exposure of any excess "dust" from the medication into your eyes, etc.
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Customer: replied 7 years ago.
This would be fine if they were in pill or capsule form but they are all liquid since he is on tube feedings he is a patient at Cardnial Glennin Hospital in St. Louis.
Expert:  Dr. Mark replied 7 years ago.

If the medications are liquid formulation -- then except for the Nystatin oral -- it should be OK to go through the G-tube.

The person to speak with at the hospital would be the clinical pharmacist, who can help the doctors in changing the route of medication delivery.
Customer: replied 7 years ago.
Thank you!