Rabijem 20.

Rabidgem 20 is included in the list of those medical products 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 the parietal cell, the main effect of the drug is that it produces an inhibitory effect on the proton pump. It belongs to the category of compounds with antisecretory properties, which, without 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, therefore, is a medicinal product that has a beneficial effect on the functioning of the digestive system and metabolic processes in the body.

Indications Rabijem 20.

Indications for the use of Rabidgem 20 are caused by the presence of such types of ulcer disease in the patient as duodenal ulcer and peptic gastric ulcer, in which the integrity of the walls of these organs is compromised under the influence of pathologically increased concentrations of acidic digestive juices.

The tendency to normalize the acidic environment that appears as a result of using the drug is manifested in a decrease in the degree of negative impact of that factor.

A similar effect is achieved by using Rabidgem 20 at the acute stage of chronic gastritis if there is excessive formation of gastric acid. This makes the use of the drug in such cases justified.

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

The next clinical case that may determine the indications for prescribing 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 for the eradication of Helicobacter pylori, a bacterium that parasitizes the gastric mucosa.

Finally, indications for the use of Rabidge 20 are based on Zollinger-Ellison syndrome, as well as other conditions of pathologically increased secretion.

Release form

The release form of Rabidzhem 20 is red-brown round tablets. Each tablet is smooth on both sides, covered with an enteric coating.

One tablet contains 20 mg of rabeprazole sodium, and in addition to it there are auxiliary substances. They are represented by light magnesium oxide, mannitol, hydroxypropyl cellulose, talc, sodium croscarmellose, magnesium sansel stearate, pH 102, ethyl cellulose, propylene glycol, hypromellose, diethyl phthalate, PEG 6000, gitane dioxide, red iron oxide.

The tablets are packed in strips made of aluminum foil. In a cardboard box, together 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 in the presence of 3 strips with tablets in the package.

Pharmacodynamics

The pharmacodynamics of Rabidgem 20 is reflected in the pharmacological action in the human body of the main active ingredient of the drug, which is rabeprazole.

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

The effect of rabeprazole on the processes of gastric acid production is that this component of Rabidgem 20 blocks gastric secretion at its final stage.

Pharmacodynamics Rabidgem 20, which should be noted regarding the chemical activity of rabeprazole, is that it is activated when the acid-base balance level pH is 1.2. The half-life is 78 seconds.

Pharmacokinetics

The pharmacokinetics of Rabidgem 20 is characterized by a bioavailability of rabeprazole of approximately 52 percent.

Tmax may undergo certain changes due to the fact that the drug is taken with food containing a large amount of fat. In this case, the time required for absorption may increase to 4 hours or require an even longer period. However, Cmax and the amount in which absorption occurs do not change significantly in this case. This gives grounds to assert that if there is any connection between the use of Rabidge 20 and the time of food intake, it is weakly expressed. Thus, food does not cause any significant decrease in the effectiveness of the drug.

In the blood, rabeprazole binds to plasma proteins in its total amount, reaching 96.3 percent. The primary products of metabolism observed in the blood plasma are sulfone and thioether. It has been established that these metabolites do not tend to have a significant antisecretory effect. The results of in vitro studies indicate that rabeprazole is metabolized in the liver primarily by cytochrome P450 3A – CYP3A. In the process, sulfone metabolites are formed. And from cytochrome P450 2C19 – CYP2C19 – desmethylrabeprazole.

Pharmacokinetics of Rabidgem 20 during drug excretion is 90% presence of the drug in urine as thioether of carboxylic acid, its glucuronide metabolites and mercaptuic acid compounds. The remains of the doses taken leave the body together with feces. Neither in urine nor in feces excretion of rabeprazole in an unchanged state occurs.

Dosing and administration

The method of administration and dosage of Rabidzhem 20 suggests that the tablets should be taken orally whole, without chewing or breaking or crushing them beforehand. This medication should be taken before meals.

For peptic ulcer of the duodenum without the presence of Helicobacter pylori, Rabidgem 20 is recommended to be taken orally at the recommended dose of one 20 mg tablet once or twice a day for 2 to 4 weeks.

For the treatment of gastric peptic ulcer in the absence of Helicobacter pylori, Rabidgem 20 is prescribed in the same dosage as in the previous case - one 20-milligram tablet 1 or 2 times a day. The only difference is in the duration of treatment using this drug: with the same minimum course of 14 days, the time period in which Rabidgem 20 should be taken can last up to 6 weeks.

For 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 maintenance therapy for this disease, a single daily intake of Rabidgem 20 is assumed in the amount of 1 tablet of 10 or 20 mg, respectively. The dose is selected individually for each specific patient.

For patients with Zollinger-Ellison syndrome with pathological hypersecretory conditions, the dosage is determined based on an individual approach to each specific case of this disease. It is recommended to begin treatment with a daily dose of Rabidgem 20 to 60 milligrams. If such a need arises, the dose of the drug is subsequently 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 gastric acid production determines the necessary dosage of Rabidgem 20 equal to 1-2 tablets per day during the course of treatment, which is 2-3 weeks.

