Rabigerd

Description

Rabigerd Tablet (Rabeprazole)

Rabigerd Tablet contains Rabeprazole, a proton pump inhibitor (PPI) that works by reducing the amount of acid produced in the stomach. It is prescribed for the treatment of various acid-related conditions, including:

• Peptic Ulcer Disease: This includes ulcers found in both the duodenum and the stomach.
• H. pylori Infection: Used as part of a combination therapy to eradicate this bacterial infection.
• Gastro-oesophageal Reflux Disease (GERD): This encompasses general GERD symptoms, the more severe erosive oesophagitis, and paediatric GERD in children over 12 years of age.
• Zollinger-Ellison Syndrome: A rare condition characterized by the excessive secretion of stomach acid.

Dosage and Administration

Rabigerd tablets can be taken with or without meals.

Adult Dosing

• Gastro-oesophageal Reflux Disease (GERD):
  • Treatment: 20 mg once daily for 4 to 8 weeks.
  • Maintenance: 10 mg or 20 mg once daily.
  • All doses should be taken once in the morning.
• Zollinger-Ellison Syndrome:
  • Initial Dose: 60 mg once daily in the morning.
  • Adjustment: The dose can be adjusted up to a maximum of 120 mg per day if needed.
  • If the daily dose exceeds 100 mg, it should be divided into two separate doses.
• Peptic Ulcer:
  • Duodenal Ulcer: 20 mg once daily in the morning for 4 to 8 weeks.
  • Gastric Ulcer: 20 mg once daily in the morning for 6 to 12 weeks.
• H. pylori Infection (1-Week Triple Therapy):
  • 20 mg twice daily, combined with either:
    • Clarithromycin 500 mg twice daily and Amoxicillin 1 g twice daily, OR
    • Clarithromycin 250 mg twice daily and Metronidazole 400 mg twice daily.
• Erosive Oesophagitis:
  • Treatment: 20 mg once daily for 4 to 8 weeks. If healing is incomplete, treatment may be continued for another 8 weeks.
  • Maintenance: 10 mg or 20 mg once daily.
  • All doses should be taken once in the morning.

Special Population Dosing

• Elderly Patients: No dosage adjustment is typically needed.
• Hepatic Impairment: No dosage adjustment is typically needed.
• Renal Impairment: No dosage adjustment is typically needed.

Paediatric Dosing (Oral)

• Gastro-oesophageal Reflux Disease (GERD):
  • Children >12 years: 20 mg once daily in the morning for up to 8 weeks.

Contraindications

Rabeprazole is contraindicated in patients with a known hypersensitivity to Rabeprazole, other proton pump inhibitors (PPIs), or any component of the formulation.

Precautions

• Gastric Malignancy: Stomach cancer should be ruled out before initiating treatment, as symptom relief from Rabigerd could mask the presence of a serious underlying condition.
• Severe Hepatic Impairment: Use with caution in patients with severe liver problems.
• Pregnancy and Lactation: Use with caution during pregnancy and breastfeeding. It is currently unknown whether rabeprazole is distributed into breast milk, thus caution is advised for nursing mothers.
• Monitoring: Blood magnesium (Mg) levels should be monitored prior to initiation and periodically during prolonged use.

Interactions

Rabigerd may interact with other medications:

• Decreased Serum Concentration: May decrease the serum concentrations of ketoconazole, itraconazole, and clopidogrel.
• Increased Risk of Hypomagnesaemia: There is an increased risk of low magnesium levels when taken concurrently with diuretics (water pills) and digoxin.
• Warfarin: May increase the prothrombin time and INR (measures of blood clotting) when co-administered with warfarin.
• Increased Plasma Concentration: May increase the plasma concentrations of saquinavir and methotrexate.
• Decreased Serum Levels: Sucralfate may decrease the serum levels of rabeprazole.
• Potentially Fatal Interactions: May significantly decrease the plasma concentrations and pharmacological effects of rilpivirine and atazanavir.

Adverse Effects

Common (1-10% of patients):

• Headache (2-10%)
• Abdominal pain (4%)
• Flatulence (3%)
• Pharyngitis (3%)
• Pain (3%)
• Diarrhea (2-5%)
• Constipation (2%)

Less Common (Less than 1% of patients):

Agitation, agranulocytosis, alopecia, anemia, angioedema, chest pain, delirium, erythema, hypokalemia, hypomagnesemia, hyponatremia, jaundice, leukocytosis, leukopenia, migraine, osteoporosis-related fracture, rhabdomyolysis, Stevens-Johnson syndrome, sudden death, toxic epidermal necrolysis, abnormal taste.

Mechanism of Action

Rabeprazole is a proton pump inhibitor (PPI) that effectively suppresses gastric acid secretion. It achieves this by specifically inhibiting the H+/K+ ATPase enzyme, also known as the “proton pump,” which is located on the secretory surface of the gastric parietal cells in the stomach.

Important Note

Rabigerd 20mg Tablet is manufactured by Acme Laboratories Ltd. Its generic name is Rabeprazole, and it is available in Nepal