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Rabeprazole



Rabeprazole
Systematic (IUPAC) name
2-[(4-(3-methoxypropoxy)- 3-methyl-pyridin-2-yl) methylsulfinyl]- 1H-benzoimidazole
Identifiers
CAS number	117976-89-3
ATC code	A02BC04
PubChem	5029
DrugBank	APRD01212
Chemical data
Formula	C₁₈H₂₁N₃O₃S
Mol. mass	359.444 g/mol
Pharmacokinetic data
Bioavailability	52%
Metabolism	Hepatic
Half life	1 - 1.5 hours
Excretion	Renal
Therapeutic considerations
Licence data	US
Pregnancy cat.	B(US)
Legal status	POM(UK) ℞-only(US)
Routes	Oral

Rabeprazole is an antiulcer drug in the class of proton pump inhibitors. It was developed by Eisai Co. and is marketed by Janssen-Cilag as rabeprazole sodium under the brand names Aciphex and Pariet.

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Pharmacology

Rabeprazole is a prodrug (metabolized by the cytochrome P450 (or CYP450)) - in the acid environment of the parietal cells it turns into active sulphenamide form associated with cysteine of H+, K+ATPase (proton pump). Rabeprazole inhibits (partly reversibly) H+, K+ATPase of the coating gastric cells and dose-dependent oppresses basal and stimulated gastric acid secretion. Rabeprazole has anti Helicobacter pylori activity (MIC 4-16 mg/ml) and shows synergistic activity with some antibiotics. Rabeprazole has been demonstrated to be effective in patients with pathological hypersecretory activity (incl. Zollinger-Ellison Syndrome).

Indications and usage

gastric ulcer

peptic ulcer (PUD)

Maintenance of Healing of Erosive or Ulcerative GERD

Healing of Erosive and Ulcerative GERD

Healing of Duodenal Ulcers.

Treatment of Symptomatic GERD

Treatment of Pathological Hypersecretory conditions (Zollinger-Ellison)

Helicobactor Pylori Eradication to Reduce Risk of Duodenal Ulcer Recurrence

Contraindications

hypersensitivity to Rabeprazole, substituted benzimidazoles or any of components of its pharmaceutical forms.

pregnancy

lactation

Restriction of usage

acute hepatic failure

pediatric use in patients under 18 years of age (there are insufficient data about safety and efficiency of Rabeprazole in this group of patients)

Side effects

Rabeprazole Adverse reactions/Side effects include:

In clincal trials the most common side effect assessed as possibly or probably related to ACIPHEX was Headache in 2.4% of patients vs 1.6% taking placebo.

diarrhea

vomiting

nausea

abdominal pains

constipation

meteorism

dry mouth

increased or decreased appetite

asthenia

headache

sleeplessness

vertigo

thrombocytopenia

granulocytopenia

leukocytopenia

skin eruption

erythema

myalgia

arthralgia

muscle or bone pain

Drug interactions

Rabeprazole decreases the concentration of ketoconazole in the plasma (in 33%), increases the concentration of digoxin (in 22%), and does not interact with liquid antiacids. Rabeprazole is compatible with any medicine metabolized by the CYP450 (theophylline, warfarin, diazepam, phenytoin).

Overdosage

There is no available data on symptoms of rabeprazole overdose.

How supplied

Rabeprazole as Aciphex,Rabeloc, Pariet is supplied in:

Tablet, Enteric-Coated; 10mg

Tablet, Enteric-Coated; 20mg

References

Morii M, Takata H, Fujisaki H, Takeguchi N., The potency of substituted benzimidazoles such as E3810, omeprazole, Ro 18-5364 to inhibit gastric H+, K(+)-ATPase is correlatedwith the rate of acid-activation of the inhibitor, Biochem. Pharmacol. 1990 Feb 15;39(4):661-7.
Prakash A, Faulds D., Rabeprazole, Drugs. 1998 Feb;55(2):261-7; discussion 268.

Categories: Prodrugs | Proton pump inhibitors

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Rabeprazole". A list of authors is available in Wikipedia.