Rabeprazole - 28 Tablets

• Prescription-only medicine containing rabeprazole
• Proton pump inhibitor (PPI) supplied as gastro-resistant tablets
• Used for conditions including GORD, reflux oesophagitis and peptic ulcers

Rabeprazole: What You Need to Know

When heartburn or acid reflux keeps returning, it is natural to wonder whether you need something more than occasional relief.

Rabeprazole is a medicine that reduces the amount of acid produced by your stomach. It belongs to a group called proton pump inhibitors, or PPIs, and is used for several acid-related conditions, including gastro-oesophageal reflux disease (GORD), reflux oesophagitis and stomach or duodenal ulcers.

Rabeprazole tablets may be prescribed when reducing stomach acid is appropriate for your symptoms or condition. The correct strength, dose and treatment length depend on why the medicine is being used and your individual circumstances.

The product is available in 10mg and 20mg strengths. The 20mg strength is used for several conditions, but it is not the appropriate dose for every type of acid reflux. For example, the licensed product information recommends 10mg once daily for symptomatic GORD in people without oesophagitis, while 20mg once daily is used for erosive or ulcerative GORD and some other conditions.

An online consultation gives a UK-registered prescriber the opportunity to assess your symptoms, medical history and current medicines before deciding whether rabeprazole is suitable. Completing a consultation does not guarantee that a prescription will be issued.

What Is Rabeprazole - 28 Tablets?

Rabeprazole - 28 Tablets contains rabeprazole sodium, which is converted to rabeprazole in the body. It is a proton pump inhibitor used to reduce stomach acid.

Rabeprazole tablets are gastro-resistant. This means they have a special coating that helps protect the medicine from stomach acid. The tablet should be swallowed whole so that the medicine can reach the part of the digestive system where it is absorbed.

Rabeprazole is licensed for several conditions. These include symptomatic GORD, erosive or ulcerative GORD, long-term management of GORD, active duodenal ulcers and benign gastric ulcers. It is also used in combination with appropriate antibiotics to eradicate Helicobacter pylori, commonly known as H. pylori, in people with peptic ulcer disease.

It is also licensed for Zollinger-Ellison syndrome, a rare condition in which the stomach produces unusually large amounts of acid. This condition requires specialist medical management and can involve considerably higher doses than those used for routine reflux symptoms.

The 20mg strength may therefore be prescribed for different reasons. For example, the licensed dose for erosive or ulcerative GORD is 20mg once daily for four to eight weeks. For long-term GORD management, either 10mg or 20mg once daily may be used depending on the person's response to treatment.

This is why you should take rabeprazole exactly as prescribed rather than choosing a strength based only on how severe your symptoms feel.

How Does Rabeprazole Work?

Your stomach needs acid to digest food, but too much acid in the wrong place can cause problems. If stomach contents repeatedly flow back into the food pipe, you may experience heartburn, acid reflux or other symptoms of GORD.

Rabeprazole reduces the amount of acid your stomach produces.

It does this by blocking an enzyme called the H+/K+-ATPase, often referred to as the proton pump. These pumps are found in cells lining the stomach and are involved in the final stage of stomach acid production.

By inhibiting these pumps, rabeprazole reduces both the normal amount of acid produced by the stomach and the extra acid produced after stimulation such as eating.

The effect starts relatively quickly. UK product information states that the anti-secretory effect begins within about one hour after a 20mg dose, with the maximum effect occurring within two to four hours. The effect on acid secretion becomes more consistent with continued once-daily treatment.

This does not mean that every person will feel complete relief immediately. Acid-related inflammation can take time to settle, and the time needed for symptoms to improve depends on the condition being treated.

Rabeprazole is therefore different from an antacid. An antacid works by neutralising acid that is already present, whereas rabeprazole reduces the production of new stomach acid.

Clinical Information at a Glance

Rabeprazole is a proton pump inhibitor containing rabeprazole sodium. The 20mg gastro-resistant tablet contains 20mg rabeprazole sodium, equivalent to 18.85mg of rabeprazole.

It is licensed for several acid-related conditions, including symptomatic and erosive or ulcerative GORD, long-term GORD management, active gastric or duodenal ulcers, Zollinger-Ellison syndrome and H. pylori eradication treatment when used with appropriate antibiotics.

For some indications, the recommended adult dose is 20mg once daily. Other conditions use 10mg once daily or a different dose under medical supervision. Rabeprazole is a prescription-only medicine in the UK.

Rabeprazole tablets should be swallowed whole and not chewed or crushed. For once-daily treatment, the licensed product information advises taking the tablet in the morning before eating.

