Kersbrook Pharmacy > Blog
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Kersbrook Pharmacy e-News

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  1. Have you reached the Safety Net?
  2. Short Supply – Estradot Patches
  3. Health Advice – Iron Deficiency – The most common nutritional disorder worldwide!
  4. Compounding News – Topical creams for pain and inflammation
  5. Our Latest Blog – Tinnitus
  6. Allied Health – Physio and Podiatrist Service
  7. Trivia –

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1. Have you reached the Safety Net?

Many people don’t realise that once a certain amount is spent on PBS medicines, the entire family may pay less on their medications. The family can combine the amount spent. The family includes two partners and children aged less than 16 years old or children studying full-time up-to 25 years old. If the combined amount reaches the safety net threshold, medicines become cheaper till the end of the calendar year.

Concession cardholders receive their medicines for free once they reached the safety net and non-concession cardholders pay $6.60 per prescription once they get their safety net.

Many people are not aware of this, and because they got to different pharmacies, the total is never tallied as each pharmacy’s record stays in each pharmacy. If you have gone over the threshold and never received your safety net, you can also claim back all the money spent over the threshold!

We are happy to help you fill in the paperwork to Medicare to claim back your safety net money.

The 2020 PBS Safety Net threshold is:

  • $316.80 for concession cardholders
  • $1,486.80 for non-concession cardholders

If you or someone you know spends more these above amounts in a calendar year, then you are eligible to reach the safety net. Call us, and we are happy to help you claim back your money from Medicare. You can also reclaim as many years back as you want![/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”5333″ img_size=”full” alignment=”center” style=”vc_box_shadow” label=””][/vc_column][vc_column width=”2/3″][vc_column_text]

2. Supply Shortage – Estradot

Estradot Patches are in short supply at the moment. If you are having difficulty filling your prescription. Please contact us to discuss supply issues.

The supply issue may continue until the end of the year. Please speak to your doctor to discuss other available options.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”5869″ img_size=”full” alignment=”center” style=”vc_box_shadow” label=””][/vc_column][vc_column width=”2/3″][vc_column_text]

3.Iron Deficiency – The most common nutritional disorder worldwide!

Iron deficiency affects over 1.2 billion people worldwide, and that does not include those who are not aware they are iron-deficient!

Causes

Iron deficiency anaemia occurs when your body doesn’t have enough iron to produce haemoglobin. Haemoglobin is the part of red blood cells that gives blood its red colour and enables the red blood cells to carry oxygenated blood throughout your body.

Causes include blood loss, lack of iron in your diet, an inability to absorb iron, menstruating women, athletes, adolescents, the elderly, people with poor gut health, Pregnancy and medications (oral contraceptive pill, aspirin, reflux medications, steroids, antacids and anti-coagulants)

Who is most at risk of being iron deficient?

  • Women
  • Vegetarians
  • Infants and Children
  • Frequent blood donors

Absorption of Iron and dosing

There are many different forms of iron supplements available on the market. The current recommendation is approximately 180mg of absorbable iron per week. However, because iron is difficult to absorb and causes side effects, it is challenging to achieve 180mg of absorbable iron per week.

The current guidelines recommend 105-210mg of elemental iron daily. Elemental iron will vary in each iron product such as Ferro-Gradumet, Ferrograd C, FGF, Fefol, Ferro-F and Maltofer. Best to check with your pharmacist how to achieve a dose of 105-210mg of elemental iron daily.

Although there is no clear evidence for one preparation over another, small studies suggest better tolerability for iron bisglycinate.

Drug Interactions and Iron Supplements.

Iron supplements may interact with various medicines, including some antibiotics and thyroid medicines. Doses should be separated by at least 2 hours. Acid-lowering drugs (used mainly for reflux such as Nexium, Somac, Pariet and Losec), aspirin or nonsteroidal anti-inflammatory drugs and haloperidol may also compromise the iron status.

Optimal Absorption of Iron

Oral Iron supplements (except for Maltofer) is best absorbed when taken on an empty stomach (one hour before or two hours after food). Tea and Coffee may substantially impair absorption. The addition of Vitamin C may also help improve absorption. It may be best to take your iron supplement first thing in the morning or later in the evening.

