section name header

Pronunciation

ra-BEP-ra-zole

Classifications

Therapeutic Classification: antiulcer agents

Pharmacologic Classification: proton pump inhibitors

Indications

BEERS REMS


Action

  • Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.
Therapeutic effects:
  • Diminished accumulation of acid in the gastric lumen, with lessened acid reflux.
  • Healing of duodenal ulcers and esophagitis.
  • Decreased acid secretion in hypersecretory conditions.

Pharmacokinetics

Absorption: Delayed-release tablet is designed to allow rabeprazole, which is not stable in gastric acid, to pass through the stomach intact. Subsequently 52% is absorbed after oral administration.

Distribution: Unknown.

Protein Binding: 96.3%.

Metabolism/Excretion: Mostly metabolized by the CYP3A4 and CYP2C19 isoenzymes in the liver; (the CYP2C19 enzyme system exhibits genetic polymorphism; 15–20% of Asian patients and 3–5% of Caucasian and Black patients may be poor metabolizers and may have significantly rabeprazole concentrations and an risk of adverse effects); 10% excreted in feces; remainder excreted in urine as inactive metabolites.

Half-Life: 1–2 hr.

Time/Action Profile

(acid suppression)

ROUTEONSETPEAKDURATION
POwithin 1 hrunknown24 hr



Suppression continues to increase over the first wk of therapy.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS (AGEP), cutaneous lupus erythematosus, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), photosensitivity, rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS (TEN)

F and E: hypocalcemia (especially if treatment duration 3 mo), hypokalemia (especially if treatment duration 3 mo), hypomagnesemia (especially if treatment duration 3 mo)

GI: abdominal pain, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), constipation, diarrhea, fundic gland polyps, nausea

GU: acute tubulointerstitial nephritis

MS: bone fracture, neck pain

Neuro: dizziness, headache, malaise

Misc: chills, fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS, ANGIOEDEMA, OR TUBULOINTERSTITIAL NEPHRITIS), systemic lupus erythematosus, vitamin B12 deficiency

Interactions

Drug-drug:

Route/Dosage

Gastroesophageal Reflux Disease

Duodenal Ulcers

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence (Triple Therapy)

Pathological Hypersecretory Conditions Including Zollinger-Ellison Syndrome

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Aciphex, Aciphex Sprinkle

Canadian Brand Names

Pariet

Code

NDC Code