The RabWELELL 20mg Madras Pharm medicine for gastroesophageal reflux treatment (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Rabeprazole

Ingredient

Composition information	Content
Rabeprazole	20mg

Uses

indications

Rabewell - 20 is indicated in the following cases:

Treatment of gastroesophageal reflux disease (GERD) causes ulcers or corrosion

Rabeprazole is indicated for treatment and gastroesophageal reflux symptoms (GERD) causing ulcers or corrosion.

Maintain after healing gastroesophageal reflux disease (GERD) causes ulcers or corrosion.

Rabeprazole is indicated for maintenance treatment after healing and reduces the rate of heartburn symptoms in patients with gastroesophageal reflux disease causing ulcers or corrosion.

Treatment of gastroesophageal reflux disease (GERD) symptoms

Rabeprazole is indicated for day and night heartburn treatment and other symptoms caused by GERD.

Treatment of duodenal ulcer

Rabeprazole is indicated for treatment and as a duodenal ulcerative.

Eliminate Helicobacter pylori to reduce the risk of duodenal ulcer.

rabeprazole in combination with amoxicillin and clarithromycin as a therapy of three drugs that are indicated for treatment for patients with duodenal ulcer H. pylori to eradicate H. pylori.

Patients who fail to treat, should perform sensitive tests. If resistance to clarithromycin or can not be tested for sensitivity, other antibiotic therapy should be used.

Treatment of pathological secretion, including Zollinger - Ellison syndrome

Rabeprazole is indicated for long -term treatment of pathological secretion, including Zollinger - Ellison syndrome.

Pharmacokology

rabeprazole belongs to the group of anti-secretions (substances inhibitors of Benzimidazole Proton pumps instead) do not manifest the H1 h1 receptor antagonistic properties or acetylcholine secretion, but prevent gastric secretion by inhibiting H+/K+-atpase-AatPase of the stomach surface of the stomach cells.

Because this enzyme is considered as an acid pump (proton) in the wall of the wall, Rabeprazole is characterized as a stomach proton pump inhibitor. Rabeprazole prevents the final stage of gastric secretion. In stomach wall cells, Rabeprazole receives an additional proton, accumulated and transformed into an active sulfenamide.

Pharmacokinetics

absorption

The absolute biological comfort of the Rabeprazole tablet tablet takes 20mg (compared to when using intravenously) is approximately 52%. When Rabeprazole is used with a high -fat meal, changing and can slow down the absorption up to 4 hours or longer. However, CMAX and Rabeprazole's absorption level (AUC) change are not significant. Therefore, Rabeprazole can be used without caring for meal time.

Distribution

rabeprazole binding to plasma proteins is 96.3%.

Metabolism

Rabeprazole is strongly metabolized. Thioether and sulphone are the main metabolites found in human plasma. These metabolites do not have significant antagonism activity. In vitro studies prove that Rabeprazole is metabolized in the liver mainly by Cytochrome P450 3A (CYP3 A) into Sulphone and Cytochrome P450 2C19 (CYP2C19) to Reducing Methyl.

Elimination

After taking the single dose of 20mg Rabeprazole, there is a 14C radioactive isotope, about 90% of the drug is discharged into the urine, mainly Thiioether carboxylic acid; Its glucuronide and mercapturic acid metabolites. The rest is found in stool. The total radioactive activity found is 99.8%. Rabeprazole is not found in urine or in feces.

Before taking The RabWELELL 20mg Madras Pharm medicine for gastroesophageal reflux treatment (3 blisters x 10 tablets)

How to use

oral medication.

Rabeprazole should be swallowed. Do not chew, crush or break the pill. Rabeprazole tablets can be used with or not accompanied by food.

Dosage

This drug is only used as prescribed by a physician.

RabWELL is recommended not for children, because there is no experience used in children.

Treatment of gastroesophageal reflux disease (GERD) causes ulcers or corrosion

The dosage for adults recommends 20mg Rabeprazole, drink once a day about 4 to 8 weeks. For patients who do not help after 8 weeks of treatment, one more treatment can be used with Rabeprazole 8 more weeks.

Maintain after healing gastroesophageal reflux disease (GERD) causes ulcers or corrosion

The dosage for adults recommends 20mg Rabeprazole, drink once a day.

Treatment of gastroesophageal reflux disease (GERD) symptoms

The dosage for adults recommends 20mg Rabeprazole, drink once a day about 4 weeks. If the symptoms are not completely resolved after 4 weeks, one more treatment may be used.

Treatment of duodenal ulcer

The recommended adult dose is 20mg Rabeprazole, drink once a day after breakfast with a treatment of about 4 weeks. The majority of patients heal duodenum ulcers within 4 weeks. Some patients may need one more treatment to heal the ulcer.

Eliminate Helicobacter pylori to reduce the risk of duodenal ulcer.

Three drug therapy:

rabeprazole: 20mg twice daily x 7 days.

amoxicillin: 1000mg twice daily x 7 days.

Clarithromycin: 500mg twice daily x 7 days.

Treatment of pathological secretion, including Zollinger - Ellison syndrome

Rabeprazole dose for patients with increased diseases that varies from individuals. The starting dose for adults recommends 60mg once a day. The dose should be adjusted according to the needs of each patient and prolonged use according to clinical indications. Some patients may need to divide the dose. Can use the dose up to 100mg once a day and 60mg twice daily.

