Rabeprazole (Aciphex) is a proton-pump inhibitor that irreversibly inhibits gastric acid secretion. It is used to treat patients with GERD, Gastric and Duodenal Ulcers, dyspepsia, hypersecretory states, and eradication of H.Pylori.

Rabeprazole Uses:

• Duodenal ulcers (tablets only):

  • It is indicated for short-term (4 weeks or fewer) treatment in the healing and symptomatic relief of duodenal ulcers in adults.

• Gastroesophageal reflux disease:

  • It is used to treat erosive or ulcerative (tablets only): Short-term (4 - 8 weeks) treatment in the healing and symptomatic relief of erosive or ulcerative gastroesophageal reflux disease (GERD) in adults; for maintaining healing and reduction in relapse rates of heartburn symptoms in adults with erosive or ulcerative GERD.
  • Symptomatic (non-erosive): Treatment of symptomatic GERD for up to 4 weeks in adults (tablets only), up to 8 weeks in children ≥12 years and adolescents (tablets only), and up to 12 weeks in children 1 to 11 years of age (capsules only).

• Helicobacter pylori eradication (tablets only):

  • It is used in combination with amoxicillin and clarithromycin as the triple regime for  H. pylori eradication and healing of duodenal ulcer disease (active or history of within the past 5 years)

• Pathological hypersecretory conditions (tablets only):

  • It is used for the long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome in adults.

• Off Label Use of Rabeprazole in Adults:

  • Dyspepsia;
  • Gastric ulcer (treatment);
  • NSAID-induced ulcer prophylaxis;
  • Prevention of recurrent gastric or duodenal ulcer bleeding postendoscopy;
  • Stress ulcer prophylaxis in critically-ill patients

Rabeprazole Dose in Adults

Rabeprazole Dose in the treatment of Duodenal ulcer: Tablets:

• Oral: 20 mg once  a day for ≤ 4 weeks

Rabeprazole Dose in the treatment of Dyspepsia (off-label):

• Oral: 20 mg once a day for up to 8 weeks

Rabeprazole Dose in the treatment of Gastric ulcer (off-label):

• Oral: 20 mg once a day for 8 weeks based on healing and/or ulcer complications

Rabeprazole Dose in the treatment of Gastroesophageal reflux disease (GERD): Tablets: Oral:

• Erosive or ulcerative GERD:

  • Treatment: 20 mg once a day for 4 - 8 weeks; If there is no sufficient response, the dose can be repeated up to an additional 8 weeks; maintenance: 20 mg once a day

• Symptomatic GERD (non-erosive):

  • Treatment: 20 mg once a day for ≤4 weeks; If there is no sufficient response dose can be repeated for an additional 4 weeks.

Rabeprazole Dose in the treatment of Helicobacter pylori eradication: Tablets: Oral:

• Manufacturer labeling:

  • 20 mg twice a day along with amoxicillin 1,000 mg and clarithromycin 500 mg twice a day for 7 days

• American College of Gastroenterology guidelines:

  • Clarithromycin triple regimen:

    • 20 - 40 mg twice a day along with clarithromycin 500 mg twice a day and either amoxicillin 1 g twice a day or metronidazole 500 mg 3 times per day
    • Continue regimen for 14 days.

Note:

• Do not use clarithromycin triple therapy in patients with  higher risk macrolide resistance e.g. prior macrolide exposure, local clarithromycin resistance rates ≥15%, eradication rates with clarithromycin-based regimens ≤85%)

• Bismuth quadruple regimen:

  • 20 mg twice a day along with tetracycline 500 mg 4 times a day, metronidazole 250 mg 4 times a day or 500 mg 3 or 4 times a day, and either bismuth subcitrate 120 - 300 mg 4 times a day or bismuth subsalicylate 300 mg 4 times a day;
  • Continue regimen for 10 - 14 days.

• Concomitant regimen:

  • 20 mg twice a day along with amoxicillin 1 g twice a day, clarithromycin 500 mg twice a day, and either metronidazole or tinidazole 500 mg twice a day
  • Continue regimen for 10 - 14 days.

