Rabeprazole

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Rabeprazole belongs to a group of medicines called ‘Proton Pump Inhibitors’ (PPIs). They work by lowering the amount of acid that the stomach produces.

Rabeprazole is used to treat Gastro-esophageal reflux disease (heartburn), stomach ulcers, Zollinger-Ellison Syndrome, and in combination with amoxicillin and clarithromycin to eradicate Helicobacter pylori.

Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Rabeprazole.jpg

[edit] MECHANISM OF ACTION

Rabeprazole is a proton pump inhibitors. it decreases the amount of acid produced in the stomach by inhibition of H+/K+ ATPase located in the luminal membrane of gastric parietal cells

[edit] INDICATIONS

  • Treatment of Gastroesophageal reflux disease (GERD)
  • Treatment of ulcer caused by H. Pylori bacteria.
  • Treatment of pathological hypersecretory conditions, including Zollinger-Ellison Syndrome

[edit] DOSAGE

Rabeprazole should be taken 30 minutes before a meal

  • Gastroesophageal Reflux Disease:
    • Adults: 20/day
    • 12 to 17 Year Olds: 20/day
    • Less than 15 kg, 5 mg once daily
    • 15 kg or greater, 10 mg once daily
  • H. pylori Eradication (Triple Therapy): Rabeprazole (20 mg) twice daily + Amoxicillin (1000 mg) Twice Daily + Clarithromycin (500 mg) Twice Daily for 7 days
  • Zollinger-Ellison syndrome: 60 mg once daily. Dose should be adjusted to patient needs

[edit] CONTRAINDICATIONS

Hypersensitivity to Rabeprazole

[edit] WARNINGS AND PRECAUTIONS

  • Symptomatic response to therapy with rabeprazole does not preclude the presence of gastric malignancy
  • PPI therapy may be associated with increased risk of Clostridium difficile associated diarrhea
  • Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine.
  • Warfarin: Patients treated with proton pump inhibitors and warfarin concomitantly may need to be monitored for increases in INR and prothrombin time
  • Hypomagnesemia has been reported rarely with prolonged treatment with PPIs

[edit] INTERACTIONS

  • Warfarin: Increased INR and prothrombin times have been reported with concomitant use with warfarin. Patients need to be monitored
  • Rabeprazole has been shown to inhibit cyclosporine metabolism in vitro
  • Rabeprazole inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (e.g., ketoconazole, iron salts and digoxin)
  • Rabeprazole may reduce the plasma levels of atazanavir.
  • Methotrexate: Rabeprazole may increase serum level of methotrexate.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). There are no adequate and well-controlled studies with Rabeprazole in pregnant women. No evidence of teratogenicity was seen in animal reproduction studies with rabeprazole at 13 and 8 times the human exposure at the recommended dose for GERD, in rats and rabbits, respectively. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
  • It is not known if Rabeprazole is excreted in human milk, caution should be exercised if administered to a nursing woman

[edit] SIDE EFFECTS

Most common: headache, pain, sore throat, flatulence, infection and constipation

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

http://www.janssenmedicalinformation.com/assets/pdf/products/files/Aciphex/pi/LIB-ACI-065136-06.pdf

[edit] REFERENCES

Heartburn/Gastritis/Gastric ulcer/Duodenal ulcer/Gastroesophageal reflux
H2 antagonists Famotidine   Nizatidine   Ranitidine (Zantac)
Proton-pump inhibitors Dexlansoprazole (Dexilant)   Esomeprazole (Nexium)   Lansoprazole (Prevacid)   Omeprazole (Losec, Prilosec)   Omeprazole/Sodium bicarbonate (Zegerid)   Pantoprazole (Controloc, Pantecta, Pantoloc, Protonix) (  Rabeprazole (Aciphex, Pariet)
Prostaglandins Misoprostol (Cytotec)
Other drugs Alginic acid   Magaldrate   Sucralfate
Combination Regimens Bismuth Subcitrate Potassium/Metronidazole/Tetracycline (Pylera)   Lansoprazole/Amoxicillin/Clarithromycin (Prevpac)