Rabidzh 20

Rabidzh 20 refers to the list of those medical devices that are intended for inclusion in the treatment plan primarily for gastroesophageal reflux disease, as well as peptic ulcer.

Due to the fact that its main component Rabeprazole is an acid-proton pump in a parietal cell, the main effect of the drug is that, with respect to the proton pump, it produces an inhibitory effect. It belongs to the category of compounds possessing antisecretory properties, which, not being antagonists of H2 receptors or cholinergic receptors, nevertheless cause a decrease in the activity of gastric acid secretion. Suppression of these processes in the stomach occurs at their last stages of gastric acid secretion.

The drug, thus, is a drug that has a beneficial effect on the functioning of the digestive system and the metabolic processes in the body.

Indications Rabidzh 20

Indications for the use of Rabidj 20 are caused by the presence in the patient of such types of peptic ulcer as duodenal ulcer and peptic gastric ulcer, in which the integrity of the walls of these organs is disturbed by the pathologically increased concentration of acidic digestive juices.

The tendency towards normalization of the acid medium that appears due to the use of the drug is manifested in a decrease in the degree of the negative effect of that factor.

This effect is achieved due to the use of Rabidj 20 at the stage of exacerbation of chronic gastritis if there is an excessive formation of gastric acid. This justifies the use of the drug in such cases.

In addition, it is also indicated for the treatment of gastroesophageal reflux disease or reflux esophagitis characterized by episodic ejections - reflux into the esophagus of gastric contents or from the duodenum, which causes damage to the esophagus acid in its lower parts.

The next clinical case that can cause indications for the appointment of this drug is functional dyspepsia.

It is also advisable to include it in the list of prescriptions as part of complex treatment with other antibacterial agents in the eradication of Helicobacter pylori - bacteria parasitizing in the gastric mucosa.

Finally, the indications for the use of Rabidzh 20 are grounded in the Zollinger-Ellison syndrome, as well as with other conditions of pathologically increased secretion.

Release form

The form of issue Rabidzh 20 has the form of the red-brown tablets of the round form. Each tablet is smooth on both sides, covered with an enteric coating.

One tablet contains 20 mg of rabeprozole sodium, and in addition there are auxiliary substances. They are represented by light magnesium oxide, mannitol, hydroxypropyl cellulose, talc, croscarmellose sodium, magnesium sancel stearate, pH 102, ethylcellulose, propylene glycol, hypromelose, diethylphthalate, PEG 6000, ghent dioxide, red iron oxide.

The tablets are packed in strips made of aluminum foil. In a cardboard box along with a folded sheet containing a description of the drug and instructions for its use, there is 1 strip with tablets. In other cases, the form of release of the drug may differ by the presence of 3 strips with tablets in the package.

Pharmacodynamics

Pharmacodynamics Rabichem 20 finds a mapping in the pharmacological action in the human body of the main component of the preparation of the active ingredient, which is rabeprazole.

This drug component from the category of compounds differing in antisecretory properties does not act as an antagonist to cholinergic or histamine H2 receptors, but leads to inhibition of the acid secretory function of the stomach. This action occurs due to the inhibition of intestinal potassium hydrogen adenosine triphosphatase, or as it is called: proton or proton pump, proton (proton) pump. This occurs on the secretory surfaces of the peri-ental cells of the stomach.

The effect produced by rabeprazole on gastric acid production processes is that this component of Rabidzh 20 blocks gastric secretion at its last stage.

Pharmacodynamics Rabidzhem 20, which should be noted about the chemical activity of rabeprazole, is manifested in the fact that it is activated when the level of acid-base balance of pH is 1.2. The half-life takes a time interval of 78 seconds.

Pharmacokinetics

The pharmacokinetics of Rabidj 20 is characterized by the degree of bioavailability of rabeprozole at a level approximately equal to 52%.

Tmax can undergo certain changes due to the fact that the drug is taken with food, in which a large amount of fat is present. At the same time, the time required for absorption can increase to 4 hours or require an even longer period. Veste with the Cmax and the amount in which the absorption takes place, in this case is not substantially changed. This gives grounds to assert that if there is any connection between the application of Rabidzh 20 and the time of eating, it is weakly expressed. Thus, food does not cause any significant reduction in the effectiveness of the drug.

