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Rabeprazole – Comparative Pharmacodynamics Percent inhibition of the H+/K+-ATPase 100% 47% 66% At 10 minutes Activation time (minutes) 100% 83% 100% At 45 minutes 7.2 84 90 At a pH of 5.1 1.3 2.8 2.0 At a pH of 1.2 Rabeprazole Omeprazole Lansoprazole Pharmaco-dynamic Parameter Pharmacodynamic Parameters of the PPIs
Rabeprazole – Increased Acid suppression * Barnett JL et al, Managed Care 2001
Rabeprazole – Faster symptom relief * Barnett JL et al, Managed Care 2001
Rabeprazole and esomeprazole achieve more rapid and profound inhibition of acid secretion than do older agents (omeprazole, lansoprazole and pantoprazole).
They sustain this suppression to provide acid control and symptom relief over 24 h.
The balanced hepatic metabolism of rabeprazole, involving both cytochrome P450 (CYP)-mediated reactions in the liver and nonenzymatic reactions, appears to confer an advantage over other PPIs including esomeprazole.
Dosing - 20 mg od – Because PPIs inhibit only actively secreting proton pumps, gastric acid suppression is optimal when the PPI is taken about 30 minutes before a meal ;
Instructions - Patients should not crush, chew or split the tablets.
Special - No dosage adjustment is necessary in renal and mild to moderate hepatic impairment, elderly subjects. Even in severe liver disease, drug accumulation is unlikely with rabeprazole but dose adjustments have not been assessed.*