Pariet (rabeprazole sodium) is a proton pump inhibitor (PPI) designed for the effective management and treatment of acid-related gastrointestinal disorders. As a next-generation therapeutic agent, it offers potent and prolonged suppression of gastric acid secretion by targeting the proton pump in gastric parietal cells. Clinically validated for both short-term symptomatic relief and long-term maintenance therapy, Pariet ensures comprehensive control over pathological acid production. Its optimized pharmacokinetic profile allows for rapid onset of action and sustained efficacy, making it a cornerstone in gastroenterological practice for a range of indications from erosive esophagitis to Helicobacter pylori eradication regimens.

Features

• Contains rabeprazole sodium as the active ingredient, available in 10 mg and 20 mg delayed-release tablets
• Delivers targeted inhibition of H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells
• Formulated with enteric coating to ensure stability in acidic environments and optimal release in the intestine
• Exhibits a rapid onset of action with antisecretory effects observable within one hour of administration
• Provides dose-dependent suppression of gastric acid secretion, maintaining intragastric pH >4 for extended periods
• Demonstrates linear pharmacokinetics with low potential for interaction with cytochrome P450 system

Benefits

• Achieves rapid and sustained relief from heartburn, regurgitation, and other GERD symptoms
• Promotes healing of erosive esophagitis with high efficacy rates demonstrated in clinical trials
• Reduces risk of ulcer recurrence in patients requiring maintenance therapy for gastroesophageal reflux disease
• Facilitates successful Helicobacter pylori eradication when used in combination antibiotic regimens
• Enables flexible dosing options suitable for various patient profiles and clinical requirements
• Maintains consistent acid control with once-daily dosing in most therapeutic indications

Common use

Pariet is indicated for the treatment and management of conditions where reduction of gastric acid secretion is clinically warranted. Primary uses include healing and maintenance therapy for erosive gastroesophageal reflux disease (GERD), treatment of duodenal ulcers, and management of pathological hypersecretory conditions including Zollinger-Ellison syndrome. It is also employed as part of combination therapy for the eradication of Helicobacter pylori infection in patients with duodenal ulcer disease or chronic gastritis. Off-label uses may include prevention of NSAID-induced gastric ulcers in high-risk patients and management of upper GI bleeding in critical care settings.

Dosage and direction

The recommended adult dosage varies according to indication:

• For healing of erosive GERD: 20 mg once daily for 4-8 weeks
• Maintenance therapy for GERD: 10 mg or 20 mg once daily
• Duodenal ulcers: 20 mg once daily for 4 weeks
• H. pylori eradication: 20 mg twice daily as part of combination therapy for 7 days
• Hypersecretory conditions: Initial dose 60 mg once daily, titrated based on acid output

Tablets should be swallowed whole with water, without crushing or chewing, preferably in the morning before food. For patients unable to swallow tablets whole, the tablet may be dispersed in water and administered immediately via oral syringe or nasogastric tube.

Precautions

Long-term therapy (beyond one year) requires periodic monitoring of magnesium levels, as hypomagnesemia may occur. Use with caution in patients with hepatic impairment, with consideration for dose reduction in severe cirrhosis. Bone fracture risk may be increased with high-dose and long-term PPI therapy, particularly in elderly patients. Monitor for signs of vitamin B12 deficiency with prolonged treatment. Avoid abrupt discontinuation after long-term use due to potential rebound acid hypersecretion. Not recommended during pregnancy unless clearly needed, and should be used during lactation only if potential benefit justifies potential risk.

Contraindications

Pariet is contraindicated in patients with known hypersensitivity to rabeprazole, substituted benzimidazoles, or any component of the formulation. Concomitant use with rilpivirine-containing products is contraindicated due to potential for reduced antiviral efficacy. Should not be used in patients with suspected or confirmed gastric malignancy, as symptom relief may delay diagnosis. Avoid use in patients with severe hepatic impairment without careful monitoring and dose adjustment.

Possible side effects

Common adverse reactions (≥1% incidence) include headache, diarrhea, nausea, vomiting, abdominal pain, flatulence, and constipation. Less frequent side effects may include dizziness, rash, dry mouth, insomnia, and elevated liver enzymes. Rare but serious adverse effects include anaphylaxis, Stevens-Johnson syndrome, acute interstitial nephritis, Clostridium difficile-associated diarrhea, hypomagnesemia, and vitamin B12 deficiency. Long-term use may be associated with increased risk of bone fractures, particularly of hip, wrist, or spine.

Drug interaction

Rabeprazole may reduce absorption of drugs requiring acidic gastric pH, including ketoconazole, iron salts, and dabigatran. May increase exposure to methotrexate, particularly at high doses. Concomitant use with warfarin may require increased monitoring of INR due to potential interaction. May alter concentrations of drugs metabolized by CYP2C19, such as phenytoin, diazepam, and clopidogrel. St John’s Wort and rifampin may decrease rabeprazole concentrations. No clinically significant interaction with theophylline, warfarin, diazepam, or phenytoin observed in studies, but monitoring is recommended.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintain consistent timing of doses to ensure optimal acid control throughout the treatment period.

Overdose

Experience with rabeprazole overdose is limited. Reported doses up to 80 mg have not produced specific symptoms. Rabeprazole is not readily dialyzable due to high protein binding. In case of suspected overdose, symptomatic and supportive treatment should be instituted. Monitor vital signs and implement appropriate supportive measures based on clinical presentation. Contact poison control center for latest guidance on management.

Storage

Store at room temperature (15-30°C or 59-86°F) in original container, protected from moisture and light. Keep blister strips intact until time of administration. Do not remove desiccant from packaging. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Do not transfer tablets to other containers as moisture protection may be compromised.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Individual patient response may vary. Healthcare professionals should exercise clinical judgment when prescribing Pariet, considering individual patient factors, contraindications, and potential interactions. Patients should consult their healthcare provider for personalized medical advice and report any adverse effects experienced during treatment. Full prescribing information should be reviewed before initiation of therapy.

Reviews

Clinical studies demonstrate healing rates of 85-95% for erosive esophagitis after 8 weeks of therapy with Pariet 20 mg daily. Maintenance therapy shows relapse rates of <15% at 52 weeks. In H. pylori eradication trials, combination therapy including Pariet achieves success rates of 85-90% with triple therapy regimens. Patient-reported outcomes indicate significant improvement in quality of life measures related to GERD symptoms. Long-term safety data support maintenance of efficacy with continued use up to 5 years in appropriate patient populations.