Rabeprazole
Rx
Generic NameRabeprazole
Therapeutic ClassProton Pump Inhibitor (PPI)
Common Dose10–20 mg
Max / Day20 mg
PregnancyCategory B
Indications ▼
Gastroesophageal reflux disease (GERD)
Erosive esophagitis
Duodenal ulcer
Gastric ulcer
Helicobacter pylori eradication (with antibiotics)
Zollinger–Ellison syndrome
Mechanism & Pharmacokinetics ▼
Mechanism: Rabeprazole irreversibly inhibits the gastric H⁺/K⁺-ATPase (proton pump) in parietal cells, leading to profound and long-lasting suppression of basal and stimulated gastric acid secretion.
Pharmacokinetics: Rapid absorption after oral administration. Bioavailability ≈ 52%. Highly protein bound. Extensively metabolized in the liver (mainly CYP3A4, CYP2C19). Eliminated via urine and feces.
Dosage & Administration ▼
| Indication | Dose | Duration |
|---|---|---|
| GERD | 20 mg once daily | 4–8 weeks |
| Duodenal ulcer | 20 mg once daily | 4 weeks |
| H. pylori | 20 mg twice daily | 7–14 days |
| Zollinger–Ellison | 20–60 mg daily | As directed |
Side Effects ▼
Headache
Diarrhea or constipation
Nausea
Abdominal pain
Long-term use: vitamin B12 deficiency, hypomagnesemia
Contraindications ▼
Known hypersensitivity to rabeprazole or other PPIs
Concurrent use with rilpivirine-containing products
Drug Interaction ▼
Reduced absorption of ketoconazole, itraconazole
May alter digoxin levels
Minimal CYP interaction compared to other PPIs
Avoid with acid-dependent antivirals
Pregnancy & Lactation ▼
Pregnancy Category B
No evidence of fetal risk in animal studies
Use during lactation only if clearly needed
Clinical / Research Summary ▼
Therapeutic Role: Rabeprazole is a proton pump inhibitor (PPI) used to treat gastroesophageal reflux disease (GERD), peptic ulcers, Zollinger-Ellison syndrome, and for H. pylori eradication in combination therapy.
Mechanism-Based Evidence: It irreversibly inhibits the H+/K+ ATPase enzyme in gastric parietal cells, reducing gastric acid secretion and increasing gastric pH.
Clinical Effectiveness: Studies show rapid symptom relief in GERD patients, improved healing rates of erosive esophagitis, and effectiveness in duodenal and gastric ulcer healing. Also effective as part of triple therapy for H. pylori eradication.
Safety Profile: Generally well tolerated. Common adverse effects include headache, nausea, diarrhea, abdominal pain. Long-term use may increase risk of vitamin B12 deficiency, hypomagnesemia, and bone fractures.
Research Directions: Ongoing studies focus on optimized dosing for refractory GERD, combination therapies for H. pylori, and effects on gut microbiota.
Patient Counseling Points ▼
Administration: Take Rabeprazole 30–60 minutes before meals, usually once daily. Swallow tablets whole; do not crush or chew.
Missed Dose: Take as soon as remembered. If close to next dose, skip the missed dose. Do not double the dose.
Lifestyle Measures: Avoid lying down immediately after meals, reduce intake of spicy/fatty foods, avoid smoking and alcohol to improve treatment outcomes.
Potential Side Effects: May include headache, nausea, diarrhea, or abdominal pain. Contact healthcare provider if severe or persistent.
Drug Interactions: Inform your doctor about all medications, especially antiretrovirals, anticoagulants, or antifungals.
Long-Term Use: Regular monitoring may be required for magnesium, vitamin B12, and bone health if used long-term.
Pregnancy & Lactation: Use only if clearly needed; consult your healthcare provider.
Follow-Up: Report persistent heartburn, abdominal pain, or any alarming symptoms like black stools or vomiting blood.
Storage & Handling ▼
Store below 30°C
Protect from moisture and heat
Keep out of reach of children
Brand Names (Bangladesh & Global) ▼
Medical Disclaimer: This content is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
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