OMIRA

Rabeprazole's mechanism of action involves the permanent inhibition of proton pumps in the stomach, which are responsible for gastric acid production. It is a prodrug - in the acid environment of the parietal cells, rabeprazole inhibits the H⁺K⁺ATPase of the coating gastric cells and gastric acid secretion is suppressed.

Indications

Reflux esophagitis
Gastro esophageal reflux disease (GERD)
Non cardiac chest pain
NSAIDs induced gastritis
Functional dyspepsia
Peptic Ulcer Disease (PUD)
Helicobacter pylori infection
Zollinger-Ellison (ZE) Syndrome

Dosage

Route of administration: Oral

GERD: 20 mg orally once a day up to 4 weeks
Reflux esophagitis: 20 mg orally once a day up to 4-8 weeks
Gastric (stomach) Ulcer: 20 mg orally once a day for 4-8 weeks
Duodenal (intestinal) Ulcer: 20 mg orally once a day up to 4 weeks
Zollinger Ellison Syndrome: 60 mg orally once a day
Helicobacter Pylori infection: 20 mg orally 2 times a day, taken concomitantly with amoxicillin and clarithromycin for 7 days

Better efficacy if taken 30 minutes before meal.

Pharmacokinetics

Absorption: Absolute bioavailability is approximately 52%.

Protein binding: 96.3% (bound to human plasma proteins)

Metabolism: Hepatic

Route of elimination: approximately 90% of the drug was eliminated in the urine.

Half-life: 1-2 hours (in plasma)

Adverse Effects

The most common side effects include headache, nausea, and diarrhea. Others include rashes, flu-like symptoms and infections. (Including by the gastrointestinal pathogen Clostridium difficile)

Contraindications

Rabeprazole is contraindicated in the following populations and situations:

People with a known hypersensitivity to rabeprazole, substituted benzimidazoles (which are chemically similar to rabeprazole, like omeprazole), or any other component of the capsule formulation (e.g. certain dyes)

Drug Interactions

The acid-suppression effects of rabeprazole, like other PPIs, may interfere with the absorption of drugs that require acid, such as ketoconazole and digoxin.
Two medications in the same class as rabeprazole can disturb the conversion of an anticoagulant medication called clopidogrel to its active metabolite.
Concurrent use of rilpivirine, a medication used to treat HIV infection; decreases the absorption of rilpivirine.