RABEPRAZOLE SODIUM

RABEPRAZOLE SODIUM
(rab-e-pra'zole)
AcipHex
Classifications: proton pump inhibitor;
Therapeutic: antiulcer
; proton pump inhibitor
Prototype: Omeprazole
Pregnancy Category: B

Availability

20 mg tablets

Action

Gastric proton pump inhibitor that specifically suppresses gastric acid secretion by inhibiting the H+, K+-ATPase enzyme system [the acid (proton H+) pump] in the parietal cells of the stomach. Produces an antisecretory effect on the hydrogen ion (H+) in the parietal cells.

Therapeutic Effect

Effectiveness indicated by a negative urea breath test for H. pylori with preexisting gastric ulcer; also by elimination of S&S of GERD or peptic ulcers.

Uses

Healing and maintenance of healing of erosive or ulcerative gastroesophageal reflux disease (GERD); healing of duodenal ulcers; treatment of hypersecretory conditions.

Contraindications

Hypersensitivity to rabeprazole, lansoprazole, or omeprazole or proton pump inhibitors (PPIs); lactation.

Cautious Use

Pregnancy (category B); severe hepatic impairment; mild to moderate hepatic disease; Japanese. Safety and efficacy in children <18 y are not established.

Route & Dosage

Healing of Erosive GERD
Adult: PO 20 mg q.d. x 48 wk, may continue up to 16 wk if needed

Maintenance Therapy for GERD
Adult: PO 20 mg q.d.

Healing Duodenal Ulcer
Adult: PO 20 mg q.d. x 4 wk

Hypersecretory Disease
Adult: PO 60 mg q.d. in 1–2 divided doses (max: 100 mg q.d. or 60 mg b.i.d.)

Administration

Oral
  • Adjust dose as needed with preexisting liver disease.
  • Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

Body as a Whole: Headache. Skin: (Rare) Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme.

Interactions

Drug: May decrease absorption of ketoconazole; may increase digoxin levels. Herbal: Ginkgo may decrease plasma levels.

Pharmacokinetics

Absorption: 52% bioavailability. Distribution: 96% protein bound. Metabolism: In liver by (CYP3A4, 2C19). Elimination: Primarily in urine. Half-Life: 1–2 h.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Routine serum chemistry; serum gastrin in long-term therapy.
  • Coadministered drugs: Monitor for changes in digoxin blood level.

Patient & Family Education

  • Report diarrhea, skin rash, other bothersome adverse effects to physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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