Side Effects of Iron Tablets

Like all medicines, Iron Supplements can cause side effects in some people.

Many people have no side effects or only minor ones.

Talk to your pharmacist or doctor if these side effects bother you or do not go away:

  • feeling or being sick (nausea or vomiting), stomach discomfort or heartburn
  • loss of appetite
  • constipation
  • diarrhoea
  • dark or black poo
  • black stained teeth (from the liquid only)

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4. Compounding News – Topical creams for pain and inflammation

Many over the counter products are used to relieve pain, produce a numbing effect or act as an anti-inflammatory. Examples of such products include Voltaren emugel, Nervoderm Patches, Zostrix HP and many more. A compounding pharmacist can often combine these products or similar ones into one product. This particular treatment is excellent for targeted areas of chronic pain. Specific anti-inflammatories are used to relieve pain, tenderness, swelling, and stiffness, frequently by patients suffering from osteoarthritis and joint pain, along with rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Muscle relaxant ingredients are used to relax muscles and relieve pain and discomfort caused by strains, sprains, and other muscle injuries. Numbing agents are used to relieving the pain of post-herpetic neuralgia along with other forms of pain. And ingredients such as Capsaicin deplete your nerve cells of a chemical that’s important for sending pain messages and typically is known to cause the burning sensation you associate with chilli peppers.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”5617″ img_size=”full” alignment=”center” style=”vc_box_shadow” label=””][/vc_column][vc_column width=”2/3″][vc_column_text]

5. Our Latest Blog – Tinnitus

Tinnitus is the perception of hearing noises that not caused by an external source.

Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:

  • Ringing
  • Buzzing
  • Roaring
  • Clicking
  • Hissing
  • Humming

To read more:

https://kersbrookpharmacy.com.au/blog/tinnitus/[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”5443″ img_size=”full” alignment=”center” style=”vc_box_shadow” label=””][/vc_column][vc_column width=”2/3″][vc_column_text]

6. Allied Health

As you may be aware you can book with our Physiotherapist: Antwan Rizk and Podiatrist: Brett Carrier

You can book online or over the phone.

Book a Physio Appointment Online:

https://kersbrook-practice.au1.cliniko.com/bookings?practitioner_id=99945#service

Book a Podiatrist Appointment Online:

https://kersbrook-practice.au1.cliniko.com/bookings?practitioner_id=99685#service[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”5753″ img_size=”full” alignment=”center” style=”vc_box_shadow” label=””][/vc_column][vc_column width=”2/3″][vc_column_text]

7.Trivia

Which of the following are true about Iron Supplements?

  1. Tea and Coffee help iron absorption
  2. Vitamin C may help with the absorption of Iron
  3. Iron supplements are no side effects
  4. Iron supplements are all equally well absorbed.

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Answer our trivia question and go in the draw to win a $20 voucher

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Answer our trivia question and go in the draw to win a $20 voucher

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Allied Health

As you may be aware you can book with our Physiotherapist: Antwan Rizk and Podiatrist: Brett Carrier

You can book online or over the phone.

Book a Physio Appointment Online: Book Now

Book a Podiatrist Appointment Online: Book Now

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Our Catalogue

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Compounding – Suspension for Reflux in infants

One of the most common medications compounded is infant reflux.

Children who suffer from colic, the issue is often self-resolved, and children grow out of it. However, when a baby’s colic has been diagnosed as caused by stomach acid (reflux), a doctor may prescribe a liquid omeprazole formulation.

Unfortunately, there isn’t a commercially available omeprazole liquid to give to infants and children. Some tablets may be dissolved, but this may be very difficult to administer and tastes unpleasant. A compounding pharmacist may compound it at a dose that suits the condition and age of the infant or child. A pleasant flavour may also be added. Please contact us if you would like to find out more about compounding for reflux in infants and children.

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Health Advice – How long should I take Reflux Tablets for?

