Rabofar 20 kwality pharmaceutical treatment for stomach ulcer, esophagitis due to reflux (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Rabeprazol sodium

Ingredient

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Composition information	Content
Rabeprazol sodium	20mg

Uses

Indications

Stomach, duodenal ulcer. Benzimidazol, which inhibits proton pump.

Mechanism of action:

rabeprazol has the effect of inhibiting basic gastric secretion and in stimulating state, no acetylcholin resistant properties or h2 huistamine antagonists, by inhibiting the enzyme H/K *- atpase in the cell wall of the gastric mucosa. This enzyme is considered an acid, hydrogen or proton pump in the cell so Rabeprazol is considered a proton pump inhibitor. Rabeprazol is attached to this enzyme to prevent the final stage of gastric secretion. In the wall cells of the stomach, Rabeprazol is protonized and converted into active sulfenamid and then attached to the cysteine of the proton pump that makes this enzyme inactivated.

Acid secretion effect:

After taking 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 acid secretion due to food stimulating at 23 hours after taking Rabeprazol's first dose is 69% and 82%, respectively. Inhibiting time can last up to 48 hours. Rabeprazol's acid secretion effect slightly increased slightly at a daily dose once and reached a stability level after 3 days of medication. Acid secretion becomes normal after 2-3 days of stopping the drug.

Reducing stomach acid due to any cause, including rabeprazol, will lead to increased normal bacteria in the stomach - intestines. Using proton pump inhibitors may increase the risk of gastric - intestinal infections with Salmonella, Campylobacter and Clostridium difficile. For Helicobacter pylori, Rabeprazol can inhibit this bacteria in people with duodenal ulcer or reflux due to esophagitis when infected, may be due to the drug attached to bacteria inhibit the activity of urease. Rabeprazol combination therapy with 1 or more antibiotics (such as Clarithromycin, amoxicilin) can effectively base H. pylori infection.

In patients using Rabeprazol 10-20 mg daily for a period of up to 43 months, serum gastrin levels in the first 2 weeks show that Rabeprazol has the effect of inhibiting acid secretion and galastin levels that maintain stable if the treatment continues. Plasma gastrin levels will return to the value before treatment within 1-2 weeks of using the drug. Gastric pH increases (due to gastric acid secretion inhibitors) increases the production of chromium-like cells (ECL-Cell). Although in rats, there has been carcinom lesions, but in the person who has used Rabeprazol for up to 1 year, so far has not seen adenoma dysplasia.

pharmacokinetics

absorption:

Rabeprazole absorbs very quickly and the peak concentration in plasma appears at 3.5 hours after taking the medication. Oral bioavailability is about 52% for tablets soluble in the intestine due to being metabolized through the first circulatory and unchanged when using one -time dose or repeated dose. There is no clinical interaction between food. Food as well as treatment time does not affect the absorption of Rabeprazole Sodium.

Distribution:

Rabeprazol attaches nearly 97% to plasma proteins.

Metabolism:

In vitro Rabeprazol metabolizes in the liver by the isenzyme cytocltronc R450 (CYP2C19 and CYP3A4) into the conductor of the thioeter, thioeter of carboxylic acid, sulfon and desmethylioeter. At test plasma concentrations, Rabeprazol does not cause induction or CYP3A4 inhibitors. Rabeprazol's waste sale time in plasma is about 1 hour, an increase of 2 to 3 times in patients with liver failure, 1.6 times in CYP2C19 enzymes that are slowly metabolized and increased by 30% in the elderly.

Era:

Metabolic derivatives are excreted mainly through urine (nearly 90%), the rest is deducted through feces.

Sex: is adjusted for body weight and height, there is no significant gender difference in pharmacokinetics parameters after using a single dose of 20 mg of rabeprazol.

Kidney dysfunction: In patients with stable end -stage renal failure requires maintenance of blood separation (creatinine clearance ≤5ml / min / 1.73m2), the use of rabeprazol is similar to in healthy volunteers. AUC and CMAX in these patients are about 35% lower than the corresponding parameters in healthy volunteers. Rabeprazol's average selling time is 0.82 hours in healthy volunteers, 0.95 hours in patients during hemorrhage and 3.6 hours after dialysis. The clearance of the drug in patients with kidney disease needs to maintain a hemorrhage that is twice as high as a healthy volunteer.

Liver dysfunction: After taking 20 mg of Rabeprazol for patients with mild to medium chronic liver failure, AUC doubled and the semi-waste time also increased by 2-3 times compared to healthy volunteers. However, at a dose of 20 mg daily in 7 days, AUC increased to only 1.5 times and cmax only 1.2 times. Rabeprazol's waste sale time in patients with hepatic impairment is 12.3 hours compared to 2.1 hours in healthy volunteers.

Elderly people: Rabeprazol's elimination has decreased in the elderly. After 7 days of using 20 mg of Rabeprazol sodium, AUC nearly double, CMAX increased by 60% and the selling time increased by about 30% compared to healthy young people. However, there is no evidence of the accumulation of Rabeprazol.

CYP2C19 polymorphism: After taking the dose of 20mg Rabeprazol for 7 days, CYP2C19 in slow metabolic people, with AUC and the sale time of approximately 1.9 and 1.6 times compared to the corresponding parameters in people with widely metabolic while CMAX only increases by 40%.

Before taking Rabofar 20 kwality pharmaceutical treatment for stomach ulcer, esophagitis due to reflux (3 blisters x 10 tablets)

How to use

Rabofar tablets should be swallowed all, without grinding, breaking or chewing. Drink when full or hungry are okay.

