rabeprazole DR
Rabeprazole (Aciphex) is a medication used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving too much stomach acid. The dosage is typically once a day for most conditions. Rabeprazole (Aciphex) isn't know to cause many side effects, but some of the more common ones include constipation and passing gas. Long-term use of rabeprazole (Aciphex) raise the risk for more serious warnings, such as the risk of bone fractures.
What is Rabeprazole (Aciphex)?
What is Rabeprazole (Aciphex) used for?
For adults only:
Lower the risk of duodenal ulcer(s) caused by Helicobacter pylori (H. pylori) infection
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)
For adults and children 12 years and older:
Gastroesophageal reflux disease (GERD)
How Rabeprazole (Aciphex) works
Rabeprazole (Aciphex) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach by blocking the final step of stomach acid production. This helps relieve heartburn and other stomach problems.
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What are the side effects of Rabeprazole (Aciphex)?
Common Side Effects
- Pain (3%)
- Sore throat (3%)
- Passing gas (3%)
- Infections (2%)
- Constipation (2%)
Other Side Effects
- Headache
- Belly pain
- Diarrhea
- Dry mouth
- Dizziness
- Swelling of the hands and feet
- Muscle or joint pain
Serious Side Effects
- Severe stomach pain or diarrhea
- Kidney problems: urinating more or less than usual, fever, poor appetite
- Lupus symptoms: joint pain, skin rash on arms or cheeks that gets worse in the sunlight
- Serious skin reactions: blistering, peeling, or bleeding skin, fever, chills
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
chills
dark urine
general feeling of tiredness and weakness
hoarseness
light-colored stools
lower back or side pain
painful or difficult urination
rapid weight gain
tingling of the hands or feet
unusual weight gain or loss
vomiting
yellow eyes and skin
Rare
Bloody urine
continuing ulcers or sores in the mouth
difficulty with breathing
seizures
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
Back, leg, or stomach pains
bleeding gums
blistering, peeling, or loosening of the skin
blood in the urine or stools
bloody, black, or tarry stools
change in consciousness
clay-colored stools
cloudy urine
confusion about identity, place, person, and time
continuing nausea or vomiting
difficulty with swallowing
dizziness
drowsiness
fast heartbeat
general body swelling
greatly decreased frequency of urination or amount of urine
headache
high fever
holding false beliefs that cannot be changed by fact
increase in the frequency of seizures
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
loss of appetite
loss of consciousness
mood or mental changes
muscle cramp, pain, or stiffness
muscle spasms (tetany) or twitching
no blood pressure
no breathing
no pulse
nosebleeds
pale skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
seeing, hearing, or feeling things that are not there
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
tightness in the chest
trembling
unpleasant breath odor
unusual excitement, nervousness, or restlessness
vomiting of blood
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bad, unusual, or unpleasant (after) taste
change in taste
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Rabeprazole (Aciphex)
Pros
Can continue to use with antacids, such as calcium carbonate
Available as a lower-cost generic medication
People with GERD can take this without regard to food
Can be taken once or twice a day
Cons
Interacts with warfarin (Coumadin), which can raise the risk of bleeding
Long-term use might weaken bones and raise the risk of bone fracture
Might cause or worsen lupus
Tablets can't be crushed or chewed, which is inconvenient for people with trouble swallowing
Pharmacist tips for Rabeprazole (Aciphex)
Typically, rabeprazole (Aciphex) can be taken with or without food. But if you're taking this medication to treat H. pylori or duodenal ulcers, it's best to take it with food.
For the treatment of duodenal ulcers, take rabeprazole (Aciphex) in the morning after breakfast. For H. pylori therapy, take your first dose with breakfast and your second dose with dinner. Ask your provider or pharmacist if you have questions about the best time to take rabeprazole (Aciphex).
Swallow the rabeprazole (Aciphex) pills whole. Don't chew or crush the pills. Doing so can change how the medication gets absorbed into your body.
Rabeprazole (Aciphex) can interact with many medications. Let your provider or pharmacist know what medications you take or plan to take. These medications include over-the-counter products and supplements. Talk with your provider or pharmacist if you have any questions about interactions with this medication.
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Frequently asked questions about Rabeprazole (Aciphex)
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What are the risks and warnings for Rabeprazole (Aciphex)?
Rabeprazole (Aciphex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of hiding symptoms of a more serious problem
Frequent episodes of GERD can sometimes be a symptom of stomach cancer. If your symptoms of GERD get worse or come back after taking rabeprazole (Aciphex), let your provider know. Also contact your provider if you have poor appetite, unexplained weight loss, or weakness along with GERD. They can check if there are other serious medical problems going on.
Sudden kidney problems
Some people taking PPIs have developed sudden kidney inflammation. Though rare, this problem can happen at any point during treatment. Talk with your provider if you are urinating more or less than usual, feel nauseous or weak, or have a fever, rash, or joint pain.
Severe infectious diarrhea
Risk factors: Older adults | Recent stay at a hospital or nursing home | People with a weakened immune system
Some clinical studies showed that taking PPIs, such as rabeprazole (Aciphex), can raise the risk of infectious diarrhea. Your risk is higher if you're over 65 years old, have recently stayed at a hospital or nursing home, or have a weakened immune system. To lower your risk of infectious diarrhea, take the lowest possible dose of rabeprazole (Aciphex) for the shortest amount of time that works well for you. If you experience severe or watery diarrhea, fever, belly pain, loss of appetite, or nausea, let your provider know right away.
