Rabefour
Generic Name
Rabeprazole Sodium
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rabefour 20 mg capsule | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Rabeprazole is a proton pump inhibitor (PPI) used to reduce the amount of acid produced in the stomach. It helps to treat acid-related stomach and esophageal problems like heartburn, ulcers, and acid reflux.
Uses & Indications
Dosage
Adults
For GERD: 20 mg once daily for 4 to 8 weeks. For Duodenal/Gastric Ulcers: 20 mg once daily for 4 to 8 weeks. For H. pylori eradication: 20 mg twice daily with appropriate antibiotics for 7 to 14 days. For Zollinger-Ellison Syndrome: Initial dose 60 mg once daily, adjusted as needed.
Elderly
No dose adjustment is generally required for elderly patients, but caution should be exercised in patients with severe hepatic impairment.
Renal_impairment
No dose adjustment is required for patients with renal impairment.
How to Take
Take orally, usually once daily, preferably in the morning before breakfast. Swallow the capsule whole with water; do not chew, crush, or break it.
Mechanism of Action
Rabeprazole inhibits the H+/K+-ATPase enzyme (proton pump) in the gastric parietal cells, thereby suppressing gastric acid secretion. This irreversible binding to the proton pump effectively reduces acid production.
Pharmacokinetics
Onset
Acid suppression begins within 1 hour, with maximal effect observed within 2-4 hours.
Excretion
Approximately 90% of a dose is excreted in the urine, primarily as metabolites, and the remaining 10% is excreted in the feces.
Half life
Plasma elimination half-life is approximately 1-2 hours, but the duration of acid suppression is much longer due to irreversible binding to the proton pump.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 2-4 hours. Bioavailability is about 52% and is not significantly affected by food.
Metabolism
Primarily hepatic, via the cytochrome P450 (CYP) enzyme system, mainly CYP2C19 and CYP3A4. Extensive first-pass metabolism occurs.
Side Effects
Contraindications
- Hypersensitivity to rabeprazole, other benzimidazole derivatives (e.g., omeprazole, lansoprazole), or any component of the formulation.
- Patients with known history of previous severe allergic reaction to similar drugs.
Drug Interactions
Digoxin
Increased digoxin plasma levels.
Warfarin
Increased INR/prothrombin time, increasing risk of bleeding.
Methotrexate
Increased and prolonged methotrexate plasma levels, potentially leading to toxicity.
Ketoconazole/Itraconazole/Atazanavir/Nelfinavir
Reduced absorption and efficacy due to increased gastric pH.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms are generally minimal or absent. In case of overdose, symptomatic and supportive treatment should be given. Rabeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and the potential benefits outweigh the risks. Excreted in breast milk in animal studies; caution advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to rabeprazole, other benzimidazole derivatives (e.g., omeprazole, lansoprazole), or any component of the formulation.
- Patients with known history of previous severe allergic reaction to similar drugs.
Drug Interactions
Digoxin
Increased digoxin plasma levels.
Warfarin
Increased INR/prothrombin time, increasing risk of bleeding.
Methotrexate
Increased and prolonged methotrexate plasma levels, potentially leading to toxicity.
Ketoconazole/Itraconazole/Atazanavir/Nelfinavir
Reduced absorption and efficacy due to increased gastric pH.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms are generally minimal or absent. In case of overdose, symptomatic and supportive treatment should be given. Rabeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and the potential benefits outweigh the risks. Excreted in breast milk in animal studies; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years from the date of manufacture. Refer to the specific packaging for exact expiry date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (DGDA, Bangladesh)
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have demonstrated the efficacy and safety of rabeprazole for the treatment of various acid-related disorders, including GERD, peptic ulcers, and H. pylori eradication.
Lab Monitoring
- Magnesium levels (for long-term use, especially with concomitant diuretics).
- Liver function tests (if symptoms suggest hepatic impairment or during prolonged therapy).
Doctor Notes
- Consider the lowest effective dose and shortest duration necessary for chronic conditions.
- Monitor patients for potential adverse effects, including hypomagnesemia and C. difficile infection, especially with long-term use.
- Advise patients on lifestyle modifications to complement drug therapy for optimal outcomes.
Patient Guidelines
- Take the capsule whole with water; do not chew, crush, or break it.
- Preferably take it in the morning before breakfast.
- Do not stop taking the medicine abruptly without consulting your doctor.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements, you are currently taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Rabeprazole may cause dizziness, drowsiness, or visual disturbances in some individuals. If these occur, avoid driving or operating machinery.
Lifestyle Advice
- Avoid large meals, especially before bedtime.
- Elevate the head of the bed for GERD symptoms.
- Avoid trigger foods such as spicy, fatty, acidic foods, caffeine, and chocolate.
- Quit smoking and reduce alcohol consumption, as these can worsen acid reflux.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.