Progut
Generic Name
Rabeprazole Sodium
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| progut 40 mg injection | ৳ 90.00 | N/A |
Description
Overview of the medicine
Rabeprazole Sodium is a proton pump inhibitor used to treat conditions caused by excess stomach acid, such as ulcers and gastroesophageal reflux disease (GERD). The injection form is used when oral administration is not possible.
Uses & Indications
Dosage
Adults
Typical dose is 20 mg once daily, for severe cases or when oral therapy is not feasible, 40 mg once daily by slow IV infusion over 15 minutes.
Elderly
No dosage adjustment generally required, but caution is advised in patients with severe hepatic impairment.
Renal_impairment
No dosage adjustment required.
How to Take
For IV injection, administer slowly over 15 minutes. Reconstitute the lyophilized powder with the supplied solvent as per manufacturer's instructions immediately before use.
Mechanism of Action
Rabeprazole inhibits the H+/K+-ATPase enzyme (proton pump) in gastric parietal cells, blocking the final step of acid secretion. This leads to a sustained reduction in gastric acid production.
Pharmacokinetics
Onset
Within 1 hour, maximum effect within 2-4 hours.
Excretion
Primarily renal (approx. 90%) and fecal (approx. 10%) as metabolites.
Half life
Approximately 1.0-2.0 hours (prolonged pharmacological effect due to irreversible binding).
Absorption
Rapidly absorbed after oral administration (bioavailability approx. 52%). For IV, 100% bioavailability.
Metabolism
Primarily hepatic, via cytochrome P450 (CYP2C19 and CYP3A4).
Side Effects
Contraindications
- Hypersensitivity to Rabeprazole, substituted benzimidazoles (e.g., Omeprazole, Pantoprazole), or any component of the formulation.
- Pregnancy and lactation (unless specifically deemed essential by a physician).
Drug Interactions
Warfarin
Increased INR/prothrombin time, monitor carefully for bleeding.
Methotrexate
Increased plasma concentration of methotrexate, especially with high doses. Consider temporary withdrawal of PPI or close monitoring.
Atazanavir, Nelfinavir, Ritonavir
Decreased absorption of antiretrovirals due to increased gastric pH, consider alternative or monitor closely. Co-administration with rabeprazole is generally not recommended.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. The reconstituted solution should be used immediately or within 4 hours if stored at room temperature (25°C).
Overdose
Limited experience. Symptoms might include confusion, headache, drowsiness, tachycardia, nausea, sweating, blurred vision. Treatment is symptomatic and supportive; rabeprazole is not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as rabeprazole is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to Rabeprazole, substituted benzimidazoles (e.g., Omeprazole, Pantoprazole), or any component of the formulation.
- Pregnancy and lactation (unless specifically deemed essential by a physician).
Drug Interactions
Warfarin
Increased INR/prothrombin time, monitor carefully for bleeding.
Methotrexate
Increased plasma concentration of methotrexate, especially with high doses. Consider temporary withdrawal of PPI or close monitoring.
Atazanavir, Nelfinavir, Ritonavir
Decreased absorption of antiretrovirals due to increased gastric pH, consider alternative or monitor closely. Co-administration with rabeprazole is generally not recommended.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. The reconstituted solution should be used immediately or within 4 hours if stored at room temperature (25°C).
Overdose
Limited experience. Symptoms might include confusion, headache, drowsiness, tachycardia, nausea, sweating, blurred vision. Treatment is symptomatic and supportive; rabeprazole is not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as rabeprazole is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24-36 months from manufacturing date, check the product label for specific expiry.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Numerous clinical trials have established the efficacy and safety of rabeprazole in various acid-related disorders, including its intravenous formulation for acute conditions or when oral therapy is inappropriate.
Lab Monitoring
- Magnesium levels (with prolonged use, especially with diuretics)
- Liver function tests (in patients with hepatic impairment)
- Vitamin B12 levels (with very long-term use)
Doctor Notes
- Consider potential for drug interactions, especially with narrow therapeutic index drugs like warfarin or methotrexate. Monitor patients accordingly.
- Advise patients on appropriate lifestyle modifications (diet, smoking cessation) to enhance treatment outcomes.
- Assess for long-term PPI use risks and consider periodic monitoring for magnesium, Vitamin B12 levels, and bone mineral density, especially in at-risk populations.
- Rule out malignancy before initiating PPI therapy in patients with alarming symptoms such as dysphagia, unexplained weight loss, or persistent vomiting.
Patient Guidelines
- Inform your doctor about all your medical conditions and medications, including over-the-counter drugs and herbal supplements.
- Do not stop the medication suddenly without consulting your doctor.
- Report any unusual or severe symptoms immediately.
- Follow the administration instructions carefully for injections.
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 your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness, somnolence, or visual disturbances. If affected, avoid driving or operating machinery.
Lifestyle Advice
- Avoid spicy, fatty foods, and large meals, especially before bedtime.
- Limit alcohol and caffeine intake.
- Maintain a healthy weight and avoid smoking to reduce acid reflux symptoms.
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