Rabeprazole Compared With Other Treatments

Rabeprazole is one of several medicines that can be used when stomach acid is contributing to symptoms. The right option depends on the condition being treated, how often symptoms occur and your medical history.

Omeprazole and pantoprazole are also proton pump inhibitors. They work in a similar way to rabeprazole by reducing stomach acid, although they contain different active ingredients and have their own dosing and interaction considerations.

Famotidine belongs to a different group called H2-receptor antagonists. It reduces acid production by blocking histamine receptors involved in acid secretion.

Antacids work differently again. They neutralise acid already present in the stomach and are generally used for short-term relief. They are not a direct substitute for a prescribed PPI when ongoing acid suppression is needed.

Key differences

Rabeprazole, omeprazole and pantoprazole are all PPIs, but the medicines are not interchangeable on a tablet-for-tablet basis. Their licensed doses, interactions and instructions can differ.

Rabeprazole is available in 10mg and 20mg gastro-resistant tablets. The strength prescribed depends on the condition being treated. For example, 20mg once daily is used for erosive or ulcerative GORD, while a lower dose may be used for some people with uncomplicated symptoms.

Food instructions can also differ between medicines. The UK product information for rabeprazole advises taking the tablet before eating when it is being used once daily. Your own prescription instructions should always take priority.

The price of each medicine can vary according to the strength, pack size and pharmacy. Cost does not determine which medicine is medically appropriate.

Your Treatment Journey

Before starting rabeprazole, the important question is not simply whether you have heartburn. Your symptoms need to be considered alongside your medical history and any medicines you already take.

This helps a prescriber decide whether acid suppression is appropriate and whether your symptoms need further investigation.

Starting treatment

An assessment may include questions about how often you experience symptoms, how long they have been happening and whether you have previously used an acid reflux medicine.

You may also be asked about symptoms such as difficulty swallowing, persistent vomiting, unexplained weight loss or bleeding. These can need medical assessment rather than simply being treated as routine heartburn.

Your prescriber will also consider your medical history and other medicines. This is particularly important because rabeprazole can interact with certain medicines and may not be suitable in some circumstances.

If rabeprazole is prescribed, you will receive instructions about the dose, timing and duration of treatment.

Choosing a dose

There is no single rabeprazole dose that is suitable for every condition.

For symptomatic GORD without oesophagitis, the licensed adult dose is generally 10mg once daily. If symptoms have not been adequately controlled after four weeks, further assessment is recommended.

For erosive or ulcerative GORD, the recommended adult dose is 20mg once daily, usually for four to eight weeks.

Other conditions have different treatment schedules. H. pylori eradication, for example, involves rabeprazole alongside specific antibiotics rather than rabeprazole being used on its own.

This is why you should not increase the dose yourself if symptoms continue. Your prescriber can decide whether your treatment needs to be changed or whether another cause needs to be considered.

Reviewing treatment

Some people only need a defined course of treatment, while others need longer-term management of GORD.

If rabeprazole is being used for long-term treatment, your need for continued acid suppression should be reviewed from time to time. The lowest effective dose may be considered where appropriate.

If symptoms return after treatment or do not improve as expected, further assessment may be needed rather than simply continuing treatment indefinitely.

Changing treatment

Treatment may sometimes need to be adjusted because symptoms have not settled, the underlying condition has changed or another medicine is more suitable.

Do not switch from rabeprazole to another PPI, increase the dose or stop prescribed treatment without discussing it with a healthcare professional.

If you have been taking rabeprazole for a longer period, stopping treatment can sometimes lead to a temporary increase in acid-related symptoms. A prescriber or pharmacist can advise on the most appropriate way to reduce or stop treatment.

How Rabeprazole Fits Into Treatment

Rabeprazole is intended to manage conditions where reducing stomach acid forms part of appropriate treatment.

For people with GORD, this may help reduce symptoms such as heartburn and acid reflux. When reflux has caused inflammation of the food pipe, reducing acid can also support healing.

The response is not necessarily immediate. Although rabeprazole begins reducing acid relatively quickly, symptoms may take longer to improve, particularly when irritation or inflammation has developed.

If symptoms continue despite treatment, that does not automatically mean you need a stronger dose. Persistent symptoms may have another cause or may require a different approach.

Follow the treatment plan provided by your prescriber and seek further advice if symptoms are not improving, change significantly or return frequently.

Why Lifestyle and Other Factors May Still Matter

Medicine is only one part of managing reflux. Everyday habits can affect symptoms, although triggers vary from one person to another.

Diet and eating habits

Some people find that particular foods make their reflux symptoms worse. Common triggers can include fatty foods, spicy foods, coffee, chocolate, alcohol and acidic foods.

