Pariet - Rabeprazole

Pariet (Rabeprazole sodium). Eisai Ltd UK Summary of product characteristics, September... 

The histamine2-receptor antagonists or H2RAs (cimetidine, famotidine, nizatidine, and ranitidine) and proton pump inhibitors (omeprazole, esomeprazole, lansoprazole, pantopra-zole, and rabeprazole) reduce the amount of acid secreted into the stomach by gastric parietal cells. These agents are also helpful for nausea and vomiting related to gastric acid secretion. 

At neutral pH proton pump inhibitors are chemically stable, lipid-soluble, weak bases that have no inhibitory activity. In an acid environment they become protonated and a sulfenamide is formed. This sulfenamide binds covalently to the K+H+-ATPase proton pump in the gastric parietal cells, inhibiting this enzyme irreversibly and thus the entry of H+ ions into lumen. Omeprazole metabolizes at a pH of about 3.9. 1, whereas rabeprazole metabolizes at a pH of about 4.9. Secretion of acid only becomes possible again after new molecules of K+H+-ATPase are formed. 

Aciphex (Rabeprazole) 8.1 (0.4) 8.5 (0.3) 7.1 (0.3) Block tbe enzyme that pumps into the secretory side of the parietal cells of the stomach. 

Rabeprazole belongs to substituted benzimidazole proton-pump inhibitors. In gastric parietal cells, rabeprazole is proto-nated, accumulates and is transformed to an active sulfenamide. 

There are currently four racemic PPIs available on the market omeprazole, lansoprazole, pantoprazole, and rabeprazole. (More recently, enantiomerically pure versions have also been studied and developed, e.g., S-omeprazole, marketed by AstraZeneca as esomeprazole see Chapter II-2.) Proton pump inhibitors share the same core structure, the substituted pyridylmethyl-sulfmyl-benzimidazole, but differ in terms of substituents on this core structure. The absolute requirements of the core structure for the activity of PPIs was not understood until it became clear that the active PPIs are derived from inactive prodrugs the prodrugs are transformed, in the acid-secreting parietal cells, by a unique cascade of chemical structural transformations leading to the active principle, a cyclic sulfenamide species. Inhibition of acid secretion in turn is then achieved by formation of covalent disulfide bonds with key cysteines of the (H+/K+)-ATPase. 

Omeprazole (p. 171) can cause maximal inhibition of HC1 secretion. Given orally in gastric juice-resistant capsules, it reaches parietal cells via the blood. In the acidic milieu of the mucosa, an active metabolite is formed and binds covalently to the ATP-driven proton pump (H+/K+-ATPase) that transports H+ in exchange for I<+ into the gastric juice. Lansoprazole, pantoprazole, and rabeprazole produce analogous effects. Omeprazole is a racemate. With respect to dosage, the now available (S)-omeprazole (esomeprazole) represents the more potent enantiomer, but this offers no therapeutic advantage. 

Rabeprazole AcipHex , Pariet Spironolactone Aldactone , Spiroctan ... 

Rabeprazole Pariet Eisai/Janssen Proton-pump inhibitor... 

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