Dosage

Stomach ulcer: The instruction dose is 20mg, once a day in the morning. The time of the treatment period depends on the severity of symptoms.

Most patients with duodenal ulcer for 4 weeks. However, some patients may need another 4 weeks of treatment to reach the healing stage.

Most patients with stomach ulcers and esophagitis due to reflux heal for 6 weeks. However, some patients may need an additional 6 weeks of treatment to reach the healing stage.

Gastroesophagitis: The recommended dose is 20mg oral once a day for 4-6 weeks.

Zollinger-Eleson syndrome: The starting dose is 60mg, once a day. The dose may be increased to 120mg/day depending on the level of the patient's response. The daily order is up to 100mg/day, with a dose of 120mg/day, it is necessary to divide 60mg/time x 2 times/day.

H. pylori: patients infected with H. pylori should be used in combination with other drugs. Rabeprazole sodium 20mg, 2 times/day + Clarithromycin 500mg, 2 times/day and amoxicillin 1g, 2 times/day. Treatment period is 7 days.

What to do when using overdose? However, at a dose of 2000mg/kg of weight, it did not cause death in the experimental dog. The manifestations of overdose (acute toxicity) are common, respiratory, showing signs of seizures on experimental mice, many times diarrhea, panic and coma on dogs.

If the victim is in a coma or not breathing, it is necessary to call for emergency immediately.

What to do when you forget 1 dose?

Side Effects

Common, 1/100

The most common ADR reported during clinical tests are headache, fire, abdominal pain, weakness, flatulence, rashes and dry mouth. Most of the ADR recorded during clinical tests belong to the light and medium and medium group.

Infection, insomnia, headache, dizziness, cough, sore throat, rhinitis, diarrhea, nausea, abdominal pain, constipation, unexplained pain, back pain, weakness, influenza symptoms.

Uncommon, 1/1 000

restlessness, drowsiness, indigestion, dry mouth, belching, itching, rash, muscle pain, cramps, joint pain, urinary tract infections, chest pain, chills, fever, liver enzyme.

Rare, 1/10 000

Neutral polygonal leukemia, leukopenia, thrombocytopenia, leukemia, hypertension, anorexia, depression, visual disorders, gastritis, tooth inflammation, taste disorders, hepatitis, jaundice, liver, itching, sweating, water -sweat reaction, interstitial kidney, weight gain.

Very rare, ADR

Diverse roses, poisoned epidermal necrosis, Stevens-Johnson syndrome.

ADR does not know the ratio:

Hypothesis, peripheral edema, large breasts in men.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Patients with hypersensitivity to Rabeprazole sodium, derivative benzimidazoles or any ingredients of the drug.

Do not use this medication for children, pregnant and lactating women.

Be cautious when using

rabeprazole can cause interstitial inflammation. Rabeprazol treatment for a long time (for example, more than 1 year) can lead to poorly absorbent cyanocobalamin (vitamin B-12), causing diarrhea, increasing the risk of osteoporosis, fractures related to hips, wrists or spine. Therefore, patients should use Rabeprazole in the lowest dose, in the shortest time. For patients with long -term treatment (especially over 1 year), there should be the supervision of the treating doctor.

Do not chew or break the tablet to drink.

This drug has no dose instructions for children because they have no experience used for this group.

There is no significant change when researching in patients with mild or moderate liver function impairment compared to the verification team, so no dose reduction on this object.

The drug covers the symptoms of stomach cancer so it is necessary to eliminate the possibility of malignant before treatment.

Redic lupus (SCLE): Proton pump inhibitors are rarely related to SCLE cases. If the lesions occur, especially in the skin exposed to the sun, and if accompanied by joint pain, patients should quickly consult physicians and should consider stopping the drug.

Interventions in tests: Increasing chromographin A (CGA) can hinder the investigation of nerve tumors. Therefore, Rabeprazol should be stopped at least 5 days before measuring CGA. If the CGA and Gastrin concentrations do not return to the scope of reference after initial measurement, the measurement must be repeated 14 days after stopping the treatment of Proton pump inhibitors.

methotrexate: Simultaneous use of rabeprazol with methotrexate can increase the concentration of methotrexate and hydroxymethotrexate metabolites in plasma.

The effect of the drug on driving and operating machinery

Based on the pharmacological characteristics of ADR, capable of Rabeprazole affects the ability to drive or control machinery. Due to drowsiness affects alertness, recommendations when using Rabeprazol must not drive or control machines.

Using drugs for women during pregnancy and lactation

Pregnancy:

Pregnant women: There is no complete research on pregnant women. Only use drugs when benefits are more than potential risks for the fetus.

Breastfeeding period:

Whether nursing mothers: It is unknown whether Rabeprazole is excreted through breast milk or not, the drug is excreted in milk, need to be cautious when using Rabeprazole for breastfeeding women.

Drug interaction

with ketoconazole or otraconazole: can reduce the absorption of ketoconazole or otraconazole. Therefore, if you need to monitor the adjustment of ketoconazole or iTraconazole. Atazanavir 400 mg with a single dose of lanzoprazol 60 mg/day on healthy volunteers shows a sharp decrease in Atazanavir levels. Atazanavir absorption depends on pH. Although it has not been studied, it is also occurring to teeth that occur with other proton pump inhibitors. Therefore, it is not only indicated to use rabeprazol simultaneously with proton pump inhibitors. Mycophenolat, Nelhnavir. Blood. Tuong.

Storage

In a dry, cool place at a temperature below 30 ° C, avoid light.

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