As with all medications, it is necessary to review their use, safety, effectiveness and duration. Reflux medications are no exception. The most commonly prescribed medications for reflux are known as proton pump inhibitors which include, Nexium, Somac, Pariet and Losec. This class of medicines is in fact, the most commonly prescribed group of medications in Australia. These medicines work by suppressing the acid in our gut, hence preventing that heartburn feeling. Ideally, people taking these medicines should be reviewed by their doctor every 4-8 weeks to assess their response to treatment. The aim of therapy is generally to control symptoms, reduce the risk of complications, heal the gut and improve quality of life. If symptoms are well controlled after 4-8 weeks with no complications, your doctor may consider it appropriate to step down to a lower dose and cease the medicine if possible.

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Supply Shortage – Estalis Patches

Estalis Patches are in short supply at the moment. If you are having difficulty filling your prescription. Please contact us to discuss supply issues.

The supply issue may continue until the end of the year. Please speak to your doctor to discuss other available options.

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What’s New? – eScripts

Electronic Prescriptions are here! An eScript can now be electronically generated as a QR code (known as a token) by your GP and sent directly to your mobile phone (via SMS) or email. You can send your eScript to your pharmacy. Feel free to send your eScript to us as SMS or Email, or you can ask us for our app in the store:

SMS: 0498 160 778

Email: info@kersbrookpharmacy.com.au.au

You can use the eScript the same way as a paper prescription; to obtain medicine from your pharmacy.

Once your eScript is dispensed, you will receive a new QR code (token) on your mobile or email.

Should you wish to know more about this service, please contact us at any time on 08 8483 4721 or 0498 160 778

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Tinnitus

Tinnitus is the perception of hearing noises that not caused by an external source.

Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:

  • Ringing
  • Buzzing
  • Roaring
  • Clicking
  • Hissing
  • Humming

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear an external sound. Tinnitus may be present all the time, or it may come and go.

Tinnitus is prevalent in Australians. It approximately affects 10% of the population. Every 1 in 10 people will suffer from it.

Tinnitus can be brought on by many factors including age, noise exposure, ototoxic medicines, people that suffer from blood vessels diseases, genetic inclination, jaw disorders, or as a consequence of other diseases, such as inner ear disease or infection.

Both men and women seem to be equally affected, and although tinnitus is more common in the elderly, it can occur at any age.

Causes of tinnitus

The more common causes of tinnitus include:

  • exposure to loud sounds
  • extreme stress or trauma
  • degeneration of the hair cells in the cochlea
  • ear problems, such as otosclerosis (abnormal bone growth in the middle ear)
  • Meniere’s disease (swelling of a duct in the ear)
  • some medications.

Types of Tinnitus

Tinnitus can be categorised as bothersome or non-bothersome. This distinction will influence your doctor’s decision on how to manage your tinnitus. Bothersome tinnitus negatively affects a person’s sleep, concentration, emotional wellbeing and their ability to interact socially.

Management of Tinnitus

If tinnitus is due to an underlying cause such as the build of wax or infection, it is essential to treat the primary source first.

Often tinnitus is associated with symptoms of vertigo, insomnia and psychological disorders such anxiety and depression.

If hearing loss is present, then further examination of the ear is required.

When tinnitus is bothersome, then tinnitus specific management may be needed. These are some strategies used to treat tinnitus

  1. hearing aids due to hearing loss.
  2. Counselling therapies
  3. Education and information about managing the condition.

Other strategies for managing bothersome tinnitus include sound, sleep and relaxation therapy. The evidence base is most vital for a combination of sound therapy and cognitive behavioural therapy-based counselling

Hearing aids & tinnitus

Tinnitus is often associated with hearing loss: 90% of people with tinnitus have some hearing loss. The hearing loss is usually mild and of gradual onset, which may explain why many people are unaware of their hearing loss. Interestingly, some people with audiometrically normal hearing will present with bothersome tinnitus, while those with hearing loss may be unaffected.  People with tinnitus who strain to hear may notice their tinnitus emerge or worsen. Correcting any hearing loss allows the person to listen more efficiently, and generally reduces the level of the tinnitus.

Hearing aids are useful even if the hearing loss is relatively mild and at a level where aids would not usually be considered. Even in the absence of marked hearing loss, hearing aids can provide some relief to people with tinnitus.

Hearing aids amplify peripheral and objective sounds and help manage tinnitus by making the sound less noticeable.

