RABEPRAZOLE

RABEPRAZOLE

RABEPRAZOLE

RABEPRAZOLE

Overview & Uses

Rabeprazole is a drug used to reduce the amount of acid secreted in the stomach.

Indication (uses)

  • Used for short term (4-8 weeks) for healing and symptomatic relief of erosive or ulcerative Gastroesophageal reflux disease (GERD).
  • Indicated for the maintenance of Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD).
  • Indicated for the treatment of symptoms of Gastroesophageal Reflux Disease (GERD).
  • Used for short term (up to 4 weeks) for the treatment of Duodenal Ulcers.
  • For the treatment of Helicobacter pylori infection and duodenal ulcer in combination with amoxicillin and clarithromycin
  • For the treatment of peptic ulcers and bleeding peptic ulcers.
  • Zollinger-Ellison syndrome.
  • For the prophylaxis of Aspiration Pneumonia.

Pharmacological classification

Proton pump inhibitor for the reduction of gastric acid secretion

Brand names

Aciphex, Aciphex sprinkle

Dosage form

  • Delayed release tablets for oral use.
  • Delayed release capsules for oral use.

Mechanism of action

All proton pump inhibitors are inactive at neutral pH. But, as soon as pH drops below 5, the drug rearranges into two positively charged ions and binds with H+K+ATPase enzyme by forming a covalent bond and inactivates the enzyme. It also inhibits the mucosal carbonic anhydrase enzyme.

How to take Rabeprazole tablets or capsules?

  • Tablets and capsules of Rabeprazole should be swallowed whole and should not be chewed, crushed or spit.

Dosage

  • For erosive or ulcerative Gastroesophageal reflux disease (GERD):
    • 1 tablet of Rabeprazole 20 mg delayed-release tablet once a day.
  • For the maintenance of Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD):
    • 1 tablet of Rabeprazole 20 mg delayed-release tablet once a day.
  • For the treatment of symptoms of Gastroesophageal Reflux Disease (GERD):
    • For 12 years or more:
      • 1 tablet of Rabeprazole 20 mg delayed-release tablet once a day for 4 weeks.
      • If symptoms do not resolve completely, treatment can be extended to another 4 weeks.
    • For 1 year or more but less than 2 years:
      • Body weight less than 15 kg: 5 mg once a day for up to 12 weeks. Dose can be increased up to 10 mg based on clinical response.
      • Body weight equal to or more than 15 kg: 10 mg once a day for up to 12 weeks.
    • For the treatment of Duodenal Ulcers:
      • 1 tablet of Rabeprazole 20 mg delayed-release tablet once a day for 4 weeks, preferably after morning meals.
      • If symptoms do not resolve completely, treatment can be extended to another 4 weeks.
    • For the treatment of Helicobacter pylori infection:
      • 1 tablet of Rabeprazole 20 mg delayed-release tablet with amoxicillin 1000 mg and clarithromycin 500 mg – all three drugs to be taken twice a day for 7 days, preferably after morning meals and evening meals.
    • Zollinger-Ellison syndrome:
      • The recommended adult dose is 60 mg once a day and can go up to 100 mg once a day.
      • Treatment should be continued for as long as clinically indicated.

RENAL DOSE ADJUSTMENTS

  • No adjustments needed.

HEPATIC DOSE ADJUSTMENT

  • No adjustments needed in mild to moderate hepatic impairment.
  • Data not available for severe hepatic impairment.

ELDERLY PATIENTS

  • No adjustments needed.

OVERDOSAGE

  • No specific antidote is known.
  • Dialysis does not aid in excess drug removal as Rabeprazole is extensively protein bound.
  • Supportive treatment should be given as and when required.
  • Contact the emergency department of your local hospital in cases of overdose or suspected overdose.

Side effects or unwanted effects

  • Bloating or swelling of the face, arms, hands, lower legs or feet, cough or hoarseness, dark urine, dry mouth, fever or chills, general tiredness and weakness, light-colored stools, lower back or side pain, nausea and vomiting, painful or difficult urination, rapid weight gain, tingling of the hands or feet, unusual weight gain or loss, yellow eyes and skin are some of the major side effects.
    • Consult your doctor as soon as possible.
  • Change of taste or a bad taste is often experienced by patients taking Rabeprazole for a long period of time.
    • Ask your pharmacist to recommend a suitable medicine and consult your doctor.
  • Acute intestinal nephritis characterized by fever, blood in the urine, exhaustion, confusion, fatigue, nausea, vomiting and rash.
    • Consult your doctor as soon as possible.
  • Longtime treatment with Rabeprazole may lead to vitamin B12 deficiency.
  • Hypomagnesemia in patients taking proton pump inhibitors for over a year, characterized by arrhythmias, seizures, and tetany.
    • Consult your doctor as soon as possible. This may require magnesium supplement and discontinuation of the proton pump inhibitor.

WARNINGS

  • Concomitant use of Rabeprazole and warfarin should be done under strict monitoring, particularly for the increases in INR and prothrombin time.
  • Treatment with proton pump inhibitor may be associated with an increased risk of Clostridium difficile associated diarrhea, particularly in hospitalized patients.
  • Longtime treatment with Rabeprazole may increase the risk of osteoporosis-related fractures of hip, wrist or spine.
  • Concomitant use of methotrexate should be avoided with Rabeprazole as it may cause methotrexate related toxicities.

Pregnancy

Category C, which means that Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Nursing

  • Data not available.
  • Caution should be exercised while administering Rabeprazole to a nursing mother as many drugs are secreted in milk.

Interactions

  • Concomitant use of Rabeprazole and warfarin should be done under strict monitoring, particularly for the increases in INR and prothrombin time.
  • Though Rabeprazole is metabolized by CYP450, it does not show any clinically significant interactions with other drugs that are metabolized by CYP450.
  • Rabeprazole inhibits the metabolism of Cyclosporin.
  • Rabeprazole decreases gastric pH. Any drug, whose absorption is dependent on gastric pH, affects the absorption of that drug when co-administered with Rabeprazole.
    • Absorption of Ketoconazole, Atazanavir, Erlotinib, iron salts and mycophenolate mofetil is decreased while absorption of digoxin in increased.
  • Plasma concentration of Rabeprazole was increased when co-administered with amoxicillin and clarithromycin.
  • Concomitant use of Rabeprazole and methotrexate may lead to increased and prolonged plasma concentration of methotrexate and/or its metabolite hydromethotrexate.
  • No dose adjustment is required when co-administered with clopidogrel.

Note: The sole purpose of every information shared on this article is to bring awareness. Do not use this information as aa piece of medical adviceor prescription advice or as a tool for the treatment, diagnosis or prevention of the disease.