Fap Plus
Generic Name
Rabeprazole Sodium + Itopride Hydrochloride
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| fap plus 500 mg tablet | ৳ 1.92 | ৳ 19.20 |
Description
Overview of the medicine
Fap Plus is a combination medicine used to treat gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid production, accompanied by motility disorders. It contains Rabeprazole, a proton pump inhibitor, and Itopride, a prokinetic agent.
Uses & Indications
Dosage
Adults
One capsule once daily, preferably before breakfast, or as directed by the physician.
Elderly
No specific dose adjustment required, but caution is advised. Consult physician.
Renal_impairment
No dosage adjustment required for Rabeprazole in mild to moderate renal impairment. Itopride dosage may need adjustment in severe cases, consult physician.
How to Take
Take the capsule orally with water. Do not chew or crush. Best taken before meals, especially breakfast.
Mechanism of Action
Rabeprazole inhibits the H+/K+-ATPase enzyme (proton pump) in gastric parietal cells, thereby suppressing gastric acid secretion. Itopride increases acetylcholine concentration by inhibiting dopamine D2 receptors and acetylcholinesterase, leading to enhanced gastrointestinal motility.
Pharmacokinetics
Onset
Rabeprazole: Acid suppression within 1 hour. Itopride: Onset within 30-60 minutes.
Excretion
Rabeprazole: Primarily renal (90%). Itopride: Primarily renal.
Half life
Rabeprazole: ~1-2 hours. Itopride: ~6 hours.
Absorption
Rabeprazole is rapidly absorbed, bioavailability ~52%. Itopride is rapidly and almost completely absorbed, bioavailability ~60%.
Metabolism
Rabeprazole: Hepatic metabolism via CYP2C19 and CYP3A4. Itopride: Extensively metabolized by hepatic flavin-containing monooxygenase (FMO3).
Side Effects
Contraindications
- Hypersensitivity to Rabeprazole, Itopride, or any component of the formulation
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation (due to Itopride's prokinetic action)
- Pregnancy and Lactation
Drug Interactions
Digoxin
Increased absorption due to Rabeprazole's acid-suppressing effect.
Warfarin
Monitor INR when co-administered with Rabeprazole.
Anticholinergic drugs
May reduce the effect of Itopride.
Ketoconazole, Itraconazole, Atazanavir
Reduced absorption due to Rabeprazole's acid-suppressing effect.
Storage
Store in a cool, dry place, away from direct sunlight. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of Rabeprazole overdose are generally mild. Itopride overdose may cause cholinergic symptoms (e.g., nausea, vomiting, diarrhea, tremors). Treatment is symptomatic and supportive. Gastric lavage may be considered.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and potential benefits outweigh risks. Not recommended during breastfeeding as both components are excreted in milk. Consult a physician.
Side Effects
Contraindications
- Hypersensitivity to Rabeprazole, Itopride, or any component of the formulation
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation (due to Itopride's prokinetic action)
- Pregnancy and Lactation
Drug Interactions
Digoxin
Increased absorption due to Rabeprazole's acid-suppressing effect.
Warfarin
Monitor INR when co-administered with Rabeprazole.
Anticholinergic drugs
May reduce the effect of Itopride.
Ketoconazole, Itraconazole, Atazanavir
Reduced absorption due to Rabeprazole's acid-suppressing effect.
Storage
Store in a cool, dry place, away from direct sunlight. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of Rabeprazole overdose are generally mild. Itopride overdose may cause cholinergic symptoms (e.g., nausea, vomiting, diarrhea, tremors). Treatment is symptomatic and supportive. Gastric lavage may be considered.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and potential benefits outweigh risks. Not recommended during breastfeeding as both components are excreted in milk. Consult a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in all pharmacies in Bangladesh
Approval Status
Approved by DGDA
Patent Status
Generic available, original patent expired
Clinical Trials
Numerous clinical trials support the efficacy and safety of Rabeprazole and Itopride individually and in combination for GERD and dyspepsia.
Lab Monitoring
- Monitor magnesium levels with prolonged use of PPIs (if relevant risk factors present).
- Liver function tests in case of pre-existing hepatic impairment or prolonged therapy.
- Monitor complete blood count with long-term use.
Doctor Notes
- Consider alternative treatments if no improvement after 4-8 weeks.
- Educate patients on lifestyle modifications for GERD.
- Monitor for potential drug interactions, especially with narrow therapeutic index drugs.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any severe or persistent side effects.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness; caution advised while driving or operating machinery.
Lifestyle Advice
- Avoid spicy and fatty foods.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating.
- Elevate the head of your bed.
- Avoid smoking and excessive alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.