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What is AcipHex?
AcipHex (Rabeprazole sodium) is a
drug used to treat gastroesophageal reflux disease, or GERD, which is a common
digestive problem. In GERD, acid from the stomach flows backward into the
esophagus, and irriatates the lining of the esophagus. A muscle usually keeps
stomach acid from flowing back into the esophagus, but in GERD, this muscle
allows acid from the stomach into the esophagus
AcipHex can be taken without regard to meals, but the manufacturer suggests
taking it after the morning meal in patients with duodenal ulcer. Tablets should
be swallowed whole, without crushing or chewing.
Acid is secreted in the stomach by a type of cell called the parietal cell.
There is an enzyme pump (called the H+/K+ ATPase pump) on the side of this cell
closest to the stomach lining that pumps acid into the stomach. This is known as
the proton pump. The class of drugs to which rabeprazole belongs inhibits this
pump. This is why they're called proton-pump inhibitors. Specifically,
rabeprazole blocks the final step in the acid secretion. In contrast to the
other PPIs, rabeprazole forms a partially reversible bond with the proton pump.
It also works at a broader range of stomach pH. For these reasons, it may work
for longer than other PPIs.
Complications: There have been some studies that suggest an increased
risk of some respiratory infections (eg. community aquired pneumonia) and
Clostridium difficile (an organism causing colitis, an inflammation of the
bowel) in people taking proton-pump inhibitors (the class of drug that
rabeprazole is in). Also, there may an increased risk of hip fracture with
prolonged use of proton pump inhibitors. All of these studies have been
criticized by some experts for having a flawed study design, so it isn't clear
whether the results are meaningful.
Precautions: Rabeprazole does not work for everyone. Improvement in
symptoms does not prevent other stomach-related medical conditions. Rabeprazole
should be used with caution in patients with severe liver impairment.
Rabeprazole is a pregnancy category B drug, meaning there are no studies to
determine whether it is safe in pregnancy. It is unknown whether rabeprazole is
distributed in breast milk; therefore, depending on the circumstances, either
breast feeding or the drug should be discontinued.
Contraindications: Rabeprazole is contraindicated for use in any patient
that is sensitive to any of its active or inactive ingredients
Proton-pump inhibitors (PPIs) in general may inhibit
the absorption of drugs such as: some antifungals, such as griseofulvin
(Grisactin), ketoconazole (Nizoral), itraconazole (Sporanox) iron salts
vitamin B12 cefpodoxime (Vantin) enoxacin (Penetrex). PPIs are metabolized
(broken down) to varying degrees by an enzyme system in the liver called the
cytochrome P450 system. They may speed up or slow down the metabolism of other
drugs by increasing or decreasing the effects of the cytochrome P450 enzymes.
This is important in patients taking medications in which a small difference in
dose can be important to its safety, such as: diazepam (Valium) phenytoin
(Dilantin) warfarin Rabeprazole is less likely to have some of these
interactions as compared to some other drugs in the proton-pump inhibitor class.
Still, possible interactions need to be kept in mind.How is AcipHex taken?
How does AcipHex work?
What are the risks of using AcipHex?
What other medications interact negatively with AcipHex?