Blood binds rabeprozole with plasma proteins in its total amount, reaching 96.3 percent. The primary metabolic products that are observed in blood plasma are represented by the sulfone and thioether. It is established that these metabolites are not peculiar to have a significant antisecretory effect. The results of in vitro studies indicate that in the liver rabeprazole undergoes metabolism with the participation of cytochrome P450 ZA-CYP3A in the first place. In the process, sulfon metabolites are formed. And from cytochrome P450 2C19 - CYP2C19 - desmethylrabeprazole.

The pharmacokinetics of Rabidj 20 during the induction of the drug consists in the 90% presence of the drug in the urine as a thioester of the carboxylic acid, glucuronide metabolites and mercaptoic acid compounds. Remains of the taken doses leave the body together with the calves. As in urine and in feces excretion of rabeprozole in the unmodified state does not occur.

Dosing and administration

The way of application and dose Rabichem 20 suggests that the tablets should be taken internally as a whole, without chewing and preliminary breaking and crushing them. Reception of this medication should occur before meals.

In peptic ulcer of the duodenum without the presence of Helicobacter pylori Rabid 20 it is recommended to take inside at the recommended dose of one tablet 20 mg once or twice a day for 2 to 4 weeks.

For the treatment of gastric peptic ulcers with absent Helicobacter pylori Rabidzh 20 is prescribed in the same dosage as in the previous case - one 20-milligram tablet 1 or 2 times during the day. The difference is only in the duration of treatment with the use of this drug: with the same minimum course at 14 days, the time period to be taken by Rabicja 20 can last up to 6 weeks.

Patients with gastroesophageal reflux disease the drug is prescribed in the recommended daily dose of 1-2 tablets of 20 mg throughout the day. The duration of the course can vary from 4 to 8 weeks. When included in supportive therapy for this disease, a one-time daily intake of Rabidj 20 in the amount of 1-st tablet 10 or 20 mg, respectively, is contemplated. The dose is selected individually for each individual patient.

For patients with Zollinger-Ellison syndrome with pathological hypersecretory conditions, the dosage is determined on the basis of an individual approach to each specific case of this disease. It is recommended to start treatment with a daily dose of Rabid 20 in 60 milligrams. If there is such a need, in the future the dose of the drug is increased to the extent that it is appropriate based on the individual characteristics of the clinical picture of the disease in a particular patient.

Exacerbation of chronic gastritis characterized by hyperfunction of production of gastric acid causes the necessary dosage Rabid 20 equal to 1-2 tablets per day during the course of treatment, which is 2-3 weeks.

In exactly the same way, as for the doses and the time period of taking the drug, it should be used with functional dyspepsia.

So, summing up all of the above, it becomes obvious that the way of application and dose of this drug is determined based on a particular clinical case in which the use of Rabidzh 20 is prescribed.

Use Rabidzh 20 during pregnancy

The use of Rabidj 20 during pregnancy, as well as during lactation and lactation, refers to a number of cases in which the use of the preparation is unacceptable.

Contraindications

Contraindications to the use of Rabidzh 20 have the basis mainly the factor of the individual reaction that can take place in the patient in this or that case, in each case, on the effect that rabeprazole exerts in the body. Equally, this also applies to the presence of hypersensitivity to any of the other constituents of the preparation of the auxiliary components. In addition to this, the replacement of benzimidazole or other ingredients contained in Rabidzh 20 belongs to this category.

Contraindications to the use of Rabidj 20 include also a ban on the use of the drug against patients in childhood. Abstain about its use, in addition, follows pregnant women and at that time after the birth of the baby when the infant is breastfed.

Side effects Rabidzh 20

The general manifestations of the side effects of Rabidzh 20 include: malaise, the appearance of an asthenic condition, the onset of fever, chills, the development of allergic reactions, pain in the sternum, hypersensitivity to light. Sometimes swelling of the face, may swell belly.

In the activity of the cardiovascular system, arterial hypertension is observed, myocardial infarction is possible, cases of fainting, migraine, heart palpitations, tachycardia, sinus bradycardia, angina pectoris, electrocardiographic changes are noted.