In exactly the same way, as regards the dose and time period of taking the drug, it should be used in functional dyspepsia.

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

Use Rabijem 20. during pregnancy

The use of Rabidgem 20 during pregnancy, as well as during lactation and breastfeeding, is one of those cases in which the use of the drug is unacceptable.

Contraindications

Contraindications to the use of Rabidgem 20 are based mainly on the factor of individual reaction that may occur in the patient in one way or another, in each specific case, to the effect that rabeprazole has on the body. This also applies equally to the presence of hypersensitivity to any of the other components of the drug auxiliary components. In addition, this category includes the replacement of benzimidazole or other ingredients contained in Rabidgem 20.

Contraindications to the use of Rabidzhem 20 also include a ban on the use of the drug in relation to patients in childhood. Pregnant women should also refrain from using it and during the period after the birth of the child when the baby is breastfed.

Side effects Rabijem 20.

Common manifestations in which side effects of Rabidgem 20 may appear include: malaise, asthenic state, fever, chills, development of various allergic reactions, pain in the sternum, hypersensitivity to light. Sometimes the face swells, the stomach may swell.

In the activity of the cardiovascular system, the occurrence of arterial hypertension is observed, myocardial infarction is possible, cases of fainting, migraine, rapid heartbeat, tachycardia, sinus bradycardia, angina pectoris appear, changes in electrocardiographic parameters are noted.

The digestive system can react with such negative consequences of the drug use as: belching, dry mouth, abdominal pain, nausea, vomiting, diarrhea, flatulence, constipation. There is a possibility of rectal bleeding, development of gastroenteritis and dyspepsia, the appearance of gallstones, the occurrence of anorexia is not excluded. In addition, the use of Rabidgem 20 can lead to mouth ulcers, stomatitis, gingivitis, dysphagia, increased appetite, cause stool disorders. This drug can provoke cholecystitis, proctitis, colitis, pancreatitis, glossitis, esophagitis.

A side effect of the drug is often the development of anemia, including hypochromic, there is a possibility of subcutaneous hemorrhages, and lymph nodes may hypertrophy.

The vector of negative effects of Rabidgem 20 is also aimed at metabolism and metabolic processes occurring in the human body. The drug often causes an increase in body weight, or, on the contrary, leads to weight loss and dehydration.

The condition of the central nervous system is also subject to changes as a result of taking the drug. Characteristic signs of this are sleep disorders - the appearance of insomnia or, conversely, excessive sleepiness, dizziness, the development of neuralgia and neuropathy, nervousness, tremor. Depressive conditions, decreased sexual desire, and convulsions may occur.

The negative consequences of using Rabidgem 20 are also indicated by changes in laboratory test results. In particular, abnormal erythrocytes and thrombocytes are present in the blood, hyperglycemia and leukocytosis are observed.

There are deviations in the urine composition and liver function tests. The latter are characterized by an increased content of ALT, and prostate-specific antigen is present in greater quantities.

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

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Overdose

An overdose of Rabidge 20 can occur mainly in cases when the main active component of the drug, rabeprazole, enters the human body in an amount exceeding the maximum permissible norm of 80 milligrams per day. This drug, taken within this designated daily amount, is usually well tolerated and its effects do not result in any pronounced clinical symptoms.

The existence of a specific antidote is currently not confirmed by medicine. Based on this, if an overdose of the drug occurs, all 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 Rabidgem 20 with other drugs is largely determined by the peculiarities of the metabolic processes to which its main active ingredient rabeprazole is subjected. Its metabolization involves enzyme symbionts of the cytochrome P450 or CYP450 system.

Studies in healthy volunteers have shown that other drugs that are also metabolized by the CYP450 system do not interact with rabeprazole in a manner that would be considered clinically significant. This includes warfarin, diazepam given intravenously as a single dose, theophylline (as a single dose given orally), and phenytoin given intravenously as a single dose with additional doses given orally.

No special studies have been conducted to identify the characteristics of combinations with the inclusion of other drugs that are metabolized by the enzymatic system.

One of the main effects of Rabidgem 20 is that it reduces the intensity of gastric secretory function, which determines the possibility of its influence on the effect produced by those drugs that their absorption is associated with the acid-base balance of gastric juice. Thus, 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%. Due to the above interaction features, simultaneous administration of Rabidgem 20 drugs whose absorption properties depend on gastric pH requires medical supervision and, if necessary, adjustment of the dosage of each of such a combination of drugs.

Interactions of Rabidgem 20 with other antacid drugs do not lead to clinically significant changes in the concentration of rabeprazole in blood plasma.

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Storage conditions

Storage conditions for Rabidgem 20 should be such that a constant temperature of 15-25 degrees Celsius is maintained. It is also important that the drug is kept in a place where it cannot fall into the hands of children.

Shelf life

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

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