Medications
Rabeprazole - Aciphex
ACIPHEX is a proton-pump inhibitor (PPI) indicated in adults for:
• Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD)
• Maintenance of Healing of Erosive or Ulcerative GERD
• Treatment of Symptomatic GERD
• Healing of Duodenal Ulcers
• Helicobacter pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence
• Treatment of Pathological Hypersecretory Conditions, Including Zollinger-EllisonSyndrome
In adolescent patients 12 years of age and older for:
• Short-term treatment of Symptomatic GERD
In pediatric patients 1 to 11 years of age for:
• Treatment of GERD
• In the adult studies (4 to 8 weeks), adverse reactions that occurred at a rate greater than 2% and greater than placebo included pain, pharyngitis, flatulence, infection, and constipation.
• In studies of pediatric and adolescent patients (ages 1 to 16 years, and up to 36 weeks exposure) adverse reactions that occurred at a rate of ≥5% of patients included abdominal pain, diarrhea, and headache.
• Increased INR and prothrombin times have been reported with concomitant use with warfarin. Patients need to be monitored.
• Rabeprazole has been shown to inhibit cyclosporine metabolism in vitro.
• ACIPHEX inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (e.g., ketoconazole, iron salts, digoxin, and mycophenolate mofetil).
• ACIPHEX may reduce the plasma levels of atazanavir.
• Methotrexate: ACIPHEX may increase serum level of methotrexate.
• Symptomatic response to therapy with rabeprazole does not preclude the presence of gastric malignancy.
• Use with warfarin: Monitor for increases in INR and prothombin time.
• Acute interstitial nephritis has been observed in patients taking PPIs.
• Cyanocobalamin (vitamin B-12) Deficiency: Daily long-term use (e.g., longer than 3 years) may lead to malabsorption or a deficiency of cyanocobalamin.
• PPI therapy may be associated with increased risk of Clostridium difficile associated diarrhea.
• Bone fracture: Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine.
• Hypomagnesemia has been reported rarely with prolonged treatment with PPIs.