You do not necessarily need to avoid all of these foods. It can be more useful to notice whether a particular food consistently brings on your symptoms.

Large meals can also make reflux more noticeable in some people. Smaller meals may be easier to manage if large meals regularly trigger symptoms.

Alcohol and smoking

Alcohol can make reflux symptoms worse for some people. If you notice a clear connection, reducing your intake may help reduce symptoms.

Smoking can also contribute to reflux. If you smoke, your pharmacist or GP can provide advice about stopping.

Sleep and daily routine

Reflux can be worse when you lie down soon after eating. Leaving around three hours between your last meal and going to bed may help reduce night-time symptoms.

If reflux regularly disturbs your sleep, raising the head end of the bed can sometimes help. Extra pillows alone may not have the same effect because they can increase pressure around the abdomen.

Weight and reflux

Being overweight can contribute to reflux in some people. If this applies to you, gradual weight loss may improve symptoms.

This is not relevant to everyone with GORD, and weight should not be assumed to be the cause of your symptoms.

Other medicines and health conditions

Tell your prescriber about all medicines you take, including medicines bought without a prescription, supplements and herbal products.

Rabeprazole can affect the absorption or effectiveness of some medicines. Important examples include atazanavir and other medicines used to treat HIV, digoxin, methotrexate and warfarin. Some combinations require particular caution or monitoring.

Rabeprazole should also not be taken with rilpivirine-containing medicines because reducing stomach acid can reduce rilpivirine exposure. Your prescriber will check your medicines as part of the assessment.

What to Know Before Taking Rabeprazole

Rabeprazole is suitable for many people with acid-related conditions, but it is not appropriate for everyone. Before treatment starts, your prescriber will consider your symptoms, medical history and any medicines you are already taking.

Tell your prescriber if you have liver problems, have previously had problems affecting your stomach or digestive system, or have been taking a PPI for a long time.

You should also mention any symptoms that are unusual for you, particularly if they have recently started, are getting worse or do not behave like your usual reflux symptoms.

Medicines that may interact with rabeprazole

Rabeprazole can interact with some medicines or affect how they work. This does not always mean that you cannot take rabeprazole, but your prescriber needs to know about your current treatment.

Medicines that may need particular consideration include:

• Rilpivirine-containing medicines
• Atazanavir and some other HIV medicines
• Digoxin
• Warfarin
• Methotrexate, particularly at higher doses
• Medicines whose absorption depends on stomach acid

Always mention medicines bought without a prescription, vitamins and herbal supplements as well. If you are unsure whether a medicine is relevant, include it in your consultation or ask a pharmacist.

How to Take Rabeprazole

Take rabeprazole exactly as prescribed. The dose depends on why you are taking it.

For some people with symptomatic GORD, the usual adult dose is 10mg once daily. For erosive or ulcerative GORD, 20mg once daily may be prescribed. Other conditions, including H. pylori infection and Zollinger-Ellison syndrome, have different treatment schedules.

When rabeprazole is being taken once daily, it is generally taken in the morning before eating. Follow the specific instructions on your prescription if they differ.

Swallow the gastro-resistant tablet whole with water. Do not chew or crush it because the coating is designed to protect the medicine from stomach acid.

What if you miss a dose?

If you forget to take rabeprazole, take it when you remember unless your next dose is due soon.

If it is nearly time for your next dose, skip the missed tablet and continue with your normal schedule. Do not take two doses together to make up for a missed dose.

Possible Side Effects of Rabeprazole

Like all medicines, rabeprazole can cause side effects, although not everyone experiences them.

Common side effects can include headache, diarrhoea, nausea, vomiting, stomach pain, constipation, wind and indigestion. These effects are often mild, but speak to a pharmacist or prescriber if they are troublesome, persistent or getting worse.

When should you seek medical help?

Seek urgent medical attention if you develop signs of a serious allergic reaction, such as swelling of the face, lips, mouth or throat, difficulty breathing or a severe skin reaction.

Severe or persistent diarrhoea, particularly if it occurs with fever or significant abdominal pain, should also be assessed by a healthcare professional.

If you take rabeprazole for a long time, your treatment may need regular review. Long-term treatment with a PPI can affect the absorption of certain nutrients and may be associated with other risks in some people.

Rabeprazole During Pregnancy and Breastfeeding

If you are pregnant, planning to become pregnant or breastfeeding, tell your prescriber before taking rabeprazole.

Your healthcare professional can consider your symptoms, the reason treatment is needed and whether rabeprazole is appropriate for you.

