Rabeprazole

Rabeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production. It is a prodrug that is converted in the acidic environment of gastric parietal cells to an active sulfenamide form that binds irreversibly to the H+/K+-ATPase enzyme, thereby inhibiting final acid secretion. The effect is long-lasting, allowing typically once-daily dosing.

Indications for rabeprazole include the treatment of gastroesophageal reflux disease (GERD) symptoms and healing of erosive esophagitis, as well as the treatment of duodenal and gastric ulcers. It is also used for prevention and treatment of NSAID-associated ulcers and, in some regions, as part of combination regimens for Helicobacter pylori eradication with antibiotics.

Rabeprazole comes in oral delayed-release forms, usually as 10 mg or 20 mg capsules or tablets. Dosing is commonly 20 mg once daily, adjusted for the condition being treated and patient response. It provides rapid symptom relief and healing over a course of weeks in many indications.

Pharmacokinetics and interactions: Rabeprazole is absorbed relatively quickly, with peak plasma concentrations reached within a few hours. It is metabolized in the liver, with a metabolic profile that results in fewer interactions mediated by cytochrome P450 enzymes than some other PPIs. Nevertheless, it can affect the absorption of drugs dependent on gastric pH (for example, certain antifungals or antiretrovirals) and may influence long-term micronutrient absorption (such as vitamin B12) or magnesium with prolonged use.

Adverse effects are generally mild and may include headache, nausea, abdominal pain, diarrhea, or dizziness. Long-term use has been associated with risks such as infections, electrolyte disturbances, and decreased mineral absorption, highlighting the importance of appropriate duration and monitoring. Rabeprazole should be used in individuals with hypersensitivity to the drug or related benzimidazole medications, and caution is advised in liver impairment and during pregnancy or breastfeeding, according to local guidance.