• Sequential regimen:

  • 20 mg twice a day plus amoxicillin 1 g twice a day for 5 - 7 days; then
  • Continue rabeprazole along with clarithromycin 500 mg twice a day, and either metronidazole or tinidazole 500 mg twice a day for 5 - 7 days.

• Hybrid regimen:

  • 20 mg twice a day plus amoxicillin 1 g twice a day for 7 days; then continue rabeprazole and amoxicillin along with clarithromycin 500 mg twice a day, and either metronidazole or tinidazole 500 mg twice a day for 7 days.

• Levofloxacin triple regimen:

  • 20 mg twice a day along with amoxicillin 1 g twice a day and levofloxacin 500 mg once a day; continue regimen for 10 - 14 days

Rabeprazole Dose in the treatment of Hypersecretory conditions (including Zollinger-Ellison Syndrome): Tablets:

• Oral: Initial: 60 mg once a day and then further dose according to patient's needs (some may require divided doses). Doses as high as 100 mg once a day and 60 mg twice a day can be given, can be given as long as the clinical requirement.

Rabeprazole Dose in the treatment of NSAID-induced ulcer prophylaxis (off-label):

• Oral: 5 - 20 mg once a day for 12 - 24 weeks

Rabeprazole Dose in the Prevention of recurrent gastric or duodenal ulcer bleeding post endoscopy (off-label):

• Oral: 20 mg twice a day for 72 hours

• Discontinuation of therapy:

  • In order to avoid worsening or rebound symptoms, a step-down approach is considered in some cases.
  • Dose reduction by 50% is considered over 2 to 4 weeks.
  • Alternate drugs should be used if the patient is already on the lowest possible dose.
  • Patients should be reassessed in case of worsening symptoms or withdrawal.

Rabeprazole Dose in Childrens

Rabeprazole Dose in the treatment of symptomatic GERD:

Note: According to recommendation of guidelines, It can be used up to 4-8 weeks and then wean off with clinical response, if no response after 4 - 8 weeks, reevaluate diagnosis and consider referral to pediatric GI specialist

• Infants: Limited data available:

  • Oral: Sprinkle capsules: 5 - 10 mg once a day

• Children ≤11 years:

  • Oral: Sprinkle capsules:
    • <15 kg: 5 mg once a day; Dose can be increased up to 10 mg once a day.
    • ≥15 kg: 10 mg once a day, higher doses of 20 mg has been given

• Children ≥12 years and Adolescents:

  • Oral: Tablets: 20 mg once a day.

Rabeprazole Dose in the treatment of Helicobacter pylori eradication:

Note: Usually, it is used for 14 days for triple therapy along with 2 antimicrobials (eg, clarithromycin, metronidazole, amoxicillin); preferred agents determined by susceptibility. Bismuth may be added to regimens as an alternative if resistance is present or susceptibility is unknown.

• Children and Adolescents <16 years:

  • 6 to <10 kg: Oral: 10 mg twice a day.
  • 10 to <30 kg: Oral: 15 mg twice a day.
  • ≥30 kg: Oral: 20 mg twice a day.

• Discontinuation of therapy:

  • Based on experience in adults: In order to avoid worsening or rebound symptoms, a step-down approach is considered in some cases.
  • Dose reduction by 50% is considered over 2 to 4 weeks.
  • Alternate drugs should be used if the patient is already on the lowest possible dose.
  • Patients should be reassessed in case of worsening symptoms or withdrawal.

Pregnancy Risk Category: N (Not assigned)

• Recommendations for treating GERD in pregnancy are available.
• Lifestyle modification and other medications are the first treatment options for pregnant patients.
• Based on the available data, PPIs can be used when indicated by the physician.

Rabeprazole use during breastfeeding:

• It is unknown if Rabeprazole is excreted in breast milk.
• After considering the risks of infant exposure, benefits of breastfeeding to the baby, and benefits to the mother, Rabeprazole should not be administered.

