Medications and Drugs
Medical Editor: Jay Marks, M.D.
GENERIC NAME: rabeprazole
BRAND NAME: Aciphex
DRUG CLASS AND MECHANISM:
Rabeprazole is an oral drug that is used for the treatment of conditions caused
by acid. It is in a class of drugs called proton pump inhibitors or PPIs which
block the production of acid by the stomach. Other drugs in the same class include lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium). PPIs are used for the treatment of acid-caused conditions such as stomach and duodenal ulcers,
gastroesophageal reflux disease (GERD) and Zollinger-Ellison Syndrome. Rabeprazole, like other PPIs, blocks the enzyme in the wall of the stomach that makes and secretes acid into the stomach. By blocking the enzyme, the secretion of acid into the stomach is decreased, and this allows ulcers in the stomach and esophagus to heal.
GENERIC AVAILABLE: No.
PRESCRIPTION: Yes.
PREPARATIONS: Tablets: 20 mg
STORAGE: Store at room
temperature, 15-30°C (59-86°F). Keep away from moisture.
PRESCRIBED FOR: Rabeprazole
is used for treating ulcers of the stomach and duodenum, erosive or ulcerative
gastroesophageal reflux disease (GERD) and Zollinger-Ellison Syndrome (in which there is overproduction of acid caused by tumors). It also is used with antibiotics for eradicating Helicobacter pylori infections of the stomach that, along with acid, are responsible for many ulcers.
DOSING: For healing ulcerative or erosive GERD, the recommended dose for adults is 20 mg daily for 4-8 weeks. If healing does not occur after 8 weeks, another 8 week course may be considered. The recommended maintenance dose is 20 mg daily. Heartburn due to GERD
is treated with 20 mg daily for 4 weeks and an additional 4 weeks if symptoms do
not resolve. Ulcers are treated with 20 mg daily for 4 weeks. For the management
of Zollinger-Ellison Syndrome, the starting dose for adults is 60 mg daily, and
the dose is adjusted based on improvement in symptoms, healing of ulcers, or the
effectiveness of acid suppression. Doses of 100 mg per day and 60 mg twice daily
have been used in some patients with Zollinger-Ellison Syndrome. The regimen for eradication of Helicobacter pylori is rabeprazole 20
mg, clarithromycin 500 mg, amoxicillin 1000 mg all
given twice daily (morning and evening) for 7 days.
Tablets should be swallowed whole and should not be
crushed, split or chewed. Rabeprazole can be taken with or without meals since
food has little effect on its absorption.
DRUG INTERACTIONS: There
have been reports of an increase in the effect of the blood thinner, warfarin, by rabeprazole which theoretically could lead to increased bleeding. Patients taking warfarin should be monitored more frequently if the begin taking rabeprazole.
Rabeprazole may reduce the elimination of cyclosporin in
the liver, thereby increasing cyclosporin levels in the blood and potentially
lead to cyclosporin toxicity.
The absorption of certain drugs may be affected by changes in stomach acidity. Rabeprazole and other PPIs that reduce stomach acid reduce the absorption and concentration in blood of ketoconazole (Nizoral) and increase the absorption and concentration in blood of digoxin (Lanoxin). This may lead to reduced effectiveness of ketoconazole or increased digoxin toxicity, respectively.
PREGNANCY: Use in pregnant
women has not been adequately evaluated.
NURSING MOTHERS: Rabeprazole has not been studied in nursing women.
SIDE EFFECTS: Rabeprazole
like other PPIs has few side effects. The most common side effects are diarrhea, nausea, vomiting,
constipation, rash and headaches. Dizziness, nervousness,
abnormal heartbeat, muscle pain, weakness, leg cramps and water retention rarely occur.
References: Aciphex Full Prescribing Information, 2003. Manufactured and Marketed by Eisai Inc., Teaneck, NJ 07666
Reference: FDA Prescribing Information
Last Editorial Review: 9/6/2005
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Gastroesophageal Reflux Disease (GERD, Heartburn) - Learn about gastroesophageal reflux disease (GERD, acid reflux, heartburn) symptoms like heartburn, chest pain, regurgitation, and nausea. Causes, diagnosis, treatment and prevention information is also included.
- pantoprazole, Protonix - Explains the medication pantoprazole (Protonix), a drug used for the treatment of gastroesophageal reflux disease (GERD), like other PPI's it also is used for treating ulcers of the stomach and duodenum, and the Zollinger-Ellison Syndrome.
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