Rabeprazole

Rabeprazole (available as the brand-name drug Aciphex[1]) is a type of medicine called a proton pump inhibitor (PPI). It reduces the amount of acid the stomach makes[2]. It is widely used to treat heartburn, acid reflux and gastro-oesophageal reflux disease (GORD).[2] GORD is when someone keeps getting acid reflux. Rabeprazole is also taken to prevent and treat stomach ulcers.[2] Sometimes, it is also prescribed for a rare condition caused by a tumour in the pancreas or gut, called Zollinger-Ellison syndrome.[2]

This medicine can cause serious allergic reactions which require emergency treatment. Make sure the signs of these reactions are known: read allergic reaction symptoms of drugs.

Rabeprazole is not usually recommended during pregnancy but someone may be able to take it while breastfeeding if the doctor says it is OK. Ask a doctor for advice.[2]

Side effects

Common side effects include headaches, diarrhoea, feeling or being sick, constipation, stomach pain. These tend to be mild and go away after stopping taking the medicine. More side effects are listed below. These may not be all of the side effects - check the inside of the medicine packet.[2]

Common side effects

There are things to do to help cope with side effects if needed. These common side effects of rabeprazole happen in more than 1 in 100 people:[2]

Keep taking the medicine, but talk to a doctor if advice does not help and the side effects are a bother or do not go away.[2]

Serious side effects

Some of these serious side effects are more common than others. Call a doctor or call non-emergency services now if there is:[2]

  • joint pain along with a red skin rash, especially in parts of the body exposed to the sun, such as the arms, cheeks and nose (this may be less noticeable on brown on black skin) – these can be signs of a rare condition called subacute cutaneous lupus erythematosus (SCLE). This can happen even if someone has been taking rabeprazole for a long time. See also: lupus
  • diarrhoea that is severe or that does not go away – this can be a sign of an inflamed bowel
  • noticing stomach pains that are getting worse, the whites of the eyes or skin turns yellow, although this may be less obvious on brown or black skin – this can be a sign of liver problems
  • getting frequent infections, such as a sore throat or high temperature, or ulcers in the mouth or throat
  • easily bruising or bleeding easily

Long term side effects

If taking rabeprazole for more than 3 months, it may cause the levels of magnesium in the blood to fall. Low magnesium can make someone feel tired, confused and dizzy, and cause muscle twitches, shakiness and an irregular heartbeat. Tell a doctor if getting any of these symptoms.[2]

Taking rabeprazole for more than a year may increase the chances (risk) of certain side effects, including:

If taking rabeprazole for longer than a year, a doctor will regularly check on the person's health to see if they should carry on taking it.[2]

Other side effects

These are not all the side effects of rabeprazole. For a full list see the leaflet inside the medicines packet.[2]

Who can and cannot take rabeprazole

Most adults can take rabeprazole. However, rabeprazole is not suitable for everyone. To make sure that it is safe, report the following to a doctor if:[2]

  • ever had an allergic reaction to rabeprazole or any other medicine
  • are pregnant, trying to get pregnant or breastfeeding
  • are due to have an endoscopy

If due to have an endoscopy, ask a doctor if taking rabeprazole should stop for a few weeks before the procedure. This is because rabeprazole may hide some of the problems that would usually be spotted during an endoscopy.[2]

Dosage and strength, and how to take it

Rabeprazole tablets contain 10mg or 20mg of rabeprazole.[2]

The usual dose to treat:[2]

  • heartburn, acid reflux and gastro-oesophageal reflux disease
    • 10mg to 20mg a day
  • stomach ulcers
    • 20mg a day
  • Zollinger-Ellison syndrome
    • 60mg to 120mg a day

Pregancy and breastfeeding

Rabeprazole is not usually recommended because there is little information about its use during pregnancy.[2]

A similar medicine, called omeprazole, may be recommended instead as there is more safety information available.[2]

If wanting to treat these symptoms without taking medicine, there are things which can be done. One could try eating smaller meals more often, avoiding fatty and spicy food and sitting up straight when eating - this will take the pressure off of the belly. If symptoms appear when going to bed at night, propping the head and shoulders up can stop stomach acid coming up while sleeping.[2]

Rabeprazole and breastfeeding

If the doctor or health visitor says the baby is healthy, it is OK to take rabeprazole while breastfeeding. However, they might recommend a similar medicine we know more about.[2]

It is not known how much rabeprazole gets into breast milk, but it is likely to be a small amount. Baby will not take in a lot from the breast milk.[2]

It is unlikely that rabeprazole will cause any side effects in baby.[2]


How long to take it

Depending on the condition it is meant to treat, someone may only take rabeprazole for a few weeks or months. Sometimes they might need to take it for longer, even many years. Some people do not need to take rabeprazole every day and take it only when they have symptoms. Once they feel better (often after a few days or weeks), they can stop taking it.[2]

Taking rabeprazole for a short time to treat symptoms is not suitable for everyone though. Speak to a doctor about what's best for you.[2]

Forgotten or missed doses

If usually taking it:[2]

  • once a day
    • take the missed dose as soon as it is remembered, unless the next dose is due in less than 12 hours, in which case skip the missed dose and take the next dose at the usual time
  • twice a day
    • take the missed dose as soon as it is remembered unless it is 4 hours or less until the next dose. In this case, take the next dose as normal

Do not take 2 doses to make up for a forgotten dose.[2]

If forgetting doses often, then it may help to set an alarm as a reminder.[2] A pharmacist may be able to offer advice on other ways to remember medicine doses.

Stopping rabeprazole

Usually, people can stop taking rabeprazole without reducing their dose first.[2]

If someone has taken rabeprazole for a long time, they should speak to the doctor before stopping taking it. Stopping the medicine suddenly could make the stomach produce a lot more acid, and make symptoms return. Reducing the dose gradually before stopping completely will prevent this happening.[2]

Taking too much

Taking 1 or 2 extra doses of rabeprazole is unlikely to cause someone any problems.[2]

After taking an extra dose, some of the common side effects may occur. If this happens or is a concern at all, contact the doctor.[2]

Conflicts/Synergies (other medicines)

Rabeprazole can be taken with antacids like calcium carbonate (Tums), sodium bicarbonate, Maalox and Milk of Magnesia. They help to relieve indigestion and heartburn by reducing the damage that acid can do to the stomach. They give quick relief that lasts for a few hours. They are ideal for occasional bouts of stomach acid symptoms.[2]

Some antacids, such as Gaviscon, have an extra ingredient called alginic acid. They work by lining the stomach so that juices from it do not splash up into the food pipe. They are especially good for relieving acid reflux[2] says the British government, who like Gaviston a lot (interest stated).

References
  1. Source HealthLine
  2. "Rabeprazole: medicine to lower stomach acid". nhs.uk. 2022-01-20. Retrieved 2024-06-11.
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