Counselling & Tinnitus

Counselling may be useful for some people with tinnitus. People with tinnitus, especially those who find tinnitus bothersome, need support.

Massage Therapy & Tinnitus

Massage may help to reduce muscular issues such as jaw clenching, tooth grinding, prior injury or muscle tension in the neck. These factors sometimes make tinnitus more noticeable. A therapist may ask the person to tighten muscle or move the jaw or neck in specific ways to see if this changes the sound. If so, tight muscles are part of the problem, and massage therapy may help relieve it.

Sleep & Tinnitus

Sleep can be a significant problem for many people with tinnitus. Tinnitus can impact people to get to sleep and stay asleep. However, there may be other factors that can affect a person’s ability to fall asleep and stay asleep, leading to insomnia.

A person with tinnitus who has difficulty getting to sleep or staying asleep may want to try:

  • Identify other causes contributing to sleep problems
  • Simple relaxation exercises
  • Listening to soft music when in bed including monotonous sounds, such as rain on a roof can stop you focusing on your tinnitus

Factors that contribute to insomnia for a person with tinnitus

Sleep disturbance usually involves a combination of:

  • health problems – for example, arthritis, migraines or asthma
  • psychological factors – for example, stress or emotional crisis
  • drug use – for example, alcohol or sleeping medication
  • disturbing environments – for example, an uncomfortable bed or intrusive lighting
  • conditioning – for example, the more you associate bed with struggling to get to sleep, the harder it is to relax there.

To successfully improve your sleep patterns, you will need to look at all the contributing factors.

Research has shown that relaxation techniques, such as yoga, meditation, biofeedback and progressive relaxation, can work well. Experiment and find a method that works for you. You might like to try a regular relaxation class or use a self-help relaxation app.

It may also help if you:

  • try and get up at the same time every day
  • reserve your bed for sleeping – avoid arguments or severe discussions in bed
  • avoid naps during the day
  • experiment with low-intensity background noises in the bedroom, for example, leave the radio playing softly or play tape recordings of the ocean surf.

When you go to bed for the night, if you are not asleep after half an hour, get up and go into another room. Do something that engages your brain (this does not mean watching TV). Write a list of things to do, plan a holiday or write a letter or email. After about 20 minutes you will be able to go back to bed and go to sleep. The same applies if you wake up in the night.

Remember, don’t go to bed if you don’t feel sleepy. Do something quiet and relaxing until you do feel sleepy.

It may help you to sleep if you avoid eating heavy meals just before bedtime. It is also a good idea to reduce your late afternoon and evening consumption of:

  • alcohol
  • chocolate
  • tea, coffee and caffeinated soft drinks
  • cigarettes.

Regular exercise helps you to cope better with stress and reduce fatigue, both of which can make sleeping more difficult or disturbed.

 

Lifestyle & Medications & Tinnitus

There is no evidence that lifestyle changes or medications may help improve tinnitus. However, people with or without tinnitus should be encouraged to follow a healthy diet and to exercise regularly. The use of complementary agents such as ginkgo Biloba, melatonin, zinc is discouraged.

Prevention and Tinnitus

Tinnitus cannot be cured, but in some situations, can be prevented. Tinnitus prevention involves the safe listening of sound to protect hearing. The intensity of sound and the duration and frequency of listening can impact the hearing. Listening to loud, high-frequency sound for long periods can cause hearing loss or tinnitus.

General Advice

People should protect their hearing. If a person is exposed to high levels of noise in their workplace or during recreational activities, it would be best to protect their hearing to reduce the risk of tinnitus.

Best to reduce sound levels to less than 80 decibels and regularly take breaks from noise exposure and use noise-cancelling earplugs where possible.

Conclusion

Tinnitus is a common condition that affects 1 in 10 Australians. Prevention and management strategies will reduce the risk and severity of tinnitus.

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Reflux, Heartburn, Indigestion and GORD

People commonly come into the pharmacy to ask for advice on heartburn or reflux. The most frequently prescribed medications in Australia are for reflux.  In general, most people will attempt to self-treat their reflux or heartburn symptoms. However, receiving proper advice on medications and lifestyle measures can be of great value in treating reflux and preventing complications and sometimes drug interactions.

