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