RABEPRAZOLE SODIUM (Generic Name)

Also called Aciphex or Pariet

(Chemical formula: C₁₈H₂₀N₃NaO₃S)

About

Rabeprazole (Aciphex) is used to treat duodenal and benign gastric ulcer (whether associated with Helicobacter pylori or not), gastro-oesophageal reflux disease (GERD), and Zollinger-Ellison syndrome.  Rabeprazole is also called Aciphex and Pariet.

Rabeprazole is a proton-pump inhibitor which inhibits the secretion of gastric juices.

It has been found also be effective in conjunction with antibiotics in the treatment of ulcers caused by the bacterium Helicobacter pylori.

Rabeprazole is also used as a preventative treatment in individuals with NSAID-associated ulcers.

Dosages

For healing of GERD – 20mg to be taken once daily for 4-8 weeks.  This can be continued for a further 8 weeks if the symptoms have not disappeared.  For maintenance of healing of erosive GERD, 10-20mg daily is recommended.

For benign gastric ulcer -  20mg to be taken daily in the morning for 6 weeks.  This can be continued for a further 6 weeks if not fully healed.

For Zollinger-Ellison syndrome –  Initially 60mg once daily.  However, different individuals respond differently to Rabeprazole and the dose may be adjusted up or down accordingly up to a maximum of 120mg daily, which may be split into two equal doses daily.

For duodenal ulcer – 20mg to be taken daily after the morning meal for up to 4 weeks.

For individuals with gastric ulcer and Helicobacter pylori infection – Rabeprazole

is usually combined with antibiotic treatment using two different antibiotics, namely Amoxicillin (1000mg to be taken twice daily for 7 days) and Clarithromycin (500mg to be taken twice daily for 7 days).  If you are following this treatment it is very important to take the antibiotics for a full 7 days.

Do not use the combined Rabeprazole/Amoxicillin treatment if you are allergic to penicillin or other macrolide antibiotic.  (also see separate description for Amoxicillin and Clarithromycin for side effects and precautions for these drugs.

Rabeprazole is not recommended for children, nursing mothers or in pregnancy.

Side Effects

Rabeprazole (Aciphex) is well tolerated in the vast majority of individuals, both in the short and long term.

The most common side effects are headache (2.4% as opposed to 1.6% in those taking a placebo) nausea, vomiting, abdominal pain, flatulence, diarrhoea, constipation, headache and dizziness.

Less common side effects are dry mouth, insomnia, blurred vision, rash, pruritis, and drowsiness.

Rare or very rare side effects are liver dysfunction, peripheral oedema, allergic reactions, photosensitivity, fever, sweating, depression, myalgia, arthralgia, skin eruptions, interstitial nephritis and blood disorders.

If taken with antibiotics, the latter may cause a severe allergic reaction in some individuals (anaphylactic shock).  The symptoms of this are difficulty in breathing, increased heart rate, swelling of the tongue and face, panic.  If you experience these symptoms seeks medical help immediately

Precautions

Rabeprazole should not be used in individuals who are pregnant (may cause foetal defects) or breast feeding without first consulting a doctor.

Do not use if you are suffering from acute hepatic failure.

Not recommended for children.

Rabeprazole may decrease the efficacy of ketonazole.

If taken with antibiotics, the latter may cause a severe allergic reaction in some individuals (anaphylactic shock).  The symptoms of this are difficulty in breathing, increased heart rate, swelling of the tongue and face, panic.  If you experience these symptoms seeks medical help immediately.

How does it work

Rabeprazole is a proton-pump inhibitor which blocks the hydrogen-potassium adenosine triphosphatase enzyme system which acts as a proton pump for gastric parietal cells. It thus inhibits the secretion of gastric juices.  Its effects are apparent approximately one hour after administration.

Individuals with confirmed erosive, ulcerative or structuring oesophagitis may need to be maintained on Rabeprazole.

More information

Rabeprazole is metabolised in the liver.  Approximately 90% is excreted in the urine, and the rest is excreted via the faeces.

Rabeprazol (Swe)

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