RabeprazoleRabeprazole Sodium

About Rabeprazole

Rabeprazole blocks the acid pumps in the stomach lining. In adults it heals erosive or ulcerative reflux disease and keeps it healed, treats reflux symptoms, heals duodenal ulcers, helps clear H. pylori with amoxicillin and clarithromycin, and controls Zollinger-Ellison syndrome; teenagers from 12 can take it short term for reflux symptoms. The usual dose is 20 mg once a day; for H. pylori it is taken twice a day with both antibiotics for 7 days.

Headache, nausea, vomiting, diarrhea, constipation, gas and sore throat are among its side effects. As with other drugs in its class, long-term use is linked to low magnesium and vitamin B12 and to fractures, and less often to C. difficile diarrhea, kidney inflammation, lupus and severe skin reactions. Feeling better does not rule out stomach cancer, so lasting symptoms need a doctor’s review. It must not be taken with the HIV drug rilpivirine, and people on warfarin need their INR checked.

Aciphex Sprinkle, a capsule opened onto soft food for children aged 1 to 11, is listed by the FDA as discontinued, and no generic sprinkle capsule is marketed, so pharmacies dispense the tablet only. It must be swallowed whole. Unlike omeprazole, esomeprazole and lansoprazole, rabeprazole is not sold over the counter in the US.

Taking Rabeprazole

How to take it

Once a day, swallowed whole with water; do not chew, crush or split it. It can be taken with or without food, except that duodenal ulcer treatment is taken after the morning meal and H. pylori treatment with the morning and evening meals.

If you miss a dose

Take it as soon as you remember, unless the next dose is nearly due; then skip the missed one. Do not take a double dose.

Storage

At room temperature, tightly closed, away from heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

It must not be taken with rilpivirine; nelfinavir is avoided, and atazanavir and saquinavir need the prescriber’s review. It can raise the INR on warfarin and levels of digoxin, tacrolimus and high-dose methotrexate. Lower stomach acid can reduce absorption of iron, ketoconazole, itraconazole and erlotinib. Transplant patients taking mycophenolate need care.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Rabeprazole differs from pharmacy to pharmacy

Generic rabeprazole tablets come from several makers, so a cash quote is mostly the pharmacy’s dispensing fee and markup, which differ widely between chains, independents and mail-order pharmacies. A prescription that names Aciphex without allowing substitution can only be filled with the brand.

With no over-the-counter version, there is no way around the dispensing fee, so pharmacy choice and fill size matter most; a ninety-day fill carries one fee instead of three.

Ways to pay less for Rabeprazole without insurance

• Make sure the prescription is written for rabeprazole, or allows substitution, so you are quoted for the generic.
• For long-term treatment, ask for a ninety-day supply.
• Ask whether rabeprazole is on the pharmacy’s flat-price generic list.
• If it is quoted high, ask the prescriber whether another proton pump inhibitor, including an over-the-counter one, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Rabeprazole

1. 1.Should I take it with food for my condition?
2. 2.What if I cannot swallow the tablet whole?
3. 3.Does it interact with my warfarin, digoxin, methotrexate or HIV medicines?
4. 4.How long should I stay on it?
5. 5.What can a young child take now that the sprinkle capsule is discontinued?

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