(British Approved Name Modified, US Adopted Name, rINNM)
Drug Nomenclature
INNs in main languages (French, Latin, Russian, and Spanish):
Synonyms: E-3810; LY-307640; Rabeprazol sódico; Sodium PariprazoleAdverse Effects and Precautions
As for Omeprazole.
Effects on the endocrine system
For cases of gynaecomastia associated with rabeprazole.
Effects on the kidneys
For reports of interstitial nephritis associated with rabeprazole.
Effects on the nervous system
For a report of neuropsychiatric symptoms associated with rabeprazole, see under Omeprazole.
Interactions
As for Omeprazole but clinically significant interactions with diazepam, phenytoin, theophylline, or warfarin have not been found in healthy subjects.
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 metabolised in the liver by cytochrome P450 isoenzymes CYP2C19 and CYP3A4 to the thioether, thioether carboxylic acid, sulfone, and desmethylthioether. Metabolites are excreted principally in the urine (about 90%) with the remainder in the faeces. The plasma half-life is about 1 hour, increased two to threefold in hepatic impairment, 1.6 times in CYP2C19 slow metabolisers (see also Metabolism under Omeprazole), and by 30% in the elderly.
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 normally 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. Thereafter, 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 4 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 the treatment of active peptic ulcer disease, 20 mg daily is given for 4 to 8 weeks for duodenal ulcer and 6 to 12 weeks for gastric ulcer. For the eradication of 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 clarithromycin 500 mg twice daily and amoxicillin 1 g twice daily, or combined with clarithromycin 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.
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.