GORD

What are the symptoms of heartburn, indigestion and Gastro-Oesophageal Reflux Disease (GORD)?

Reflux is a normal process which occurs when stomach acid frequently flows back into the tube, connecting your mouth and stomach (Oesophagus). This backwash (acid reflux) can irritate the lining of your Oesophagus. Many people experience acid reflux from time to time.

These symptoms occur; however, their severity and frequency can vary depending on diet and lifestyle factors. When the symptoms occur two or more times a week, become troublesome, or complications arise, then it is classified as a disease known as Gastro-Oesophageal Reflux Disease (GORD).

 

Heartburn

Heartburn is not always GORD. Heartburn is the burning sensation from the stomach or behind the breastbone, rising up towards the throat. Heartburn can also include an unpleasant taste in the mouth and uncommonly chest pain. Other symptoms include over salivation and nausea. However, heartburn can be part of GORD but does not define the disease.

 

Regurgitation is the rising of the stomach contents into the mouth or throat.  If reflux symptoms are severe enough to affect the quality of life, then the patient is considered to have GORD.

 

Indigestion

Indigestion often called dyspepsia, is the term used to describe the symptoms of pain, burning or discomfort in the upper abdomen. Other symptoms include feeling full soon after eating, belching, bloating, flatulence, heartburn, nausea and vomiting. Indigestion is mostly linked to eating or drinking but may be associated with other diseases.

 

The Sphincter and GORD

The tube linking the stomach and the mouth known as the Oesophagus, is connected by a ring of muscles known as the sphincter. If the sphincter is working properly, it prevents food from moving back up from the stomach to the Oesophagus. When the sphincter loses tone or weakens, food passes back more easily from the stomach to the Oesophagus, causing that heartburn feeling. The loss in tone or weakness in the sphincter is known as Gastro-Oesophageal Reflux Disease (GORD).

 

 

Who is at risk of getting Heartburn and Indigestion?

 Risk factors for reflux symptoms such as heartburn include obesity, increased age, male gender, poor diet, excessive alcohol/caffeine intake, smoking, stress and genetics.1,4

Heartburn may be caused by indigestion, stress/anxiety, delayed gastric emptying, GORD, Helicobacter pylori infection, peptic ulcer disease and gall bladder disease.

Indigestion can be triggered by diet and lifestyle factors such as overeating, eating too quickly, and eating spicy, rich or fatty foods. Caffeine and alcohol are both known to precipitate indigestion; sugary or carbonated beverages can also cause symptoms.

 

Heartburn can also be the result of a hiatal hernia. A hiatal hernia happens when part of the stomach pushes through the diaphragm and into the chest.

Heartburn is also a common condition during pregnancy. When a woman is pregnant, the progesterone hormone can cause the lower oesophageal sphincter to relax. This allows stomach contents to travel into the Oesophagus, causing irritation.

 

Lifestyle and GORD

Health conditions or lifestyle choices which can worsen your heartburn, include:

  • Smoking
  • Increased age
  • Males
  • Poor diet
  • Stress/Anxiety
  • Genetics
  • Being overweight or obese
  • Consuming caffeine, chocolate, or alcohol
  • Eating spicy foods
  • Lying down immediately after eating
  • Medications (See below)
  • Other diseases such as GORD, Helicobacter pylori infection, peptic ulcer disease and gall bladder disease.

 

Medicines that can cause heartburn and indigestion

Medications can play a role in heartburn or indigestion in several ways.

Some medications can irritate the Oesophagus (tube linking stomach to mouth), these include:

  • Aspirin
  • Non-Steriondal anti-inflammatories such over the counter Voltaren and Nurofen
  • Drugs used for Osteoporosis known as Bisphonsphonates (e.g. Actonel and Fosamax)
  • Iron and Potassium Supplements
  • Antibiotic known as tetracycline

 

Other Medications can delay the presence of food in the stomach by delaying the process of digestion. These medications increase the chance of food being pushed back up into the Oesophagus, causing that heartburn feeling. These group of drugs include:

  • Glucagon-like peptide-1 analogues (e.g. Trulicity, Byetta, Saxenda)
  • Anticholinergic Medications (Ditropan and other very long list of medications)
  • Opioids (Morphine-like medications)

