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PHARMACOLOGICAL COMPATIBILITY*

Rabeprazole Metabolization

Rabeprazole inhibits the secretion of acid in the stomach. The drug binds to the proton pump in the gastric parietal cell, inhibiting the transport of H+ to the gastric lumen. It is a drug belonging to the family of proton pump inhibitors (PPIs). Rabeprazole is contraindicated in individuals with hypersensitivity to the drug or substituted benzimidazoles. Rabeprazole is contraindicated during pregnancy and lactation.

CAUTIONS

There is no experience in children, so caution should be exercised when prescribing.

Caution should be exercised in patients with severe hepatic impairment. Discard treatment with rabeprazole in individuals with malignant gastric or esophageal process. A regular monitorization should be carried out on prolonged treatment with rabeprazole (more than 1 year).

There is a risk of cross-hypersensitivity with other proton pump inhibitors or with substituted benzimidazoles, blood dyscrasias (thrombocytopenia and neutropenia), alteration of liver enzymes, gastrointestinal infections by Salmonella, Campylobacter and C. Difficile.

There is a risk of hypomagnesemia in prolonged treatment and in concomitance with digoxin or other drugs that can reduce the plasma level of Mg (eg diuretics); consider the plasma control of Mg at the beginning and periodically during treatment.

At high doses and in prolonged treatment rabeprazole may increase the risk of fracture of the hip, wrist and spine, especially in the elderly or in the presence of other risk factors, therefore, the intake of Ca and D vitamin should be assured if there is a risk of osteoporosis.

Treatment with pantoprazole is associated with a risk of developing subacute cutaneous erythematosus lupus (SCEL) (if lesions occur, especially in areas of the skin exposed to the sun, accompanied by arthralgia, consider stopping treatment).

SIDE EFFECTS

Infection; insomnia; headache, vertigo; cough, pharyngitis, rhinitis; diarrhea, vomiting, nausea, abdominal pain, constipation, flatulence; non-specific pain/back pain; asthenia, flu syndrome; skin rash, dry mouth.

PHARMACOLOGIC INTERACTIONS

Rabeprazole decreases the absorption of: ketoconazole and itraconazole (monitor and adjust dose of antifungal agent if necessary).

Not recommended concomitant treatment with atazanavir.

BRAND NAMES

  • Aciphex ®
  • Pariet ®

GENE OR REGION STUDIED


  • CYP2C19