Dose in Kidney Disease:

No dosage adjustment required

Dose in Liver disease:

• Mild-to-moderate impairment (Child-Pugh class A or B): No dosage adjustment required.
• Severe impairment (Child-Pugh class C): Avoid use; if treatment is required monitor for adverse reactions.

Common Side Effects of Rabeprazole:

• Gastrointestinal:

  • Diarrhea
  • Abdominal Pain
  • Vomiting

Less Common Side Effects of Rabeprazole:

• Cardiovascular:

  • Peripheral Edema

• Central Nervous System:

  • Headache
  • Pain
  • Dizziness

• Gastrointestinal:

  • Nausea
  • Flatulence
  • Constipation
  • Xerostomia

• Hepatic:

  • Hepatic Encephalopathy
  • Hepatitis
  • Increased Liver Enzymes

• Infection:

  • Infection

• Neuromuscular & Skeletal:

  • Arthralgia
  • Myalgia

• Respiratory:

  • Pharyngitis

Contraindications to Rabeprazole:

• Hypersensitivity to rabeprazole or other substitutedbenzimidazoles or any component of this formulation
• Concomitant use with rilpivirine-containing products

Warnings and precautions

• Atrophic gastritis

  • Atrophic gastritis may occur if omeprazole and rabeprazole are combined for long-term treatment

• Carcinoma

  • There are no reports of adenomatoid, dysplastic, or neoplastic changes of enterochromaffin-like (ECL) cells in the gastric mucosa have occurred.

• Clostridium difficile-associated diarrhea (formerly Clostridium), Clostridioides:

  • There has been an increase in the risk of CDAD due to the use of proton pump inhibitors, (PPIs).
  • CDAD should be considered for patients with diarrhea, especially elderly patients who are hospitalized.
  • The lowest effective dose of PPIs (including pantoprazole) should be administered and the duration should not exceed 30 minutes.

• Cutaneous and systemic Lupus Erythematosus

  • Rabeprazole has been linked to autoimmune diseases such as Lupus.
  • The majority of cases reported involved cutaneous lupus, which is most commonly subacute and can last for weeks or months.
  • It is rarer to get systemic lupus, which can occur in a matter of days. This is most common in young adults.
  • The patient must stop receiving treatment and be referred to the specialist.
  • After discontinuing treatment, symptoms usually improve in 4-12 weeks.

• Fractures

  • Increased bone fracture risk has been linked to PPIs such as rabeprazole.
  • The hip, spine and wrist are the most common fractures that PPIs cause.
  • Long-term therapy patients (more than one year) as well as those who take high doses PPIs must be evaluated for osteoporosis.
  • These patients require adequate calcium intake and vitamin D supplements.

• Polyps of the fundic gland:

  • Long-term (more than one) use of PPIs has been linked to an increase in risk of stomach polyps.
  • The best PPIs should not be taken for longer than necessary and at the lowest dose.
  • Diagnosis of gastrointestinal polyps can lead to dyspepsia or gastrointestinal bleeding, anemia or obstruction.
• Gastrointestinal infection (eg, Salmonella, Campylobacter):
  • These infections can be exacerbated by the use of proton pump inhibitors.

• Hypomagnesemia:

  • Long-term use of PPIs (three months or more) has been associated with hypomagnesemia, either symptomatic or asymptomatic.
  • Baseline serum magnesium levels should always be checked when PPIs are to be used for long-term purposes.
  • Patients taking concomitant medications which may cause hypomagnesemia, or medication that may increase the risk of arrhythmias, should have their baseline serum magnesium levels checked before initiating long-term PPIs.
  • When the medication is stopped along with magnesium supplementation, hypomagnesemia will usually disappear within 2 weeks.

• Interstitial nephritis:

  • Acute interstitial Nephritis may be a sign of idiopathic hypersensitivity reactions. This can occur at any stage during treatment.

