What is Rabeprazole
Rabeprazole is a gastric proton-pump inhibitor (PPI) indicated for the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger-Ellison syndrome.
Rabeprazole is also indicated for short-term treatment of duodenal ulcers, and in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection to reduce the risk of duodenal ulcer recurrence.
Clinicians should test for H. pylori infection in patients presenting with non-ulcer dyspepsia; patients found to be H. pylori positive should be started on combination eradication therapy.
Eradication of H. pylori offers modest, but significant, symptom relief in non-ulcer dyspepsia and reduces the risk of developing peptic ulcer disease, atrophic gastritis, and gastric cancer.
For populations with a low prevalence of H. pylori infection (less than 10%), starting a 2 to 4 week empiric trial of a PPI is an alternate approach.
Rabeprazole is as effective as omeprazole in the treatment of duodenal ulcer, and gastric ulcer, and it is more effective than ranitidine in the treatment of GERD.
On the basis of available research, no clear advantage has been demonstrated for the use of one PPI over another in the treatment of GERD.
Instead, a key to optimizing effectiveness is tailoring dosage timing and considering twice daily dosing; traditional delayed release PPIs should be administered 30 to 60 minutes before a meal for maximal pH control.
A one-time switch to a different PPI in a refractory patient may be useful.
Rabeprazole uses a non-enzymatic pathway in addition to the CYP system for its metabolism, so drug interactions and the effects of CYP2C19 polymorphism on rabeprazole are minimal compared to other PPIs.
Brand Name
- AcipHex
- Aciphex Sprinkle
Indications
- duodenal ulcer
- dyspepsia
- eosinophilic esophagitis
- esophagitis
- gastric ulcer
- gastroesophageal reflux disease (GERD)
- Helicobacter pylori (H. pylori) eradication
- pyrosis (heartburn)
- Zollinger-Ellison syndrome
Side Effects
- abdominal pain
- agranulocytosis
- anaphylactoid reactions
- angioedema
- arthralgia
- blurred vision
- bone fractures
- bullous rash
- coma
- constipation
- delirium
- diarrhea
- dizziness
- elevated hepatic enzymes
- erythema multiforme
- flatulence
- gastric polyps
- headache
- hemolytic anemia
- hepatic encephalopathy
- hepatitis
- hyperammonemia
- hypomagnesemia
- infection
- interstitial nephritis
- jaundice
- leukopenia
- lupus-like symptoms
- myalgia
- nausea
- pancytopenia
- peripheral edema
- pernicious anemia
- pharyngitis
- pseudomembranous colitis
- rhabdomyolysis
- Stevens-Johnson syndrome
- thrombocytopenia
- toxic epidermal necrolysis
- vertigo
- vitamin B12 deficiency
- vomiting
- xerostomia
Monitoring Parameters
- LFTs
- serum magnesium
Contraindications
- bone fractures
- breast-feeding
- diarrhea
- gastric cancer
- geriatric
- hepatic disease
- hypomagnesemia
- infants
- laboratory test interference
- long QT syndrome
- neonates
- osteopenia
- osteoporosis
- pregnancy
- proton pump inhibitors (PPIs) hypersensitivity
- pseudomembranous colitis
- rebound acid hypersecretion
- systemic lupus erythematosus (SLE)
- vitamin B12 deficiency
Interactions
- Acalabrutinib
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Alendronate
- Alendronate; Cholecalciferol
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Amiloride; Hydrochlorothiazide, HCTZ
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amobarbital
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Ampicillin
- Ampicillin; Sulbactam
- Anticholinergics
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol; Chlorthalidone
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azilsartan; Chlorthalidone
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Bisacodyl
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bortezomib
- Bosutinib
- Budesonide
- Budesonide; Formoterol
- Bumetanide
- Butabarbital
- Calcium Carbonate; Risedronate
- Candesartan; Hydrochlorothiazide, HCTZ
- Cannabidiol
- Capecitabine
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Cefpodoxime
- Ceftibuten
- Cefuroxime
- Chlordiazepoxide; Clidinium
- Chlorothiazide
- Chlorthalidone
- Chlorthalidone; Clonidine
- Citalopram
- Clobazam
- Cobicistat
- Cyanocobalamin, Vitamin B12
- Cyclosporine
- Cysteamine
- Dacomitinib
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Delavirdine
- Dexmethylphenidate
- Dextroamphetamine
- Dicyclomine
- Digoxin
- Dolutegravir; Rilpivirine
- Dronedarone
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Enalapril; Hydrochlorothiazide, HCTZ
- Eprosartan; Hydrochlorothiazide, HCTZ
- Erlotinib
- Escitalopram
- Eslicarbazepine
- Ethacrynic Acid
- Fenofibric Acid
- Flavoxate
- Fosinopril; Hydrochlorothiazide, HCTZ
- Furosemide
- Gefitinib
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Homatropine; Hydrocodone
- Hydantoins
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Idelalisib
- Indacaterol; Glycopyrrolate
- Iron
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ketoconazole
- Ledipasvir; Sofosbuvir
- Loop diuretics
- Lopinavir; Ritonavir
- Luliconazole
- Lumacaftor; Ivacaftor
- Mefloquine
- Mepenzolate
- Mephobarbital
- Mesalamine, 5-ASA
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methohexital
- Methotrexate
- Methscopolamine
- Methyclothiazide
- Methylphenidate
- Metolazone
- Mitotane
- Modafinil
- Mycophenolate
- Nelfinavir
- Neratinib
- Nilotinib
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Oxybutynin
- Pazopanib
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Polyethylene Glycol; Electrolytes; Bisacodyl
- Ponatinib
- Posaconazole
- Primidone
- Propantheline
- Rifabutin
- Rifampin
- Rifamycins
- Rifapentine
- Rilpivirine
- Risedronate
- Ritonavir
- Saquinavir
- Scopolamine
- Secobarbital
- Secretin
- Selpercatinib
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- St. John’s Wort, Hypericum perforatum
- Tacrolimus
- Telaprevir
- Telotristat Ethyl
- Terbinafine
- Theophylline, Aminophylline
- Thiazide diuretics
- Thiopental
- Thyroid hormones
- Tipranavir
- Tolterodine
- Torsemide
- Trihexyphenidyl
- Trospium
- Voriconazole
- Warfarin
- Zonisamide