Do not start, stop or change regular treatment during pregnancy without discussing it with your doctor, prescriber or pharmacist.

Rabeprazole and Mounjaro

If you are taking Mounjaro (tirzepatide), tell your prescriber before starting rabeprazole.

Mounjaro can cause digestive symptoms such as nausea, indigestion, abdominal discomfort and reflux in some people. If you develop new or worsening heartburn while taking Mounjaro, it is worth discussing the symptoms rather than automatically assuming that you need another acid-reducing medicine.

Rabeprazole and Mounjaro may sometimes be used together when clinically appropriate. However, taking Mounjaro does not automatically mean that rabeprazole is needed. Your symptoms, medical history and other medicines should be considered before treatment is started.

How Long Does Rabeprazole Take to Work?

Rabeprazole starts reducing stomach acid relatively quickly, but this does not mean that all symptoms will disappear straight away.

The medicine's effect on acid production begins within a relatively short time after a dose, while symptoms caused by irritation or inflammation can take longer to settle.

If you are taking rabeprazole for GORD and your symptoms are not improving as expected, speak to your prescriber. Do not increase the dose yourself simply because you have not noticed an immediate change.

What If Rabeprazole Does Not Help?

If your heartburn or acid reflux continues while taking rabeprazole, there may be several possible reasons.

The symptoms may not be caused mainly by excess stomach acid, your dose or treatment length may need reviewing, or another condition may need to be considered. Other medicines and lifestyle factors can also contribute to reflux symptoms.

If symptoms continue, become more frequent or change significantly, speak to a GP, prescriber or pharmacist. They may review your treatment or decide whether further investigation is needed.

Persistent symptoms do not automatically mean that you need a higher dose. Do not increase your rabeprazole without professional advice.

Stopping Rabeprazole

How you stop rabeprazole depends on why you were taking it and how long you have been using it.

After longer-term PPI treatment, some people experience a temporary increase in acid-related symptoms when treatment is stopped. This can make heartburn or reflux feel worse for a short period.

If you have been taking rabeprazole regularly for a longer time, speak to your prescriber before stopping it. They can advise whether you should stop treatment, reduce the dose or use another approach.

Rabeprazole and Alcohol

Alcohol can make reflux symptoms worse in some people, even though it does not have a specific interaction with rabeprazole that means everyone must avoid alcohol.

If you notice that drinking regularly triggers heartburn, acid regurgitation or indigestion, reducing your intake may help.

If symptoms continue despite making changes, speak to a healthcare professional rather than assuming that you need a higher dose of rabeprazole.

Rabeprazole and Antacids

Antacids work differently from rabeprazole. They neutralise acid that is already present in the stomach, while rabeprazole reduces the amount of new acid produced.

They may sometimes be used alongside acid-reducing treatment, but you should follow the instructions provided with your medicines. If you regularly need an antacid because your symptoms are not controlled, speak to a pharmacist or prescriber.

When Should You Speak to a GP About Acid Reflux?

Heartburn and reflux are common, but symptoms that keep returning or do not improve with treatment may need further assessment.

Speak to a GP or another healthcare professional if you have:

• Difficulty or pain when swallowing
• A feeling that food is getting stuck when you swallow
• Unexplained weight loss
• Repeated vomiting
• Vomiting blood or material that looks like coffee grounds
• Black or tar-like stools
• Persistent or worsening stomach pain
• Reflux symptoms that continue despite treatment

Chest pain should not automatically be assumed to be heartburn. If you have new, severe or unusual chest pain, particularly with breathlessness, sweating, dizziness or pain spreading to your arm, jaw or back, seek urgent medical attention.

Key Points About Rabeprazole

Rabeprazole is a proton pump inhibitor that reduces the amount of acid produced by the stomach.

It is available in 10mg and 20mg strengths, and the appropriate dose depends on the condition being treated. A 20mg dose is used for conditions such as erosive or ulcerative GORD, while some people with uncomplicated GORD may be prescribed 10mg once daily.

Rabeprazole tablets are gastro-resistant and should be swallowed whole rather than chewed or crushed. When taken once daily, they are generally taken in the morning before eating.

Rabeprazole begins reducing stomach acid relatively quickly, but symptoms may take longer to settle, particularly when reflux has caused irritation or inflammation.

If treatment does not improve your symptoms, symptoms keep returning or you develop warning signs such as difficulty swallowing, unexplained weight loss, vomiting blood or black stools, speak to a healthcare professional.

If you are obtaining rabeprazole through an online pharmacy, a UK-registered prescriber should assess your symptoms, medical history and current medicines before deciding whether it is appropriate. Completing a consultation does not automatically result in a prescription.