PARIET ® Rabeprazole

PARIET ® is a Rabeprazole sodium based drug.

THERAPEUTIC GROUP: Antireflux - Antiulcer-Proton pump inhibitors

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications PARIET ® Rabeprazole

PARIET ® is useful in the treatment of all those diseases of the gastrointestinal tract, associated with increased gastric acidity, such as duodenal ulcers, gastric ulcer, gastro-oesophageal reflux disease, esophagitis and Zollinger-Ellison syndrome.

In combination with antibiotics PARIET ® can also be used in the eradicating therapy of Helicobacter Pylori.

Mechanism of action PARIET ® Rabeprazole

Rabeprazole, contained in PARIET ®, is one of the benzimidazole derivatives and in the broadest category of proton pump inhibitors.

Its therapeutic efficacy, in fact, is due to its capacity, once absorbed intestinal and distributed through the circulatory stream linked to plasma proteins, to activate in acidic environments such as gastric canaliculi and selectively inhibit the H + / K + ATPase pump, involved in the secretion of hydrogenions in the intragastric lumen, and expressed on the surface of the parietal cells.

More precisely, the inhibitory action is observed after a few hours, to optimize around the third day, with a reduction of the intragastric acid content of about 80%.

Following a hepatic metabolism, supported by highly polymorphic enzymes such as cytochrome p450 (CYP2C19 and CYP3A4), the metabolites of rabeprazole are eliminated mainly through the urine in the form of inactive compounds.

Studies carried out and clinical efficacy

1. EFFECTIVENESS AND SAFETY OF LONG-TERM RABEPRAZOLE THERAPY

Rabeprazole is also very suitable for long-term treatment of gastro esophageal reflux. This study conducted on Japanese patients who took this drug for about 2 years, showed an important regression of symptoms, without the appearance of significant gastric lesions, despite the appearance in a few cases of polyps or cysts without tumor markers. Although this effect has not yet been demonstrated, it could be associated with increased drug-induced gastrin secretion.

2. RABEPRAZOLE AND GASTRIC ULCERS

The surgical treatment of gastric carcinoma removal evidently determines the appearance of lesions and ulcers of the gastric mucosa. The concomitant therapy between rabeprazole and rebapimide, has proved to be particularly effective in reducing the symptoms, decisively facilitating the healing of the ulcer induced by the intervention.

3. INHIBITORS OF THE PROTONIC PUMP COMPARED

This interesting study has shown that controlled release rabeprazole can guarantee a longer duration of action than suppression of acid secretion, prolonged even by 24 hours compared to that induced by esomeprazole or standard formulations of the same active ingredient.

Method of use and dosage

PARIET ® gastro-resistant tablets of 10 - 20 mg of rabeprazole:

a daily dose of 20 mg of raberazole, taken in a single morning administration, was found to be particularly effective in reducing the symptoms associated with gastro-oesophageal reflux and in healing duodenal and gastric ulcers, in just 4-8 weeks of treatment.

Despite the aforementioned dosage, which is the most commonly used, the intake of rabeprazole may be subject to important variations in terms of dosage depending on the patient's physiopathological conditions and therapeutic goals.

Consequently the intake of PARIET ® should be regulated and supervised by a competent doctor.

Warnings PARIET ® Rabeprazole

The intake of PARIET ® in patients with impaired renal and hepatic function, should take place under strict medical supervision, given the presence of studies showing that reduced hepatic metabolism may lead to an increase in even significant rabeprazole blood concentrations.

Before taking rabeprazole as well as for all acid proton pump inhibitors, it would be important to exclude malignant forms of gastro-intestinal disease, whose symptoms could be masked by the therapeutic effects of the drug during its intake.

Despite the administration of rabeprazole, especially when continued over time, is responsible for a significant increase in blood gastrin levels, no incidence of histological pathologies or lesions of the gastric mucosa was observed.

The presence of side effects such as headache, dizziness and drowsiness could compromise the normal ability to drive vehicles and use machinery.

PREGNANCY AND BREASTFEEDING

Intake PARIET ® is contraindicated in pregnancy and during the subsequent lactation period, given the absence of clinical trials or experimental models able to attest to the absence of toxicity to the health of the fetus and infant, following the assumption of rabeprazole in pregnancy or lactation.

Interactions

Although rabeprazole is metabolised by cytochrome p450 enzymes, involved in the metabolism of numerous active ingredients, the absence of interference with the normal metabolic activities of these enzymes has been observed.

So in most cases, the main pharmacokinetic changes induced by PARIET ® are essentially due to the significant reduction in the acid content of the stomach, which can reduce the absorption of different drugs such as antifungals.

Contraindications PARIET ® Rabeprazole

PARIET ® is contraindicated in pregnancy and lactation and in patients with known hypersensitivity to rabeprazole or other active ingredients belonging to the category of proton pump inhibitors.

Undesirable effects - Side effects

Rabeprazole contained in PARIET ® has proved to be quite well tolerated despite the presence of side effects such as cough, pharyngitis, rhinitis, diarrhea, nausea, vomiting, flatulence, constipation, abdominal pain, insomnia, dizziness and clinically insignificant headaches.

More serious adverse reactions such as nephritis, gastritis, skin, visual and hematological disorders have been observed very rarely and especially in particular categories of patients at risk.