The digestive system is able to react with such negative consequences of the drug as: the eructation, dry mouth, abdominal pain, nausea, vomiting, diarrhea, flatulence, constipation. There is the possibility of rectal bleeding, the development of gastroenteritis and dyspepsia, the appearance of stones in the gallbladder, the emergence of anorexia. In addition, the use of Rabidzh 20 can lead to ulcers in the mouth, stomatitis, gingivitis, dysphagia, increased appetite, cause stool disorders. This drug is able to provoke cholecystitis, proctitis, colitis, pancreatitis, glossitis, esophagitis.

The side effect of the drug is often the development of anemia, including hypochromic, there is a possibility of subcutaneous hemorrhage, lymph nodes can be hypertrophied.

The vector of negative influences Rabichem 20 is directed to the metabolism and metabolic processes taking place in the human body. The drug often causes an increase in body weight, or on the contrary, leads to weight loss and dehydration.

Due to the adoption of the drug, the state of the central nervous system is also affected. Characteristic signs of this are sleep disorders - the appearance of insomnia or vice versa, excessive drowsiness, dizziness, the development of neuralgia and neuropathy, nervous condition, tremor. Perhaps the emergence of a depressed state, a decrease in sexual desire, convulsions.

The negative consequences of the use of Rabidzh 20 are also indicated by changes in the indices of laboratory studies. In particular, abnormal erythrocytes and platelets are present in the blood, hyperglycemia, leukocytosis are noted.

There are deviations in the composition of urine and in the indicators of hepatic tests. The latter is characterized by an increased content of ALT, and also a greater amount of prostate-specific antigen.

Side effects of Rabidzh 20, as we see, in some cases, its use can take place in the form of all kinds of negative phenomena in various organs and systems of the patient's body.

[1], [2]

Overdose

Overdose Rabichem 20 can occur mainly in cases where the main component of the active ingredient preparation, rabeprazole, reaches the inside of the human body in excess of the maximum permissible norm of 80 milligrams per day. This medication taken within this designated daily amount, as a rule, is well tolerated, and as a result of its influence, no marked clinical symptomatology develops.

Currently, medicine does not confirm the existence of a specific antidote. If they are overdosed with the drug, all the necessary medical measures aimed at eliminating and reducing the degree of its negative consequences are reduced to the implementation of therapeutic measures of a symptomatic and supportive nature.

Interactions with other drugs

The interaction of Rabidzh 20 with other drugs is largely due to the peculiarities of metabolic processes to which its main active ingredient, rabeprazole, is exposed. In the metabolism of it, the feline symbionts of the cytochrome P450 or CYP450 system participate.

Based on the results of studies involving healthy volunteers, it was found that other drugs, the metabolism of which also occurs with the involvement of the CYP450 system, do not enter into such interactions with rabeprazole that they could be designated clinically significant. This refers to warfarin, diazepam administered intravenously in a single dose, theophylline (as a single dose taken orally), and phenytoin - once intravenously with additional doses orally.

To identify the characteristics of combinations with the inclusion of other drugs, the metabolism of which is carried out by the enzyme system, no special studies have been conducted.

One of the main actions of Rabidj 20 is that the intensity of the gastric secretory function decreases, which causes the possibility of its effect on the effect produced by those drugs that their absorption is associated with the acid-base balance of gastric juice. So in combination with ketoconazole, a 33% decrease in the bioavailability of the latter is noted. Digoxin in combination with rabeprazole increases its maximum concentration by 20%. In view of the above interaction, the simultaneous administration with Rabidzh of 20 preparations, the absorption properties of which depends on the gastric pH, requires medical supervision and, if necessary, adjusting the dosage of each of these formed combinations of medicines.

The interactions of Rabidzh 20 with other antacid agents do not lead to clinically significant changes in the concentration in which rabeprazole is present in the blood plasma.

[3], [4]

Storage conditions

The storage conditions of Rabid 20 should be those where a constant temperature regime of 15-25 degrees Celsius is maintained. It is also important that the drug is in a place where it can not fall into the hands of children.

Shelf life

The shelf life of Rabidzh 20 is 2 years from the date of manufacture, which is indicated by the manufacturer on the package.

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