Top 300 Pharmacy Drug Cards

RABEPRAZOLE: Aciphex

Class: Proton Pump Inhibitor

Dosage Forms. Tablet, Delayed Release: 20 mg

Image

Common FDA Label Indication, Dosing, and Titration.

1. Duodenal ulcer disease: 20 mg po daily × up to 4 wk

2. Helicobacter pylori GI infection: 20 mg po bid × 10-14 d in combination with amoxicillin 1000 mg and clarithromycin 500 mg po bid

3. Gastric hypersecretion: 60 mg po daily, may titrate to 60 mg po bid

4. Gastroesophageal reflux disease, erosive or ulcerative, for symptom control, initial treatment, or maintenance: Adults and Children >12 y, 20 mg po daily

Off-Label Uses.

1. Drug-induced gastrointestinal disturbance, indigestion: 20 mg po daily

2. Gastric ulcer disease: 20-40 mg po daily

MOA. Rabeprazole is a proton pump inhibitor (PPI) that, when protonated in the secretory canaliculi of the parietal cells, covalently binds to H+/K+-ATPase (proton pump), which is the final pathway for acid secretion. Rabeprazole produces a profound and prolonged antisecretory effect and inhibits basal, nocturnal, and pentagastrin- and food-stimulated gastric acid secretion.

Drug Characteristics: Rabeprazole

Image

Medication Safety Issues: Rabeprazole

Image

Drug Interactions: Rabeprazole

Image

Adverse Reactions: Rabeprazole

Image

Efficacy Monitoring Parameters. Resolution of GI discomfort, resolution of ulcers shown on endoscopy; for treatment of H pylori, negative urea breath test.

Toxicity Monitoring Parameters. Severe headache or blistering skin rash.

Key Patient Counseling Points. Should be taken 1 h before meals.

Clinical Pearls. Multiple H pylori regimens exist that include different combinations of PPIs and antibiotics; patients should complete full regimen if prescribed for H pylori management. Many PPI and H2 antagonists available OTC; warn patients not to take multiple products concurrently to avoid additive risk of adverse effects. Possible risk of osteoporosis. Use for shortest period of time and avoid use in those at risk for osteoporosis if possible. Aciphex sprinkle formulation approved in March 2013.