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Baby vomiting every night at 3am

Hi,
My 5month old son (premature born at 34w) has been vomiting every night for the past month or two at 3am. It isn’t like normal spit up. He cries and is super uncomfortable twists and contorts his body until he pukes. Often times it starts with coughing.

Some background on him. He has a large VSD and being formula fed through NG tube. Due to his poor weight gain he has been on 24cal formula. He is on antacids (Pepcid) and already at max dosage. He’s also taking heart medication (Lasix and Enalapril) but his cardiologist said those meds should not have anything to do with his vomiting.

He is ok during the days but at nights he always puked and super uncomfortable. I tried giving his

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