What is rabeprazole, and how does it work (mechanism of action)?
Rabeprazole is an oral drug that is used for
the treatment of conditions caused by acid. It is in a class of drugs called
proton pump inhibitors or PPIs which block the production of acid by the
stomach. Other drugs in the same class include:
- lansoprazole (Prevacid),
- omeprazole (Prilosec),
- pantoprazole (Protonix),
- esomeprazole (Nexium), and
- dexlansoprazole (Dexilant).
PPIs are used for the treatment of acid-caused
conditions such as stomach and duodenal ulcers, gastroesophageal reflux disease
(GERD) and Zollinger-Ellison Syndrome. Rabeprazole, like other PPIs, blocks the
pump in the wall of the stomach that secretes acid into the stomach. By blocking
the pump, the secretion of acid into the stomach is decreased, and this allows
ulcers in the stomach and esophagus to heal. The FDA approved rabeprazole in
August 1999.
What brand names are available for rabeprazole?
Aciphex
Is rabeprazole available as a generic drug?
Yes
Do I need a prescription for rabeprazole?
Yes.
What are the uses for rabeprazole?
Rabeprazole is used for treating ulcers of the stomach
and duodenum, erosive or ulcerative gastroesophageal reflux disease (GERD)
and Zollinger-Ellison Syndrome (in which there is overproduction of acid caused
by tumors). It also is used with antibiotics for eradicating Helicobacter pylori
infections of the stomach that, along with acid, are responsible for many
ulcers.
What are the side effects of rabeprazole?
Rabeprazole like other PPIs has few side effects. The
most common side effects are:
Other side effects include:
- nervousness,
- abnormal heartbeat,
- muscle pain,
- weakness,
- leg cramps, and
- water retention.
What is the dosage for rabeprazole?
Tablets should be swallowed whole and should not be crushed,
split or chewed. Rabeprazole can be taken with or without meals since food has
little effect on its absorption.
- For healing ulcerating GERD, the recommended dose for adults is 20 mg
daily for 4-8 weeks. If healing does not occur after 8 weeks, another 8 week
course may be considered. The recommended maintenance dose is 20 mg daily. - Heartburn due to GERD is treated with 20 mg daily for 4 weeks and an
additional 4 weeks if symptoms do not resolve. - Ulcers are treated with 20 mg daily for 4 weeks.
- For the management of Zollinger-Ellison Syndrome, the starting dose for
adults is 60 mg daily, and the dose is adjusted based on improvement in
symptoms, healing of ulcers, or the effectiveness of acid suppression. Doses
of 100 mg per day and 60 mg twice daily have been used in some patients with
Zollinger-Ellison Syndrome. - The regimen for eradication of Helicobacter pylori is rabeprazole 20 mg,
clarithromycin 500 mg, amoxicillin 1000 mg all given twice daily (morning
and evening) for 7 days.
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Which drugs or supplements interact with rabeprazole?
There have been reports of an increase in the
effect of the blood thinner, warfarin
(Coumadin), by rabeprazole which theoretically could
lead to increased bleeding. Patients taking warfarin should be monitored more
frequently if they begin taking rabeprazole. Rabeprazole may reduce the
elimination of cyclosporin in the liver, thereby increasing cyclosporin levels
in the blood and potentially leading to cyclosporin toxicity. The absorption of
certain drugs may be affected by changes in stomach acidity. Rabeprazole and
other PPIs that reduce stomach acid reduce the absorption and concentration in
blood of ketoconazole (Nizoral) and increase the absorption and concentration in
blood of digoxin (Lanoxin). This may lead to reduced effectiveness of
ketoconazole or increased digoxin toxicity, respectively. PPIs may decrease
blood levels of atazanavir (Reyataz).
Is rabeprazole safe to take if I’m pregnant or breastfeeding?
Use in pregnant women has not been adequately evaluated.
Rabeprazole has not been studied in
nursing women.
What else should I know about rabeprazole?
What preparations of rabeprazole are available?
Tablets (Delayed release): 20 mg
How should I keep rabeprazole stored?
Rabeprazole should be stored at room temperature, 15 C – 30 C
(59 F – 86 F) and should be kept away from moisture.