It is not necessary to adjust the dose for the elderly, patients with kidney disease or mild to medium liver failure patients. Due to the lack of clinical data of Rabeprazole in patients with severe liver failure, caution should be used for drugs for these patients.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when using overdose? There is no specific antidote for Rabeprazole. Rabeprazole is strongly linked to protein and is not easily separated. In case of overdose, symptomatic treatment and support.

The only doses of oral Rabeprazole 786mg/kg and 1024mg/kg respectively kill mice and large mice. The only dose of 2000mg/kg is not fatal for dogs. The main symptoms of acute poisoning are reduced activity, breathing, lying on their stomach or leaning on one side and convulsions that occur in mice and large mice, diarrhea, tremor, convulsions and coma in dogs.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using RabWELLL - 20, you may experience unwanted effects (ADR).

In the short -term and long -term studies, the following side effects, regardless of the cause, have been reported in patients treated with Rabeprazole.

Body:

weakness, fever, allergic reactions, chills, discomfort, chest pain under the breastbone, stiff neck, light sensitive reaction.

Cardiovascular system:

High blood pressure, abnormal electrocardiogram, migraine, faint, angina, suspense, slow heart sinus, tachycardia.

diarrhea, nausea, abdominal pain, vomiting, indigestion, flatulence, constipation, dry mouth, belching, gastritis, rectal hemorrhage, black blood defecation, anorexia, mouth ulcers, stomatitis, difficulty swallowing, gingivitis, cholecystitis, increased appetite, colitis, esophagitis, inflammation, pancreatitis, colonitis.

hyperthyroidism, weak thyroid.

Anemia, bruises, lymph nodes.

Metabolic and nutrition disorders:

peripheral edema, weight gain, dehydration, weight loss.

Muscle pain, arthritis, cramps, joint disease, barbar inflammation.

Nervous system:

Insomnia, anxiety, dizziness, weakness, stress, drowsiness, tone of force, neurological pain, dizziness, convulsions, reduced sexual ability, neurological disease, abnormal, tremor.

Respiratory system:

Difficulty breathing, asthma, nosebleeds, laryngitis, hiccups, increased ventilation.

rash, itching, sweating, urticaria, hair loss.

Urinary system - Sex:

Cystitis, urination, expression, difficulty urinating, uterine hemorrhage, polyuria.

Testing values:

The following changes in the test parameters have been reported as side effects: platelet abnormalities, diuretic albumin, creatine phosphokinase increased, abnormal pink, hyperchemical hyperemia, hyperactivity, hyperlemia, hypokary blood, hypoglycet, leukemia, abnormal liver function tests, abnormal urine,

For amoxicillin and clarithromycin:

In rabeprazole coordination treatment with amoxicillin and clarithromycin (RAC), no side effects are caused by the combination of drugs. There are no clinical significant tests due to drug combination.

Instructions on how to handle ADR

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.

Warnings

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

contraindicated

RabWELLL - 20 contraindications in the following cases:

Rabeprazole anti -limb in patients who know hypersensitivity to Rabeprazole, benzimidazole instead or any ingredients of the drug.

Be cautious when using

rabeprazole covers symptoms and slowed down the diagnosis of malignant tumors. Therefore, it is necessary to rule out the possibility of stomach cancer before taking this medication.

Interaction in Rabeprazole's stable state with Warfarin has not been fully evaluated in patients. There have been several reports on Inr and prothrombin increase in patients treated and proton pump inhibitors with warfarin. Inronger and prothrombin time can lead to abnormal bleeding and even death. The patients treated at the same time inhibit the proton pump with warfarin, they need to monitor the increase of Inr and the prothrombin time.

The ability to drive and operate machinery

No report.

Pregnancy

There are no good and suitable studies for pregnant women. Because studies on animal reproduction do not always predict the response to humans, so it should only be used during pregnancy if really necessary.

The period of breastfeeding

Due to many excreted drugs in milk, and due to the possibility of side effects on infant breastfeeding from Rabeprazole, deciding to stop the medication or stop breastfeeding, to consider the importance of the mother for the mother.

Drug interaction

Rabeprazole is metabolized by the P450 (CYP450) enzyme system. Studies on healthy people suggest that Rabeprazole does not have a clinical significant interaction with other drugs metabolized by the CYP450 system, such as Warfarin and Theophylline using single doses, diazepam doses of single -dose injection, and Phenytoin using single -dose injection (with additional oral dose).

Interaction in Rabeprazole's stability with other drugs metabolized by this enzyme has not been studied in patients. There have been several reports on Inr and prothrombin increase in patients treated and proton pump inhibitors, including rabeprazole with warfarin. Inranger and prothrombin time can lead to abnormal bleeding and even death.

Rabeprazole inhibits continuous gastric secretion. The interaction may occur with substances that the absorption of the drug depends on the stomach pH due to the acid -secreting intensity of Rabeprazole. For example, in normal people, simultaneously rabeprazole 20mg once a day reduces approximately 30% of the bioavailability of ketoconazole and increases the AUC and CMAX of Digoxin, respectively 19% and 29% respectively. Therefore, it is necessary to monitor patients when such drugs are used simultaneously with Rabeprazole.

Treatment for combination of three rabeprazole, amoxicillin and clarithromycin drugs increases the plasma concentrations of rabeprazole and 14 - hydroxyclarithromycin.

Storage

Store in a cool dry place, avoid light.

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