• Vitamin B deficiency:

  • Long-term (more than two years) use may lead to malabsorption, which can manifest as diarrhea or deficiency in B complex vitamins.
  • Malabsorption is more common in younger patients and females.
  • When PPI treatment is stopped, the condition will improve.

• Gastric cancer:

  • PPIs can mask the symptoms of gastrointestinal malignancies.

• Hepatic impairment

  • It should be avoided in cases of severe hepatic impairment. If it is indicated, monitor carefully

Rabeprazole: Drug Interaction

Risk Factor C (Monitor therapy)
Amphetamine	Proton Pump Inhibitors may increase the absorption of Amphetamine.
Bisphosphonate Derivatives	Proton Pump Inhibitors may diminish the therapeutic effect of Bisphosphonate Derivatives.
Bosentan	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Capecitabine	Proton Pump Inhibitors may diminish the therapeutic effect of Capecitabine.
Cefpodoxime	Proton Pump Inhibitors may decrease the serum concentration of Cefpodoxime.
CYP2C19 Inducers (Moderate)	May decrease the serum concentration of CYP2C19 Substrates (High risk with Inducers).
CYP3A4 Inducers (Moderate)	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Cysteamine (Systemic)	Proton Pump Inhibitors may diminish the therapeutic effect of Cysteamine (Systemic).
Deferasirox	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Dexmethylphenidate	Proton Pump Inhibitors may increase the absorption of Dexmethylphenidate. Specifically, proton pump inhibitors may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption.
Dextroamphetamine	Proton Pump Inhibitors may increase the absorption of Dextroamphetamine. Specifically, the dextroamphetamine absorption rate from mixed amphetamine salt extended release (XR) capsules may be increased in the first hours after dosing.
Doxycycline	Proton Pump Inhibitors may decrease the bioavailability of Doxycycline.
Erdafitinib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Fluconazole	May increase the serum concentration of Proton Pump Inhibitors.
Indinavir	Proton Pump Inhibitors may decrease the serum concentration of Indinavir.
Iron Salts	Proton Pump Inhibitors may decrease the absorption of Iron Salts. Exceptions: Ferric Carboxymaltose; Ferric Citrate; Ferric Gluconate; Ferric Hydroxide Polymaltose Complex; Ferric Pyrophosphate Citrate; Ferumoxytol; Iron Dextran Complex; Iron Isomaltoside; Iron Sucrose.
Ivosidenib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Methotrexate	Proton Pump Inhibitors may increase the serum concentration of Methotrexate.
Methylphenidate	Proton Pump Inhibitors may increase the absorption of Methylphenidate. Specifically, proton pump inhibitors may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption.
Multivitamins/Minerals (with ADEK, Folate, Iron)	Proton Pump Inhibitors may decrease the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron). Specifically, the absorption of iron may be decreased.
Mycophenolate	Proton Pump Inhibitors may decrease the serum concentration of Mycophenolate. Specifically, concentrations of the active mycophenolic acid may be reduced.
Raltegravir	Proton Pump Inhibitors may increase the serum concentration of Raltegravir.
Riociguat	Proton Pump Inhibitors may decrease the serum concentration of Riociguat.
Saquinavir	Proton Pump Inhibitors may increase the serum concentration of Saquinavir.
Sarilumab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Siltuximab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
SORAfenib	Proton Pump Inhibitors may decrease the absorption of SORAfenib.
Tipranavir	May decrease the serum concentration of Proton Pump Inhibitors. These data are derived from studies with Ritonavir-boosted Tipranavir.
Tocilizumab	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).
