Rabeprazole adverse effects

PHENYTOIN PROTON PUMP INHIBITORS Possible t efficacy and adverse effects of phenytoin Unclear possible altered metabolism via CYP2C19 1 dose may be required. Use the proton pump inhibitor regularly, not PRN monitor phenytoin levels when starting or stopping treatment. Patients have received omeprazole for 3 weeks without altered phenytoin levels. Effect not reported with pantoprazole or rabeprazole... 

In a similar study in 221 patients with peptic ulcer disease associated with H. pylori, rabeprazole has been compared with omeprazole and lansoprazole (combining them with amoxicillin plus clarithromycin for 1 week) (6). Rabeprazole was as effective as omeprazole and lansoprazole in eradicating H. pylori (84-88% each). There were no differences in reported adverse events. Common adverse effects were soft stools, glossitis, taste disturbances, and skin rashes. 

In a randomized, controlled trial in 120 patients supplementation with inactivated Lactobacillus acidophilus tds significantly improved the efficacy of a standard 7-day regimen with rabeprazole 20 mg bd, clarithromycin 250 mg tds, and amoxicillin 500 mg tds (12). There was no significant difference in adverse effects between the two groups. Those reported were abdominal pain, nausea, and diarrhea. 

In a randomized, placebo-controlled trial in 60 healthy, asymptomatic subjects who screened positive for H. pylori, supplementation with Lactobacillus GG twice daily for 14 days significantly reduced the adverse effects (diarrhea, nausea, taste disturbance) and improved the overall tolerability of a standard 7-day eradication regimen consisting of rabeprazole 20 mg bd, clarithromycin 500 mg bd, and tinidazole 500 mg bd (13). 

Rabeprazole 20 mg/day has been compared with omeprazole 20 mg/day in a randomized, double-blind, multicenter study in 205 patients with active duodenal ulcers (6). Rabeprazole produced healing rates equivalent to omeprazole at 2 and 4 weeks of treatment (69 versus 61% and 98 versus 93% respectively) and greater improvement in day-time pain. Both drugs were well tolerated adverse effects were similar, and included... 

In a multicenter, double-blind, crossover study in primary care in 240 patients with acid-related disorders, omeprazole 20 mg/day and rabeprazole 40 mg/day for 4 weeks provided similar symptom control (16). The adverse effect profiles were also similar in the two groups. However, more patients preferred rabeprazole to omeprazole. 

The adverse effects profile of the proton pump inhibitors during short-term administration (under 12 weeks) is similar to that reported with short-term use of histamine receptor antagonists. The type and frequency of adverse effects reported with lansoprazole, omeprazole, pantoprazole, and rabeprazole are comparable. The most common adverse effects include headache, diarrhea, nausea, abdominal pain, constipation, dizziness, and skin rashes. 

The benefits and risk profile of rabeprazole, a proton pump inhibitor, have been reviewed (1,2). It has been well tolerated in both short-term and long-term studies. The overall rate of drug withdrawal because of adverse effects was 3%. Common adverse effects included diarrhea, headache, and rash. 

The safety and efficacy of rabeprazole have been evaluated in 124 patients aged 65 years and over being treated for a variety of acid-related disorders (6). Rabeprazole controlled symptoms and healed mucosal lesions. The incidence of adverse effects was 4.9%, and adverse effects were more common in the presence of hepatic dysfunction and with increasing duration of treatment. 

In an open, multicenter trial in 2579 patients with erosive gastro-esophageal reflux disease, rabeprazole 20 mg/ day for 8 weeks relieved symptoms in most patients (in over 60% by day 1 and over 80% by day 7) (8). Rabeprazole was well tolerated, and the most common adverse effects were headache, diarrhea, abdominal pain, and nausea, each reported by under 2% of the patients. 

In another open, multicenter study in 92 patients with erosive esophagitis, rabeprazole 20 mg/day was effective in healing esophageal lesions and relieving heartburn (9). Adverse effects (diarrhea, headache, and nausea) were attributed to the medication in four cases. 

In an open study in 189 patients rabeprazole 20 mg/day for 4 weeks was effective in functional dyspepsia (3). The incidence of adverse events was 8%, and included dys-geusia, diarrhea, constipation, and headache. 

Placebo-controlled studies A double-blind, placebo-controlled, randomized study of maintenance intermittent treatment with rabeprazole 20 mg/day in patients with symptomatic gastroesophageal reflux disease without esophageal erosions included a first phase of run-in with single-blind placebo for 2 weeks, a second open phase of acute treatment with rabeprazole 20 mg/day ( = 388) for 4 weeks, and a third doubleblind, placebo-controlled, intermittent maintenance phase with rabeprazole 20 mg/day ( = 200) for 6 months [75 ]. Rabeprazole was more effective than placebo. During the acute treatment phase, 52 adverse events in 26 patients were judged to be possibly or probably related to rabeprazole, the most common being nausea, diarrhea, abdominal pain, and headache. During the intermittent maintenance phase, the most common adverse events compared with placebo included diarrhea (6.8% versus 1%), nausea (4.9% versus 3.1%), and headache (4.9% versus 3.1%). 

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