Risk of bone fractures
Risk factors: Taking high doses of rabeprazole (Aciphex) | Taking rabeprazole (Aciphex) for longer than a year | Risk for osteoporosis
PPIs, like rabeprazole (Aciphex), might raise the risk of bone fractures in the hip, wrist, or spine. Your risk is higher if you take more than one dose of rabeprazole (Aciphex) per day or if you take it for more than a year. To prevent the risk of bone fracture, take the lowest possible dose of rabeprazole (Aciphex) for the shortest amount of time for your symptoms. If you've had bone fractures before or have osteoporosis (weak bones), talk to your provider about your risk before using this medication.
Skin reactions
PPIs, such as rabeprazole (Aciphex), have rarely caused serious skin reactions. These reactions include Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Symptoms can include fever, body aches, rash, peeling skin, painful blisters, and swelling of the face. If you notice any of these symptoms, get medical help immediately.
Lupus
Some people taking PPIs like rabeprazole (Aciphex) developed new or worsening lupus, a condition where your immune system attacks your own body. Lupus symptoms can occur any time during treatment with rabeprazole (Aciphex). Some typical symptoms include joint pain or rash, but they often improve within 1 to 3 months of stopping this medication. If you experience any lupus symptoms while taking rabeprazole (Aciphex), stop the medication and contact your provider.
Low vitamin B12 and magnesium levels
Taking acid-lowering medications like rabeprazole (Aciphex) for 3 years or longer can lead to poor vitamin B12 absorption. Talk to your provider if you've symptoms of vitamin B12 deficiency, such as dizziness, muscle weakness, pale skin, tiredness, or tingling in arms or legs.
Taking rabeprazole (Aciphex) for 3 months or longer can raise your risk for low magnesium levels, which can sometimes lead to other electrolyte problems. Your risk is higher if you're also taking other medications that can affect electrolyte levels, such as digoxin (Lanoxin) or [water pills]. Let your provider know if you've symptoms electrolyte problems like irregular heart rate, muscle cramps, and tremors.
Interaction with other medications
Rabeprazole (Aciphex) can interfere with how other medications work. An important medication to avoid with rabeprazole (Aciphex) is Edurant (rilpivirine). This is because rabeprazole (Aciphex) can lower the amount of Edurant (rilpivirine) in your body and cause the medication to not work as well, which can lead to human immunodeficiency virus (HIV) spreading in your body. Make sure to avoid taking these medications together.
In addition, rabeprazole (Aciphex) can also interact with warfarin (Coumadin), which can raise your risk of abnormal bleeding. Your provider will monitor your bloodwork (e.g., INR) to make sure these medications are safe to take together. Watch out for nosebleeds, dizziness, unusual bruising, or bleeding from cuts that take a long time to stop.
Finally, rabeprazole (Aciphex) can raise the risk of methotrexate toxicity when taken together with methotrexate.
Rabeprazole (Aciphex) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 30 tablets | $19.94 | $0.66 |
Typical dosing for Rabeprazole (Aciphex)
Treatment of ulcerative gastroesophageal reflux disease (GERD): The typical recommended dose is 20 mg by mouth once daily for 4-8 weeks. Your provider might consider another 8 weeks of treatment for you if you still have symptoms.
Maintenance treatment of ulcerative GERD: The typical recommended dose is 20 mg by mouth once daily.
Duodenal ulcer: The typical recommended dose is 20 mg by mouth in the morning for up to 4 weeks.
H. pylori triple therapy: The typical recommended dose is 20 mg by mouth twice a day for 7 days. It's usually taken together with amoxicillin and clarithromycin.
Medical conditions that cause too much stomach acid: The typical starting dose is 60 mg by mouth once daily.
Interactions between Rabeprazole (Aciphex) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Rilpivirine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acalabrutinib
- Amphetamine
- Atazanavir
- Benzphetamine
- Bosutinib
- Capecitabine
- Cilostazol
- Clopidogrel
- Dacomitinib
- Dasatinib
- Dextroamphetamine
- Digoxin
- Erlotinib
- Eslicarbazepine Acetate
- Gefitinib
- Ketoconazole
- Ledipasvir
- Lisdexamfetamine
- Methamphetamine
- Methotrexate
- Mycophenolate Mofetil
- Nelfinavir
- Neratinib
- Nilotinib
- Octreotide
- Pazopanib
- Pexidartinib
- Saquinavir
- Secretin Human
- Selpercatinib
- Sunitinib
- Velpatasvir
- Vismodegib
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Rabeprazole (Aciphex) cost?
Rabeprazole (Aciphex) contraindications
People taking Edurant (rilpivirine) or rilpivirine-containing medications (e.g., Complera)
What are alternatives to Rabeprazole (Aciphex)?
For adults only:
Lower the risk of duodenal ulcer(s) caused by Helicobacter pylori (H. pylori) infection
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)
For adults and children 12 years and older:
Gastroesophageal reflux disease (GERD)
Heartburn — OTC only
Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)
Frequent heartburn (2 or more days a week) - OTC only
Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
Lower the risk of stomach ulcer due to nonsteroidal anti-inflammatory drugs (NSAID)
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)
What is the latest news about Rabeprazole (Aciphex)?
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References
Best studies we foundAmerican Cancer Society. (2021). Signs and symptoms of stomach cancer.
Aurobindo Pharma Limited. (2023). Rabeprazole sodium - rabeprazole sodium tablet, delayed release. DailyMed.
Bidaki, R., et al. (2017). Accidental chronic poisoning with methotrexate; Report of two cases. Emergency.
Cheung, K. S., et al. (2019). Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence. Therapeutic Advances in Gastroenterology.
Katz, P. O., et al. (2022). ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. The American Journal of Gastroenterology.
MedlinePlus. (2022). Prothrombin time test and INR (PT/INR).
O’Brien, F. (2023). Tubulointerstitial nephritis. Merck Manual Consumer Version.
Pace, F., et al. (2007). A review of rabeprazole in the treatment of acid-related diseases. Therapeutics and Clinical Risk Management.
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