Voriconazole	May increase the serum concentration of Proton Pump Inhibitors. Proton Pump Inhibitors may increase the serum concentration of Voriconazole. Management: In patients receiving omeprazole 40 mg/day or greater, reduce omeprazole dose by half when initiating voriconazole.
Risk Factor D (Consider therapy modification)
Atazanavir	Proton Pump Inhibitors may decrease the serum concentration of Atazanavir. Management: See full drug interaction monograph for details.
Bosutinib	Proton Pump Inhibitors may decrease the serum concentration of Bosutinib. Management: Consider alternatives to proton pump inhibitors, such as short-acting antacids or histamine-2 receptor antagonists. Administer alternative agents more than 2 hours before or after bosutinib.
Cefditoren	Proton Pump Inhibitors may decrease the serum concentration of Cefditoren. Management: If possible, avoid use of cefditoren with proton pump inhibitors (PPIs). Consider alternative methods to minimize/control acid reflux (eg, diet modification) or alternative antimicrobial therapy if use of PPIs can not be avoided.
CYP2C19 Inducers (Strong)	May increase the metabolism of CYP2C19 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.
CYP3A4 Inducers (Strong)	May increase the metabolism of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.
Dabrafenib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects).
Dabrafenib	May decrease the serum concentration of CYP2C19 Substrates (High risk with Inducers). Management: Seek alternatives to the CYP2C19 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects).
Enzalutamide	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP3A4 substrate should be performed with caution and close monitoring.
Enzalutamide	May decrease the serum concentration of CYP2C19 Substrates (High risk with Inducers). Conversely, concentrations of active metabolites may be increased for those drugs activated by CYP2C19. Management: Concurrent use of enzalutamide with CYP2C19 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP2C19 substrate should be performed with caution and close monitoring.
Gefitinib	Proton Pump Inhibitors may decrease the serum concentration of Gefitinib. Management: Avoid use of proton pump inhibitors (PPIs) with gefitinib when possible. If required, administer gefitinib 12 hours after administration of the PPI or 12 hours before the next dose of the PPI.
Itraconazole	Proton Pump Inhibitors may increase the serum concentration of Itraconazole. Proton Pump Inhibitors may decrease the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any proton pump inhibitors (PPIs). Exposure to Tolsura brand itraconazole may be increased by PPIs; consider itraconazole dose reduction.
Ketoconazole (Systemic)	Proton Pump Inhibitors may decrease the serum concentration of Ketoconazole (Systemic). Ketoconazole (Systemic) may increase the serum concentration of Proton Pump Inhibitors. Management: Avoid concomitant administration of proton pump inhibitors (PPIs) and ketoconazole when possible due to the risk of ketoconazole therapeutic failure. Administration of ketoconazole with an acidic beverage (eg, cola) may facilitate ketoconazole absorption.
Ledipasvir	Proton Pump Inhibitors may decrease the serum concentration of Ledipasvir. Management: PPI doses equivalent to omeprazole 20 mg or lower may be given with ledipasvir under fasted conditions. Administration with higher doses of PPIs, 2 hours after a PPI, or in combination with food and PPIs may reduce ledipasvir bioavailability.
Lorlatinib	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Avoid concurrent use of lorlatinib with any CYP3A4 substrates for which a minimal decrease in serum concentrations of the CYP3A4 substrate could lead to therapeutic failure and serious clinical consequences.
