Rabeprazole Sodium (Aciphex)
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Other names of Aciphex
Barole, Dexrobel-dsr, Eraloc, Eurorapi, Finix, Gastrodine, Gasul, Happi, Intas, Novo-rabeprazole, Paricel, Pariet, Prabex, Rabec, Rabee-isr, Rabeloc, Rabemac, Rabeprazol, Rabeprazolum, Rabibit, Rabibit-d, Rabibit-isr, Rabium, Ramprazole, Razo, Rebilex-dsr, Rebilex-isr, Rotec, Rozy-d, Rozy-dsr, Rozydex, Veloz.
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(British Approved Name Modified, US Adopted Name, rINNM)
What Is Rabeprazole Sodium?
Rabeprazole Sodium is a medication belonging to the proton pump inhibitor (PPI) class, commonly used to treat excess stomach acid production conditions. It works by inhibiting the proton pump in the stomach lining, reducing the secretion of gastric acid. This helps alleviate gastroesophageal reflux disease (GERD) symptoms, such as heartburn and acid regurgitation. Rabeprazole Sodium is also prescribed for the treatment of peptic ulcers and Zollinger-Ellison syndrome, a rare condition causing excessive stomach acid production. It is typically taken orally, and the dosage depends on the specific medical condition being treated. As with any medication, it’s essential to use Rabeprazole Sodium under the guidance of a healthcare professional to ensure its effectiveness and safety.
Pharmacokinetics
Rabeprazole is rapidly absorbed, and peak plasma concentrations are reached about 3.5 hours after an oral dose. The oral bioavailability is about 52% with the enteric-coated tablet formulation because of first-pass metabolism and does not appear to vary after single or repeated doses. Rabeprazole is about 97% bound to plasma proteins. It is extensively metabolized in the liver by cytochrome P450 isoenzymes CYP2C19 and CYP3A4 to the thioether, thioether carboxylic acid, sulfone, and desmethyl thioether. Metabolites are excreted in the urine (about 90%), with the remainder in the feces. The plasma half-life is about 1 hour, increased two to threefold in hepatic impairment, 1.6 times in CYP2C19 slow metabolizers, and 30% in senior patients.
Uses and Administration
Rabeprazole is a proton pump inhibitor with actions and uses similar to those of omeprazole. It is given orally as rabeprazole sodium in the form of enteric-coated tablets. It is usually taken in the morning. In the treatment of severe (erosive or ulcerative) gastro-oesophageal reflux, the usual dose of rabeprazole sodium is 20 mg once daily for 4 to 8 weeks in the USA; a further 8-week course is permitted for healing of erosive oesophagitis. After that, maintenance therapy can be continued with 10 or 20 mg daily, depending on the response.
For symptomatic disease without erosive or ulcerative oesophagitis, a dose of 10 or 20 mg may be given once daily for four weeks in the USA; a further 4-week course is permitted. Once symptoms have resolved, a dose of 10 mg once daily may be given as necessary. For treating active peptic ulcer disease, 20 mg daily is given for 4 to 8 weeks for duodenal ulcers and 6 to 12 weeks for gastric ulcers. To eradicate Helicobacter pylori, rabeprazole sodium may be combined with two antibacterials in a 1-week triple therapy regimen.
Effective regimens include 20 mg twice daily combined with 500 mg twice daily, amoxicillin 1 g twice daily or combined with 250 mg twice daily, and metronidazole 400 mg twice daily. For Zollinger-Ellison syndrome, the starting dose is 60 mg once daily, adjusted according to response. Doses up to 120 mg daily have been given; when the daily dose is more than 100 mg, it should be given in 2 divided doses.
Adverse Effects and Precautions
As for Omeprazole.
Effects on the Endocrine System
Rabeprazole Sodium typically doesn’t have significant direct effects on the endocrine system. However, prolonged use of proton pump inhibitors (PPIs), including rabeprazole, has been associated with a slightly increased risk of bone fractures, particularly in the hip, wrist, and spine. This may be linked to reduced calcium absorption, indirectly affecting bone health.
Effects on the Kidneys
In rare cases, PPIs like rabeprazole may lead to mild kidney issues such as interstitial nephritis. Symptoms may include reduced urine output, swelling, and fatigue. It’s crucial to monitor kidney function, especially in individuals with pre-existing kidney conditions, and consult a healthcare professional if any concerning symptoms arise.
Effects on the Nervous System
Rabeprazole Sodium generally doesn’t directly impact the nervous system. However, there have been rare reports of neurological side effects, including dizziness and headaches. These symptoms are usually mild and transient but should be discussed with a healthcare provider if persistent or severe.
Other Side Effects
Common side effects of Rabeprazole Sodium include nausea, abdominal pain, diarrhea, and flatulence. These are usually temporary and subside as the body adjusts to the medication. Long-term use may also be associated with vitamin B12 deficiency, so regular monitoring and supplementation may be necessary.
It’s important for individuals taking Rabeprazole Sodium to be aware of potential side effects and promptly report any unusual symptoms to their healthcare provider. Always follow the prescribed dosage and consult a healthcare professional before making any changes to the treatment plan.
Interactions
As for Omeprazole. Clinically significant interactions with diazepam, phenytoin, theophylline, or warfarin have not been found in healthy subjects.
Drug Nomenclature
INNs in main languages (French, Latin, Russian, and Spanish):
Synonyms: E-3810; LY-307640; Rabeprazol sódico; Sodium Pariprazole
BAN: Rabeprazole Sodium [BANM]
USAN: Rabeprazole Sodium
INN: Rabeprazole Sodium [rINNM (en)]
INN: Rabeprazol sódico [rINNM (es)]
INN: Rabéprazole Sodique [rINNM (fr)]
INN: Natrii Rabeprazolum [rINNM (la)]
INN: Натрий Рабепразол [rINNM (ru)]
Chemical name: 2-({[4-(3-Methoxypropoxy)-3-methyl-2-pyridyl]methyl}sulfinyl)-1H-benzimidazole sodium
Molecular formula: C18H20N3NaO3S =381.4
CAS: 117976-89-3 (rabeprazole); 117976-90-6 (rabeprazole sodium)
ATC code: A02BC04
Proprietary Preparations
Argentina: Pariet Rabec
Australia: Pariet
Austria: Pariet
Belgium: Pariet
Brazil: Pariet
Canada: Pariet
Chile: Gastrodine
Denmark: Pariet
Finland: Pariet
France: Pariet
Germany: Pariet
Greece: Pariet
Hong Kong: Pariet
Hungary: Pariet
India: Odirab Rabeloc Rabicip
Indonesia: Pariet
Ireland: Pariet
Italy: Pariet
Japan: Pariet
Malaysia: Pariet
Mexico: Pariet
The Netherlands: Pariet
Philippines: Pariet
Poland: Pariet
Portugal: Pariet
Russia: Pariet
South Africa: Pariet
Singapore: Pariet
Spain: Aciphex Pariet
Sweden: Pariet
Switzerland: Pariet
Thailand: Pariet
Turkey: Pariet
United Kingdom: Pariet
USA: Aciphex
Venezuela: Pariet
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.