Rabeprazole

Indications

Rabeprazole is used for: Peptic ulcer disease, H. pylori infection, Gastro-oesophageal reflux disease, Paediatric GERD

Adult Dose

Oral Gastro-oesophageal reflux disease Adult: 20 mg daily for 4-8 wk. Maintenance: 10 or 20 mg/day. All doses to be taken once in the morning. Zollinger-Ellison syndrome Adult: Initially, 60 mg once in the morning, adjusted to max dose of 120 mg/day if needed. Daily doses >100 mg should be given in 2 divided doses. Peptic ulcer Adult: 20 mg once in the morning for 4-8 wk (duodenal ulcer) or for 6-12 wk (gastric ulcer). H.pylori infection Adult: 1-wk triple therapy: 20 mg bid combined w/ clarithromycin 500 mg bid and amoxicillin 1 g bid or combined w/ clarithromycin 250 mg bid and metronidazole 400 mg bid. Erosive oesophagitis Adult: 20 mg/day for 4-8 wk. May continue for another 8 wk if healing is incomplete. Maintenance: 10 or 20 mg/day. All doses to be taken once in the morning. Elderly: No dosage adjustment needed. Hepatic impairment: No dosage adjustment needed.

Child Dose

Oral Gastro-oesophageal reflux disease Child: >12 yr 20 mg once in the morning for up to 8 wk.

Renal Dose

Renal impairment: No dosage adjustment needed.

Administration

Administer with or without meals

Contra Indications

Rabeprazole is contraindicated in patients with known hypersensitivity to Rabeprazole, other PPIs or to any component of the formulation.

Precautions

Gastric malignancy should be ruled out. Severe hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor Mg levels prior to initiation and periodically during prolonged use. Lactation: Unknown whether rabeprazole is distributed into breast milk; use caution

Pregnancy-Lactation

Interactions

May decrease serum concentration of ketoconazole, itraconazole and clopidogrel. Increased risk of hypomagnesaemia w/ diuretics and digoxin. May increase prothrombin time and INR of warfarin. May increase plasma concentration of saquinavir and methotrexate. Decreased serum levels w/ sucralfate. Potentially Fatal: May decrease plasma concentrations and pharmacological effects of rilpivirine and atazanavir.

Adverse Effects

Side effects of Rabeprazole : 1-10% Headache (2-10%),Constipation (2%),Diarrhea (2-5%),Flatulence (3%),Pain (3%),Pharyngitis (3%),Abdominal pain (4%) <1% Agitation,Agranulocytosis,Alopecia,Anemia,Angioedema,Chest pain,Delirium,Erythema,Hypokalemia,Hypomagnesemia,Hyponatremia,Jaundice,Leukocytosis,Leukopenia,Migraine,Osteoporosis related fracture,Rhabdomyolysis,Stevens-Johnson syndrome,Sudden death,Toxic epidermal necrolysis,Abnormal taste

Mechanism of Action

Rabeprazole is a PPI that suppresses gastric acid secretion by inhibiting H+/K+ ATPase at the secretory surface of the gastric parietal cell.