Mesalamine	Proton Pump Inhibitors may diminish the therapeutic effect of Mesalamine. Proton pump inhibitor-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Consider avoiding concurrent administration of high-dose proton pump inhibitors (PPIs) with sustainedrelease mesalamine products.
Mitotane	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Doses of CYP3A4 substrates may need to be adjusted substantially when used in patients being treated with mitotane.
Nilotinib	Proton Pump Inhibitors may decrease the serum concentration of Nilotinib. Management: Avoid this combination when possible since separation of doses is not likely to be an adequate method of minimizing the interaction.
Posaconazole	Proton Pump Inhibitors may decrease the serum concentration of Posaconazole.
Risedronate	Proton Pump Inhibitors may diminish the therapeutic effect of Risedronate. Proton Pump Inhibitors may increase the serum concentration of Risedronate. This applies specifically to use of delayed-release risedronate.
Secretin	Proton Pump Inhibitors may diminish the diagnostic effect of Secretin. Specifically, use of PPIs may cause a hyperresponse in gastrin secretion in response to secretin stimulation testing, falsely suggesting gastrinoma. Management: Avoid concomitant use of proton pump inhibitors (PPIs) and secretin, and discontinue PPIs several weeks prior to secretin administration, with the duration of separation determined by the specific PPI. See full monograph for details.
St John's Wort	May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.
Tacrolimus (Systemic)	Proton Pump Inhibitors may increase the serum concentration of Tacrolimus (Systemic). Management: Tacrolimus dose adjustment may be required. Rabeprazole, pantoprazole, or selected H2-receptor antagonists (i.e., ranitidine or famotidine) may be less likely to interact. Genetic testing may predict patients at highest risk.
Risk Factor X (Avoid combination)
Acalabrutinib	Proton Pump Inhibitors may decrease the serum concentration of Acalabrutinib.
Cefuroxime	Proton Pump Inhibitors may decrease the absorption of Cefuroxime.
Dacomitinib	Proton Pump Inhibitors may decrease the serum concentration of Dacomitinib. Management: Avoid concurrent use of dacomitinib with proton pump inhibitors. Antacids may be used. Histamine H2-receptor antagonists (HR2A) may be used if dacomitinib is given at least 6 hours before or 10 hours after the H2RA.
Dasatinib	Proton Pump Inhibitors may decrease the serum concentration of Dasatinib. Management: Antacids (taken 2 hours before or after dasatinib administration) can be used in place of the proton pump inhibitor if some acid-reducing therapy is needed.
Delavirdine	Proton Pump Inhibitors may decrease the serum concentration of Delavirdine. Management: Chronic therapy with proton pump inhibitors (PPIs) should be avoided in patients treated with delavirdine. The clinical significance of short-term PPI therapy with delavirdine is uncertain, but such therapy should be undertaken with caution.
Erlotinib	Proton Pump Inhibitors may decrease the serum concentration of Erlotinib.
Nelfinavir	Proton Pump Inhibitors may decrease serum concentrations of the active metabolite(s) of Nelfinavir. Proton Pump Inhibitors may decrease the serum concentration of Nelfinavir.
Neratinib	Proton Pump Inhibitors may decrease the serum concentration of Neratinib. Specifically, proton pump inhibitors may reduce neratinib absorption.
PAZOPanib	Proton Pump Inhibitors may decrease the serum concentration of PAZOPanib.
Pexidartinib	Proton Pump Inhibitors may decrease the serum concentration of Pexidartinib. Management: If acid-reduction is needed, consider administering an antacid 2 hours before or after pexidartinib, or administer pexidartinib 2 hours before or 10 hours after an H2 receptor antagonist.
Rilpivirine	Proton Pump Inhibitors may decrease the serum concentration of Rilpivirine.
Velpatasvir	Proton Pump Inhibitors may decrease the serum concentration of Velpatasvir.