 

Another group of drugs can also contribute to reflux by relaxing the sphincter. These include:

  • Alpha Blockers (e.g. Prozasin)
  • Anticholinergic Medications (e.g. Endep)
  • Benzodiazepines (e.g. Valium and similar medications)
  • Calcium Channel Blockers (e.g. Amlodipine and Nifedipine)
  • Oral and Inhaled Corticosteroids (e.g. Prednisolone, Seretide, Symbicort)
  • Dopaminergic Agents (e.g. Sinemet)
  • Nitrates (e.g. Duride and Imdur)
  • Phosphodiesterase-5 Inhibitors (e.g. Viagra and Cialis)
  • Progesterone
  • Theophylline

 

Complications of Heartburn and Indigestion

Complications arising from unmanaged heartburn can be serious.

Prolonged exposure of acid to the Oesophagus from the stomach can lead to scarring in the Oesophagus. These scars can cause narrowing of the Oesophagus leading to difficulty of swallowing. Surgery may be required to dilate the Oesophagus.

The continued exposure of acid in the Oesophagus can also burn the cells causing bleeding known as Peptic Ulcer and Barrett’s Oesophagus.

Other complications of continued acid exposure include cellular changes leading to some forms of cancer.

Hence, often getting the correct advice is not just about treating your current issue but preventing that preventable disease.

 

What self-care options can relieve symptoms of heartburn and indigestion?

The main treatment goals for heartburn are relief of symptoms and improvement in the quality of life. However, suppose heartburn has been unmanaged for a significant period. In that case, the purposes of treatment also include healing the Oesophagus and reducing the risk of long-term complications.

Lifestyle changes, such as reducing alcohol intake and smoking cessation, can help relieve symptoms. Weight loss in overweight patients or raising the bed head (if symptoms occur at bedtime) can also be beneficial.

Dietary modifications such as avoiding trigger foods (e.g. chocolate, caffeine, fatty or spicy foods), eating smaller meals, and not eating close to bedtime can all help reduce reflux symptoms such as heartburn.

 

Current Treatment for GORD

If diet and lifestyle modifications are insufficient to manage symptoms, then medications can be used when necessary.

Antacids can be used on an ‘as required’ basis to manage mild, intermittent symptoms. However, antacids tend to have a short duration of effect, so are best reserved for those with intermittent symptoms.

A step up approach can be used from weakest to strongest.

  1. Antacids (such as Mylanta and Gaviscon)
  2. Alginates (Gaviscon Dual Action)
  3. Prescription Medications

 

Complications of GORD medications

It is strongly recommended to always to check with your doctor how long you should take a medication for GORD. Many of the prescription medications may have long term complications. These complications are predictable as the acid in our stomach is there for a reason. Studies have shown that the long-term of some prescription medications for GORD can lead to gut infections, pneumonia and kidney disease. Depletion of magnesium levels, reduced bone mineral density and fracture, and reduced vitamin B12 levels can also occur.

 

Compounding, Reflux and Children

Children often suffer from GORD too. They may be more challenging to treat, as it is obviously difficult to know the source of their discomfort. Reflux is presented as spitting up, posseting or bringing milk up, and is common in babies, especially after a feed.

 

How is reflux diagnosed in babies?

A doctor diagnoses reflux. GORD requires a doctor’s assessment and tests to confirm a diagnosis.

Sometimes there may be another problem that causes reflux. You should see your GP if your baby has any of the following symptoms:

  • Green, yellow or blood-stained vomiting
  • Difficulty swallowing is gagging or choking
  • Fever
  • Irritability and consistently challenging to settle
  • Sudden and forceful vomiting in large volumes
  • Refusing feeds or won’t eat
  • Swollen or bloated tummy area
  • Blood or mucous in poo
  • Losing weight or only gaining weight slowly.

 

Treatment in Babies

It is often tricky to dose babies. A compounding pharmacist can design a tailored dose to suit your baby. The strength, volume and flavour can be tailor-made. Often doctors and paediatricians will prescribe a compounding prescription for reflux. Contact us for further details or enquiries.

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