July/August 2004

Doping Kids

Using potent adult drugs to treat common childhood ailments raises safety questions

by Helen Cordes

For Dr. Stephen Borowitz, the most frustrating office visits are with parents of kids suffering from stomachaches and infants prone to spitting up. Often, he says, the parents already know what they wantÑadult heartburn drugs such as the “purple pill,” Prilosec. “I tell them about non-drug tactics that often help the symptoms,” says Borowitz, a professor of pediatric gastroenterology at the University of Virginia. “But they want their kids to have the pills they’ve seen on TV.”

Borowitz and other experts worry about the safety of using potent adult drugs to ease common childhood ailments. But their warnings are unlikely to be heeded by many doctors parentsÑthanks, in large part, to aggressive marketing campaigns by pharmaceutical companies. Nearly a quarter million children took Prilosec in 2000, according to U.S. Food and Drug Administration documents, and nearly 100,000 were prescribed similar “proton pump inhibitor” (PPI) heartburn drugs such as Prevacid, Nexium, Protonix and Aciphex. None of these PPIs were approved for pediatric use at the time (Prevacid finally secured approval in 2002), and the FDA had warned that children taking Prilosec could face risks of pancreatitis and liver problems. Yet drugmakers have continued to fund medical conference presentations, publications and tutorials touting PPIs as “highly effective and safe” for children. And this January, TAP Pharmaceuticals (which makes a strawberry-flavored version of Prevacid) sponsored a nationwide campaign featuring best-selling baby-book author Dr. Bill Sears to publicize what it calls “one of the most common esophageal disorders in children”Ñgastroesophageal reflux disease, or GERD. It’s a claim that angers Borowitz, who says there is no evidence of a GERD epidemic. PPIs may be useful in a few “relatively rare” conditions, he says; but too often, “ordinary childhood problems are pathologized into a disease.”

For the rest of this story, you can order the July/August 2004 issue of Hampton Roads Magazine.