Monitoring parameters:

• Magnesium levels before starting the therapy and then periodically if rabeprazole is being used for the long term or with concomitant use of digoxin, diuretics, or other drugs that cause hypomagnesemia
• Susceptibility testing recommended in patients who fail the H.pylori eradication regimen.

How to administer Rabeprazole?

• It can be taken with an anti-inflammatory.

Capsules

• It can be used 30 minutes before you prepare a meal.
• You can use the entire contents of an open capsule with any other food, or just the contents.
  • A small amount of soft foods (e.g., applesauce or fruit- or vegetable-based baby food, yogurt, etc.)
  • A small amount of liquid (eg infant formula, apple juice or pediatric electrolyte solutions)
  • Liquids and food should be kept at room temperature.
  • Do not keep the entire dose for more than 15 minutes after preparation.

Tablets

• Consume whole
• Do not crush, break, or chew.
• You can take it with or without food.
• Take after a meal if indicated for duodenal ulcers
• Take with your morning and evening meals if H. pylori is indicated.

Mechanism of action of Rabeprazole:

• The proton pump inhibitors block the (H+ and K+) ATPase enzyme, which is the last step in the production of gastric acid.
• This decreases the acid secretion within the gastric parietal cells.

The onset of action: Within 1 hour

Duration: 24 hours

Absorption: Oral: Well absorbed within 1 hour; food delayed absorption up to 4 hours or longer

Protein binding: 96.3%

Metabolism:

• Hepatic via CYP3A and 2C19 to inactive metabolites

Bioavailability: Tablet: ~52%

Half-life elimination (dose-dependent):

• Children ≤11 years: 2.5 hours
• Children ≥12 years and Adolescents: 20 mg tablet: 0.97 ± 0.19 hours
• Adults: 1 - 2 hours

Time to peak, plasma:

• Children ≤11 years: Sprinkle capsule: 2 - 4 hours
• Children ≥12 years and Adolescents: 20 mg tablet: 4.1 ± 0.45 hours
• Adults: Tablet: 2 - 5 hours; Sprinkle capsule: 1 - 6.5 hours

Excretion:

• Urine (90% primarily as thioether carboxylic acid metabolites)
• Remainder in feces

International Brand Names of Rabeprazole:

• Aciphex
• AcipHex Sprinkle
• Abbott-Rabeprazole
• APO-Rabeprazole
• DOM-Rabeprazole EC
• MYLAN-Rabeprazole
• Pariet
• PMS-Rabeprazole EC
• PRO-Rabeprazole
• RAN-Rabeprazole
• RIVA-Rabeprazole EC
• SANDOZ Rabeprazole
• TEVA-Rabeprazole EC
• Acifix
• Acilesol
• Aciprazol
• Ares
• Barole
• Bepra
• Gastrodine
• Gelbra
• Happi
• Hygigastin
• Noflux
• Pacredo
• Paliell
• Paramet
• Parbezol
• Paricel
• Pariet
• Parzol
• Promto
• Rabe
• Rabeact
• Rabeact-20
• Rabec
• Rabecid
• Rabegen
• Rabekind
• Rabeloc
• Rabeol
• Raberin
• Rabesta
• Rabestad
• Rabet
• Rabetra
• Rabezole
• Rabiet
• Rabister
• Rabium
• Rabtas
• Rapoxol
• Rapzol
• Rasonix
• Raxium
• Razit
• Razole
• Relitaz
• Renom
• Risol
• Veloz
• Zabep
• Zulbex

Rabeprazole Brand Names in Pakistan:

Rabeprazole Injection 20 Mg in Pakistan
Rabz	Wilshire Laboratories (Pvt) Ltd.
Virotab	Vision 2000 Plus

 

Rabeprazole Tablets 10 Mg in Pakistan
Albizole	Lexicon Pharmaceuticals (Pvt) Ltd.
Apt	Nexus Pharma (Pvt) Ltd
Arro	Tabros Pharma
Arzol	Shrooq Pharmaceuticals
Bepra	Consolidated Chemical Laboratories (Pvt) Ltd.
Cara-Rib	Caraway Pharmaceuticals
Cararib	Caraway Pharmaceuticals
Eraze	Shaigan Pharmaceuticals (Pvt) Ltd
Novipraz	Novins International
Promto	Getz Pharma Pakistan (Pvt) Ltd.
Protorib	Helix Pharma (Private) Limited
Rabecid	Highnoon Laboratories Ltd.
Rabecid	Highnoon Laboratories Ltd.
Rabipra	Envoy Pharma
Rabosh	Bosch Pharmaceuticals (Pvt) Ltd.
Ratiser	Sami Pharmaceuticals (Pvt) Ltd.
Rebaz	Cirin Pharmaceuticals (Pvt) Ltd.
Rebeloc	Cherwel Pharmaceuticals (Pvt) Ltd
Rebip	Genome Pharmaceuticals (Pvt) Ltd
Rebosive	Max Pharmaceuticals
Rebzer	Mega Pharmaceuticals (Pvt) Ltd
Repar	Barrett Hodgson Pakistan (Pvt) Ltd.
Revolt	Shrooq Pharmaceuticals
Ribazep	Swan Pharmaceuticals(Pvt) Ltd
Rpz	High - Q International
Wiber	Wns Field Pharmaceuticals

