Indications

Rexiet (Rabeprazole) is a proton pump inhibitor used to treat:

• Active duodenal and benign gastric ulcers.
• Symptomatic erosive or ulcerative Gastro-esophageal Reflux Disease (GERD).
• Long-term management of GERD.
• Symptomatic treatment of moderate to severe GERD.
• Zollinger-Ellison Syndrome.
• In combination with antibiotics to eradicate Helicobacter pylori in patients with peptic ulcer disease.

Pharmacology

Rabeprazole suppresses gastric acid secretion by inhibiting the gastric H+/K+-ATPase (the proton pump) in the stomach's parietal cells. This action makes it a gastric proton-pump inhibitor.

Dosage

• Duodenal and Gastric Ulcers: 20 mg once daily in the morning. Treatment duration is typically 4-6 weeks, with an option for an additional 4-6 weeks if needed.
• Erosive or Ulcerative GERD: 20 mg once daily for 4 to 8 weeks.
• GERD Maintenance: 10 mg or 20 mg once daily.
• Symptomatic GERD: 10 mg once daily. An "on-demand" regimen of 10 mg can be used once symptoms resolve.
• Pediatric GERD (1-11 years): 5 mg once daily for those under 15 kg, and 10 mg once daily for those 15 kg or more, for up to 12 weeks.
• Zollinger-Ellison Syndrome: Starting dose is 60 mg once daily, which can be increased up to 120 mg/day. Doses over 100 mg may require a divided dose.
• H. pylori Eradication: 20 mg twice daily for 7 days, in combination with clarithromycin and amoxicillin.

Administration

Tablets should be taken in the morning, before eating, and swallowed whole. They should not be chewed or crushed.

Interaction

Because Rabeprazole significantly reduces gastric acid, it may affect the absorption of drugs that are pH-dependent, such as ketoconazole and itraconazole, leading to decreased plasma levels. Rexiet should not be co-administered with atazanavir.

Contraindications

This medication is contraindicated in patients with hypersensitivity to the active substance or other components. It is also contraindicated during pregnancy and breastfeeding.

Side Effects

Common side effects include headache, diarrhea, abdominal pain, vomiting, constipation, dry mouth, and dizziness.

Pregnancy & Lactation

Rabeprazole is in pregnancy category 'C'. It should be used during pregnancy only if the potential benefit justifies the potential risk. It is likely to be excreted in human milk, so a decision to discontinue nursing or the drug should be made by a healthcare professional.

Precautions & Warnings

• A patient's positive response to Rexiet does not rule out the presence of a malignancy.
• Long-term use (over a year), especially at high doses, may increase the risk of hip, wrist, and spine fractures, particularly in the elderly.
• There have been post-marketing reports of blood disorders (thrombocytopenia, neutropenia) and hepatic enzyme abnormalities, which typically resolved upon discontinuation of the drug.
• Long-term use of acid-blocking medicines may reduce the absorption of vitamin B12.
• Severe hypomagnesaemia has been reported in patients on long-term PPI treatment.
• Rexiet may increase the risk of gastrointestinal infections.
• SCLE (Subacute cutaneous lupus erythematosus) has been very infrequently associated with PPI use.

Overdose Effects

Acute overdosage is unlikely. The maximum established dose is 160 mg once daily. Treatment should be symptomatic and supportive. Rabeprazole is not dialyzable.

Therapeutic Class

Rexiet is classified as a Proton Pump Inhibitor.

Storage Conditions

Keep below 30°C, away from light and moisture. Keep out of the reach of children.