rabeprazole sodium

rabeprazole sodium

AcipHex, Pariet (UK)

Pharmacologic class: Proton pump inhibitor

Therapeutic class: Gastric antisecretory agent

Pregnancy risk category B

Action

Reduces gastric acid secretion and increases gastric mucus and bicarbonate production, creating a protective coating on gastric mucosa

Availability

Tablets (delayed-release): 20 mg

⊘Indications and dosages

➣ Erosive or ulcerative gastroesophageal reflux disease (GERD)

Adults: 20 mg P.O. daily for 4 to 8 weeks. If healing doesn't occur within 8 weeks, another 8 weeks of therapy may be considered. Maintenance dosage is 20 mg P.O. daily.

➣ GERD

Adults: 20 mg P.O. daily for 4 weeks. If symptoms don't resolve after 4 weeks, another course of therapy may be considered.

➣ Hypersecretory conditions, including Zollinger-Ellison syndrome

Adults: Initially, 60 mg P.O. daily; adjust dosage as needed up to 100 mg P.O. daily as a single dose or 60 mg P.O. b.i.d. Maximum daily dosage is 120 mg.

➣ Duodenal ulcer

Adults: 20 mg P.O. daily for up to 4 weeks

➣Helicobacter pylori eradication

Adults: 20 mg P.O. b.i.d. for 7 days (given with amoxicillin and clarithromycin)

Off-label uses

• Dyspepsia
• Benign gastric ulcer

Contraindications

• Hypersensitivity to drug, its components, or benzimidazoles

Precautions

Use cautiously in:
• severe hepatic impairment
• pregnant patients
• breastfeeding patients (not recommended)
• children (safety not established).

Administration

• Don't crush or split tablets.
• Give without regard to food.

Route	Onset	Peak	Duration
P.O.	Within 1 hr	Unknown	24 hr

Adverse reactions

CNS: headache

Interactions

Drug-drug. Gastric pH-dependent drugs (such as digoxin, ketoconazole): increased or decreased absorption

Warfarin: increased risk of bleeding

Patient monitoring

• Stay alert for symptomatic response, but know that a positive response doesn't rule out gastric cancer.

Patient teaching

• Tell patient he may take with or without food. Instruct him not to crush, chew, or split tablets.
• Caution female patient not to breastfeed during therapy.
• As appropriate, review all significant adverse reactions and interactions, especially those related to the drugs mentioned above.