 

Rabeprazole Tablets 20 Mg in Pakistan
Acifix	Aries Pharmaceuticals (Pvt) Ltd
Aciphexa	Medicraft Pharmaceuticals (Pvt) Ltd.
Albizole	Lexicon Pharmaceuticals (Pvt) Ltd.
Alcifix	Accurate Medical Suppliers
Apt	Nexus Pharma (Pvt) Ltd
Arro	Tabros Pharma
Awapro	Usawa Pharmaceuticals
Bebra	Karachi Chemical Industries
Bepra	Consolidated Chemical Laboratories (Pvt) Ltd.
Bezolid	Pulse Pharmaceuticals
Bromasal	Universal Pharmaceuticals (Pvt) Ltd
Cara-Rib	Caraway Pharmaceuticals
Cararib	Caraway Pharmaceuticals
Eraze	Shaigan Pharmaceuticals (Pvt) Ltd
Novipraz	Novins International
Prazole	Prays Pharmaceuticals
Procone	Pharma Health Pakistan (Pvt) Ltd
Promto	Getz Pharma Pakistan (Pvt) Ltd.
Protorib	Helix Pharma (Private) Limited
Rabecid	Highnoon Laboratories Ltd.
Rabecid	Highnoon Laboratories Ltd.
Rabek	Fynk Pharmaceuticals
Rabep Ec	Gray`S Pharmaceuticals
Rabetec	Opal Laboratories (Pvt) Ltd.
Rabezole	Pulse Pharmaceuticals
Rabipra	Envoy Pharma
Rabosh	Bosch Pharmaceuticals (Pvt) Ltd.
Rabz	Wilshire Laboratories (Pvt) Ltd.
Rabzole	Everest Pharmaceuticals
Ransid	Mcolson Research Laboratories
Rapezol	Rakaposhi Pharmaceutical (Pvt) Ltd.
Rapro	Paramount Pharmaceuticals
Ratiser	Sami Pharmaceuticals (Pvt) Ltd.
Rebaz	Cirin Pharmaceuticals (Pvt) Ltd.
Rebosive	Max Pharmaceuticals
Rebzer	Mega Pharmaceuticals (Pvt) Ltd
Repar	Barrett Hodgson Pakistan (Pvt) Ltd.
Revolt	Shrooq Pharmaceuticals
Ribazep	Swan Pharmaceuticals(Pvt) Ltd
Robetec	Panacea Pharmaceuticals
Rpz	High - Q International
Stareb	Standard Drug Co.
Wiber	Wns Field Pharmaceuticals
Zechin	S.J. & G. Fazul Ellahie (Pvt) Ltd.

 

Rabeprazole Tablets 40 Mg in Pakistan
Isra	Tagma Pharma (Pvt) Ltd.
Rabzole	Everest Pharmaceuticals
Rebek	Fynk Pharmaceuticals
Rebip	Genome Pharmaceuticals (Pvt) Ltd

 

Rabeprazole Capsules 10 Mg in Pakistan
Rabiton	Envoy Pharma
Repit	Shrooq Pharmaceuticals
Zolben	Benson Pharamceuticals.

 

Rabeprazole Capsules 20 Mg in Pakistan
Rabeadvan	Advanced Pharmaceuticals
Rabeloc	Aries Pharmaceuticals (Pvt) Ltd
Rabezin	Panacea Pharmaceuticals
Rabiton	Envoy Pharma
Rabixin	Genetics Pharmaceuticals
Renom	Genome Pharmaceuticals (Pvt) Ltd
Repit	Shrooq Pharmaceuticals
Zolben	Benson Pharamceuticals.

 

Rabeprazole Capsules 40 Mg in Pakistan
R-Zole	Rogen Pharmaceuticals

 

Rabeprazole Capsules 200 Mg in Pakistan
Rabecap	Aries Pharmaceuticals (Pvt) Ltd