Aciphex (rabeprazole sodium) is a proton pump inhibitor (PPI) designed for the effective management of gastroesophageal reflux disease (GERD), erosive esophagitis, and other acid-related disorders. By selectively inhibiting the gastric proton pump, it provides sustained suppression of gastric acid secretion, offering both symptomatic relief and mucosal healing. Its delayed-release formulation ensures targeted delivery and optimized bioavailability, making it a first-line therapeutic option in clinical gastroenterology.

Features

• Active ingredient: Rabeprazole sodium
• Delayed-release tablet formulation
• Available in 20 mg strength
• CYP2C19 metabolism pathway
• Rapid onset of acid suppression
• Long duration of action (up to 24 hours)

Benefits

• Provides rapid and sustained relief from heartburn and regurgitation symptoms
• Promotes healing of erosive esophagitis with high efficacy rates
• Reduces the risk of NSAID-associated gastric ulcers in at-risk patients
• Supports maintenance of healed erosive esophagitis and symptom control
• Minimizes nocturnal acid breakthrough
• Offers convenient once-daily dosing for improved adherence

Common use

Aciphex 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 maintenance of healing of erosive esophagitis and for the treatment of pathological hypersecretory conditions, such as Zollinger-Ellison syndrome. Additionally, it is used in combination with antibiotics for the eradication of Helicobacter pylori in patients with duodenal ulcer disease.

Dosage and direction

The recommended adult dosage for most indications is 20 mg once daily. For GERD and healing of erosive esophagitis, treatment typically lasts 4 to 8 weeks, though maintenance therapy may be continued as needed. For H. pylori eradication, Aciphex 20 mg is administered twice daily alongside prescribed antibiotics for 7 days. Tablets should be swallowed whole, with or without food, and must not be crushed, split, or chewed.

Precautions

Patients should be advised that Aciphex may mask symptoms of gastric malignancy; appropriate diagnostic evaluation should be conducted if alarm features (e.g., unintended weight loss, recurrent vomiting, dysphagia) are present. Long-term use may be associated with an increased risk of fractures of the hip, wrist, and spine, particularly at high doses and with prolonged therapy. Hypomagnesemia has been reported rarely with prolonged PPI use; monitoring magnesium levels should be considered in patients expected to be on long-term therapy or those taking concomitant medications such as digoxin or diuretics.

Contraindications

Aciphex 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 the potential for decreased rilpivirine plasma concentrations and loss of virologic response.

Possible side effect

Common adverse reactions (≥2% incidence) include headache, diarrhea, nausea, vomiting, abdominal pain, and pharyngitis. Less frequently, rash, flatulence, infection, and insomnia may occur. Serious side effects, though rare, may include Clostridium difficile-associated diarrhea, acute interstitial nephritis, cutaneous and systemic lupus erythematosus, vitamin B12 deficiency (with long-term use), and fundic gland polyps.

Drug interaction

Aciphex may alter the absorption of drugs dependent on gastric pH for bioavailability, such as ketoconazole, iron salts, and digoxin. As a weak inhibitor of CYP2C19, it may increase plasma concentrations of drugs metabolized by this enzyme, including warfarin, phenytoin, and diazepam. Concomitant use with methotrexate may elevate methotrexate levels. Caution is advised when co-administering with tacrolimus or saquinavir.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose is not recommended.

Overdose

Limited data exist on Aciphex overdose. Reported doses of up to 80 mg have been tolerated without incident. In the event of suspected overdose, supportive and symptomatic treatment is recommended. Rabeprazole is not dialyzable.

Storage

Store at room temperature (20–25°C or 68–77°F), with excursions permitted between 15–30°C (59–86°F). Keep in the original container, tightly closed, and protect from moisture and light. Keep out of reach of children.

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 needs and responses may vary.

Reviews

Clinical studies and post-marketing surveillance demonstrate that Aciphex is well-tolerated and effective for acid suppression and mucosal healing. Many patients report significant improvement in quality of life due to reduced GERD symptoms. Healthcare providers often note its reliable pharmacokinetic profile and favorable safety record in both short- and long-term use.