A significant portion of ACIPHEX is systemically metabolized via nonenzymatic reduction.
Rabeprazole thioether and rabeprazole sulphone are the 2 primary metabolites of ACIPHEX.
THE CORRELATION OF THESE DATA TO CLINICAL EFFECT HAS NOT BEEN ESTABLISHED.
In adults (≥18 years of age), ACIPHEX 20 mg is indicated for: treatment of daytime and nighttime heartburn and other symptoms associated with GERD; short-term, up to 4 weeks, treatment in the healing and symptomatic relief of duodenal ulcers; short-term, 4 to 8 weeks, treatment in the healing and symptomatic relief of erosive GERD; and maintenance of healing and reduction in relapse rates of heartburn symptoms or erosive GERD (controlled maintenance studies do not extend beyond 12 months).
In adolescent patients 12 years of age and above, ACIPHEX 20 mg is indicated for: short-term, up to 8 weeks, treatment of daytime and nighttime heartburn and other symptoms associated with GERD.
ACIPHEX is contraindicated in patients with known hypersensitivity to rabeprazole, substituted benzimidazoles, or to any component of the formulation.
As with all PPIs, patients treated concomitantly with warfarin may need to be monitored for increases in INR and prothrombin time, which may lead to abnormal bleeding and even death.
In adolescents, the related reported adverse reactions that occurred in ≥2% of patients were headache and nausea. The adverse reactions reported without regard to relationship to ACIPHEX that occurred in ≥2% of patients were headache, diarrhea, nausea, vomiting, and abdominal pain.
In adults, clinical trials revealed the following adverse reactions appearing in ≥2% of ACIPHEX patients and with a frequency greater than placebo: pain, pharyngitis, flatulence, infection, and constipation.
Symptomatic response to therapy does not preclude the presence of gastric malignancy.
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 and digoxin).
ACIPHEX may reduce the plasma levels of atazanavir.
Rabeprazole has been shown to inhibit cyclosporine metabolism in vitro.
References: 1. ACIPHEX Full Prescribing Information. 2. Yasuda S, Ohnishi A, Ogawa T, et al. Pharmacokinetic properties of E3810, a new proton pump inhibitor, in healthy male volunteers. Int J Clin Pharmacol Ther. 1994;32:466-473.
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