Revera-20

Rabeprazole sodium is a substituted benzimidazole and belongs to the class of proton pump inhibitors. Rabeprazole Sodium is an antiulcerant drug in the class of Proton Pump Inhibitors. It suppresses gastric acid secretion by inhibiting the gastric H+/K+-ATPase enzyme at the secretory surface of the gastric parietal cell. It is an enteric coated tablet, because of its coated formulation it is highly stable in stomach and because of higher pKa value of Rabeprazole Sodium it provides faster onset of action.

INDICATION AND USAGE:

♦ Rabeprazole tablets belong to a group of medicines called Proton Pump Inhibitors (PPIs).
♦ Rabeprazole tablets act by reducing the amount of acid made by the stomach.

Rabeprazole tablets are used to treat:
♦ Ulcer in the upper part of the intestine (duodenal ulcer) and benign stomach ulcer.
♦ Gastro-oesophageal reflux disease (GERD) with or without ulcer. GERD is commonly referred to as inflammation of the gullet caused by acid and associated with heartburn. Heartburn is a burning feeling rising from the stomach or lower chest up towards the neck.
Rabeprazole tablets may be used as a long term treatment of GERD (GERD maintenance). Rabeprazole tablets may also be used for the symptomatic treatment of moderate to very severe gastro-oesophageal reflux disease (symptomatic GERD).
♦ Zollinger-Ellison Syndrome, which is a condition when the stomach makes extremely high amounts of acid.

MECHANISM OF ACTION :

Rabeprazole belongs to a class of antisecretory compounds (substituted benzimidazole proton-pump inhibitors) that do not exhibit anticholinergic orhistamine H2- receptor antagonist properties, but suppress gastric acid secretion by inhibiting the gastric H+, K+ATPase at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as a gastric proton-pump inhibitor. Rabeprazole blocks the final step of gastric acid secretion.
In gastric parietal cells, rabeprazole is protonated, accumulates, and is transformed to an active sulfenamide. When studied in vitro, rabeprazole is chemically activated at pH 1.2 with a half-life of 78 seconds. It inhibits acid transport in porcine gastric vesicles with a half-life of 90 seconds.

INTERACTIONS:

Rabeprazole increased gastric pH and has the potential to affect the bioavailability of any medication for which absorption is pH-dependent.
Combinations containing any of the following medications, depending on the amount present, may also interact with this medication.
♦ Digoxin(rabeprazole may increase gastrointestinal pH; concurrent use with rabeprazole resulted in increase of the serum peak concentration by 29% in normal subjects.
♦ Ketoconazole(rabeprazole may increase gastrointestinal pH; concurrent use with rabeprazole resulted in 30% reduction of bioavailability.

WARNINGS:

Symptomatic response to therapy with rabeprazole sodium does not preclude the presence of gastric or oesophageal malignancy, therefore the possibility of malignancy should be excluded prior to commencing treatment with rabeprazole.
No evidence of significant drug related safety problems was seen in a study of patients with mild to moderate hepatic impairment versus normal age and sex matched controls, the prescriber is advised to exercise caution when treatment with rabeprazole is first initiated in patients with severe hepatic dysfunction.
♦If you are pregnant, trying for a baby or breast-feeding.
♦If you have liver problems.
♦If you have any of the following symptoms:
bleeding, difficulty swallowing, being sick frequently, or unexplained weight loss.
♦If you have ever had an allergic reaction to any medicine.
♦If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines.

CONTRAINDICATIONS:

Hypersensitivity to Nimesulide and Serratiopeptidase. Nimesulide Serratiopeptidase is contraindicated in patients of active peptic ulcer disease, moderate to severe hepatic impairment, severe renal failure and with blood coagulation disorders.

SIDE EFFECTS:

♦ Headache
♦ Upset stomach, mild diarrhea
♦ Insomnia or nervousness; or
♦ Rash or itching
♦ Dizziness, confusion
♦ Dry mouth
♦ Stomach cramps
♦ Nervousness

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