Generic
Rabeprazole
79 brands available in the market
At a glance
Rabeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting H+/K+-ATPase, used for acid-related diseases such as heartburn, acid reflux, peptic ulcer disease, and Zollinger-Ellison syndrome.
Description
Rabeprazole suppresses gastric acid secretion by inhibiting the gastric H+/K+-ATPase at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as a gastric proton-pump inhibitor.
Indications
- Active duodenal ulcer
- Active benign gastric ulcer
- Erosive or ulcerative gastro-esophageal reflux disease (GERD)
- GERD long-term management
- Symptomatic GERD (moderate to very severe)
- Zollinger-Ellison Syndrome
- Helicobacter pylori eradication (in peptic ulcer disease)
Therapeutic class
Proton Pump Inhibitor
Pharmacological class
PPI (Proton Pump Inhibitor)
Pharmacology
Rabeprazole suppresses gastric acid secretion by inhibiting H+/K+-ATPase at the secretory surface of the gastric parietal cell. This enzyme acts as the acid (proton) pump within the parietal cell.
Mechanism of action
Relieves acid-related stomach conditions by inhibiting gastric acid secretion.
Dosage
Adult Dose (Oral):
- Duodenal/Gastric ulcer: 20 mg once daily in the morning (4-8 weeks duodenal; 6-12 weeks gastric)
- GERD (erosive): 20 mg/day for 4-8 weeks; may continue for another 8 weeks; maintenance 10 or 20 mg/day
- Symptomatic GERD: 10 mg/day (without esophagitis); on-demand if needed
- Zollinger-Ellison Syndrome: 60 mg/day initially; may titrate up to 120 mg/day; >100 mg/day in 2 divided doses
- H. pylori eradication: 20 mg twice daily + clarithromycin 500 mg twice daily + amoxicillin 1 g twice daily for 7 days
- Pediatric GERD (1-11 years, <15 kg): 5 mg/day; (≥15 kg): 10 mg/day for up to 12 weeks
Administration
- Take on an empty stomach (in the morning, before eating)
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Headache
- Diarrhea
- Abdominal pain
- Vomiting
- Constipation
- Dry mouth
- Increased/decreased appetite
- Muscle pain
- Drowsiness
- Dizziness
Precautions & warnings
- Rule out gastric or esophageal malignancy before treatment
- Long-term use (>1 year) may increase risk of bone fractures (especially in elderly); ensure adequate vitamin D and calcium intake
- Hypomagnesemia (fatigue, tetany, delirium, convulsions, arrhythmias); monitor magnesium with prolonged use
- May reduce vitamin B12 absorption with long-term use
- Increased risk of gastrointestinal infections (Salmonella, Campylobacter, C. difficile)
- Do not co-administer with atazanavir
Contraindications
- Hypersensitivity to rabeprazole, other PPIs, or any component
- Pregnancy and lactation
Drug interactions
- Ketoconazole, itraconazole: Significantly decreased antifungal plasma levels
- Atazanavir: Absorption is pH-dependent; do not co-administer
- Warfarin: May increase prothrombin time and INR
- Diuretics, digoxin: Increased risk of hypomagnesemia
- Saquinavir, methotrexate: Increased plasma concentrations
- Sucralfate: Decreased serum levels
- Potentially fatal: Decreased plasma concentrations and pharmacological effects of rilpivirine and atazanavir
Food interactions
Caution is advised when consuming alcohol with Rabeprazole.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; limited human data suggests drug may pass into breast milk; consult your doctor.
Pediatric use
Dose established for GERD in pediatric patients 1-11 years; limited safety and efficacy data.
Geriatric use
Elderly patients require no dose adjustment; however, fracture risk is higher.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; consult your doctor.
Hepatic Impairment: Caution in severe liver disease; dose adjustment may be needed; consult your doctor.
Overdose effects
Overdose: Up to 60 mg twice daily or 160 mg/day administered; effects generally minimal; no specific antidote; symptomatic and supportive care; not dialyzable (protein-bound).
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Rabeprazole