Pariet (rabeprazole sodium) is a proton pump inhibitor (PPI) designed for the effective management of acid-related gastrointestinal disorders. It works by selectively and irreversibly inhibiting the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell, thereby suppressing gastric acid secretion. This mechanism provides potent and prolonged acid suppression, facilitating mucosal healing and symptom relief in conditions such as gastroesophageal reflux disease (GERD), peptic ulcers, and Zollinger-Ellison syndrome. Clinically, it is valued for its rapid onset of action, predictable pharmacokinetics, and favorable safety profile, making it a cornerstone in gastroenterological therapeutic strategies.

Features

• Contains rabeprazole sodium as the active ingredient
• Available in delayed-release tablet formulations (typically 10 mg and 20 mg)
• Designed for oral administration with enteric coating to protect against gastric acid degradation
• Exhibits high bioavailability and rapid absorption
• Demonstrated efficacy in 24-hour acid suppression with once-daily dosing
• Suitable for short-term and maintenance therapy in acid-related disorders

Benefits

• Provides rapid and sustained relief from heartburn, regurgitation, and other GERD symptoms
• Promotes healing of erosive esophagitis and reduces risk of recurrence
• Effective in eradicating Helicobacter pylori when used in combination therapy
• Reduces gastric acid secretion in hypersecretory conditions like Zollinger-Ellison syndrome
• Minimizes nocturnal acid breakthrough, improving sleep quality and daytime comfort
• Supports mucosal repair in gastric and duodenal ulcer disease

Common use

Pariet is commonly prescribed for the treatment of gastroesophageal reflux disease (GERD), including symptomatic relief and healing of erosive esophagitis. It is also indicated for the short-term treatment of active duodenal ulcers, active benign gastric ulcers, and pathological hypersecretory conditions such as Zollinger-Ellison syndrome. Additionally, it is used as part of combination therapy for the eradication of Helicobacter pylori infection to reduce the risk of duodenal ulcer recurrence.

Dosage and direction

The recommended dosage varies based on indication:

• For healing of erosive GERD: 20 mg once daily for 4–8 weeks.
• Maintenance of healed erosive GERD: 20 mg once daily.
• Duodenal ulcers: 20 mg once daily after morning meal for 4 weeks.
• H. pylori eradication: 20 mg twice daily combined with antibiotics for 7 days.
• Zollinger-Ellison syndrome: starting dose 60 mg once daily; adjust based on acid output.

Tablets should be swallowed whole, with water, and not crushed or chewed. Can be taken with or without food.

Precautions

• Long-term use may be associated with an increased risk of bone fractures, particularly with high doses and prolonged therapy.
• Hypomagnesemia has been reported rarely with prolonged PPI use; monitor magnesium levels periodically in long-term treatment.
• May mask symptoms of gastric malignancy; exclude malignancy before initiating therapy.
• Use with caution in patients with severe hepatic impairment; consider dose adjustment.
• Not recommended during pregnancy unless clearly needed; discuss risks with healthcare provider.

Contraindications

• Hypersensitivity to rabeprazole, substituted benzimidazoles, or any component of the formulation.
• Concomitant use with rilpivirine-containing products due to potential for reduced antiviral efficacy.
• Avoid use in patients with a history of acute interstitial nephritis with previous PPI use.

Possible side effect

Common side effects may include headache, diarrhea, nausea, abdominal pain, flatulence, and vomiting. Less frequently, dizziness, rash, dry mouth, and constipation may occur. Rare but serious adverse effects include Clostridium difficile-associated diarrhea, acute interstitial nephritis, cutaneous lupus erythematosus, and vitamin B12 deficiency with long-term use.

Drug interaction

• May reduce absorption of drugs requiring acidic gastric pH for absorption (e.g., ketoconazole, iron salts, digoxin).
• Can increase serum levels of methotrexate when used concomitantly.
• Potential interaction with warfarin; monitor INR regularly.
• May affect bioavailability of atazanavir and other pH-dependent drugs.
• Concomitant use with clopidogrel may reduce antiplatelet activity (theoretical; clinical relevance uncertain).

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule.

Overdose

Experience with rabeprazole overdose is limited. Symptoms may reflect exaggerated pharmacological effects (e.g., hypersecretion, dizziness, gastrointestinal disturbances). Management is supportive; no specific antidote exists. Hemodialysis is not effective due to high protein binding.

Storage

Store at room temperature (15–30°C), in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient responses may vary.

Reviews

Clinical studies and post-marketing surveillance demonstrate high patient satisfaction with Pariet, particularly regarding rapid symptom relief and tolerability. Many users report significant improvement in quality of life, especially those with severe GERD. Medical professionals appreciate its consistent efficacy and low interaction profile, though some note the importance of monitoring long-term users for potential nutrient deficiencies.