Barole 20mg Mega Lifesciences treatment for ulcerative ulcerative gastroesophageal - esophagus (10 blisters x 10 tablets)

Acid secretion effect

After taking the dose of 20 mg Rabeprazol, the effect of inhibiting gastric acid secretion will appear within 1 hour, maximum effect within 2-4 hours. The ratio of basic acid secretion and food stimulating at 23 hours after taking Rabeprazol's first dose is 69% and 82% in order, the inhibitor can last up to 48 hours. The effect of inhibiting acid secretion increases slightly at a daily dose once and stabilizes after 3 days of medication. Acid secretion returns to normal after 2-3 days of stopping the drug.

Pharmacokinetics

absorption

When taking orally 20 mg Rabeprazol, the peak plasma concentration is achieved after 2-5 hours. There is no significant accumulation when taking a dose of 10 - 40 mg for 24 hours, Rabeprazol's pharmacokinetics does not change by high doses. Selling time for plasma is 1-2 hours.

Distribution

rabeprazol is detected in plasma after 1 hour oral at a dose of 20 mg.

Absolute bioavailability of rabeprazol capsules is about 52% and about 93% Rabeprazole binds to plasma proteins.

Metabolism

Rabeprazol is strongly metabolized, the main metabolic form detected in plasma is thioete and sulphon. There is no excretion inhibition in these forms of metabolic. In vitro tests show that Rabeprazol is metabolized mainly through the liver, due to Cytochrom P450 3A (Sulphon form) and 2C19 (Desmethyl Rabeprazol).

Elimination

90% of the drug excreted in the urine, mainly in the form of a carboxylic acid, glucoronide bonding and mercapturic acid metabolism. 

rabeprazol gives anti -secreting effect within 1 hour after taking the dose of 20 mg. The average inhibitory effect of Rabeprazol on the acidity of the stomach within 24 hours is equal to 88% of the maximum after using the single dose. Compared to placebo, Rabeprazol 20 mg inhibits acidic excretion due to stimulation by normal meals and pepton meals are 86% and 95%, increasing the percentage of the period of 24 hours and the stomach has a pH> 3 from 10% to 65%. This prolonged pharmacological impact compared to the short selling time of the drug (1-2 hours) shows the prolonged inhibition effect on H+-K+-atpase.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Be cautious when using

need to rule out the possibility of gastric cancer or esophageal cancer before using the drug.

Patients with long -term treatment (especially over 1 year) need to be checked regularly.

There is a risk of cross -allergy to other proton pump inhibitors or benzimidazol derivatives.

Barole 20 is not chewed or crushed, need to swallow the whole tablet.

It is not recommended to use Barole 20 for children as well as careful use of Barole 20 in patients with severe liver failure because they have no experience in using these objects.

Rabeprazol may cause hematopathy (thrombocytopenia and neutrophils), liver enzyme disorders. At that time, if there is no other cause, it is necessary to stop rabeprazol.

There is no recommendation to simultaneously use Azatanavir with Barole 20.

Barole 20 can increase the risk of gastrointestinal infections with Samonella, Campylobacter and Clostridium difficile.

Proton pump inhibitors, especially when using high and long -term doses (> 1 year) can increase the risk of hip, wrist and spine fractures, mostly occurs in the elderly or other risk factors. Patients with the risk of osteoporosis should be treated according to the current regimen and should use enough vitamin D and calcium.

Rabeprazole can cause serious blood magnesia when used for 3 months or more and most of them are about 1 year. The serious manifestations of blood magnesi blood such as fatigue, muscle spasms, delirium, convulsions, dizziness and ventricular arrhyths may occur but they can progress silently and be overlooked. Blood magnesium reduction is improved after supplementing magnesi and stopping using Proton pump inhibitors.

In patients who need long -term treatment or use proton pump inhibitors with digoxin or drugs that can cause blood magnesium (such as diuretics), doctors need to consider magnesium levels before starting treatment with proton pump inhibitors and periodic monitoring during treatment.

Proton pump inhibitors are related to the cases of SCLE Red Red Red Red Red Red Red Red Red Red. If the lesions occur, especially in the skin -exposed skin areas and if there is pain, the patient should be provided with medical support immediately and need to consider stopping the use of Barole 20.

Increased chromographin A (CGA) concentration can obstruct the diagnosis of endocrine nerve tumors. Stop using Barole 10 at least 5 days before measuring CGA. If CGA and Gastrin level do not return to the reference value after the first measurement, need to be repeated after 14 days when stopping treatment with proton pump inhibitors.

The ability to drive and operate machinery

The drug can cause headaches or dizziness, recommend not to drive or operate machinery when using Rabeprazol.

Pregnancy

Contraindicated in pregnant women.

Lactation period

Contraindicated in breastfeeding women.

Drug interaction

simultaneous use of proton pump inhibitors with methotrexate may increase and prolong the serum level of methotrexate and its metabolic substances, resulting in toxicity of methotrexate. When indicating high doses of methotrexate, the temporary suspension of Proton pump inhibitors can be considered.

Rabeprazol sodium can reduce the absorption of vitamin B12 (cyanocobalamin). Therefore, this should be considered when treated in patients with a decrease in vitamin B12 reserve in the body, or there are risk factors for reducing vitamin B12 absorption when long -term treatment or when observing the clinical symptoms of this deficiency.

Rabeprazol is metabolized through the cytochrom P450 metabolic enzyme system (CYP450) but there is no significant clinical interaction with other drugs metabolized through CYP450 systems such as Warfarin, Theophylin, Diazepam and Phenytoin. 

rabeprazol gives prolonged excretion of gastric acid excretion, so it may occur interactive with drugs where the level of absorption depends on the stomach pH such as ketoconazole (down 33%). Therefore, patients need to be carefully monitored when using rabeprazol with these drugs.

Using rabeprazol with antacids that do not change rabeprazol levels in plasma.