Rabeprazole

Proton Pump Inhibitor (PPI)

Generic Name

Rabeprazole Sodium

Drug Class

Proton pump inhibitor (PPI)

Indications

Gastroesophageal reflux disease (GERD)
Peptic ulcer disease (gastric and duodenal ulcers)
Helicobacter pylori eradication (as part of combination therapy)
Zollinger–Ellison syndrome
Prevention of NSAID-induced ulcers

Dosage

Adults: 20 mg orally once daily before meals (may increase to 20 mg twice daily for severe disease)
Children ≥12 years: 10–20 mg orally once daily

Note: Adjust dose in severe hepatic impairment; therapy duration should follow clinical guidelines.

Route of Administration

Oral (tablet, delayed-release capsule, oral suspension)

Mechanism of Action

Rabeprazole inhibits H+/K+ ATPase in gastric parietal cells, reducing gastric acid secretion. It increases gastric pH, promoting healing of ulcers and reducing GERD symptoms.

Common Adverse Effects

Headache
Diarrhea
Nausea
Abdominal pain
Dizziness

Serious Adverse Effects

Clostridium difficile-associated diarrhea (rare)
Hypomagnesemia with long-term use
Bone fractures (long-term use)
Severe allergic reactions (rare)

Contraindications

Hypersensitivity to rabeprazole or other PPIs

Precautions

Use with caution in severe hepatic impairment
Monitor magnesium levels if therapy exceeds 3 months
Avoid abrupt discontinuation after long-term use

Drug Interactions

Clopidogrel – reduced effectiveness (CYP2C19 inhibition)
Warfarin – monitor INR
Drugs requiring acidic pH for absorption (ketoconazole, atazanavir)

Pregnancy & Lactation

Use only if clearly needed; limited human data available. Excreted in breast milk – monitor infant for effects.

Patient Counseling

Take 30–60 minutes before meals
Swallow tablets whole; do not crush or chew
Report persistent diarrhea, abdominal pain, or allergic reactions
Do not stop therapy abruptly if on long-term use