Rabeprazole belongs to the class of medications known as proton pump inhibitors (PPIs). It works by slowing or preventing the production of acid in the stomach. Rabeprazole is used to treat and maintain healing of gastroesophageal reflux disease (GERD). It is also used to treat symptoms, such as heartburn and regurgitation, of non-erosive reflux disease (NERD).

It is also used for short-term treatment in the healing and relief of symptoms associated with duodenal and gastric ulcers. Rabeprazole is used in combination with antibiotics to treat ulcers caused by the bacterium Helicobacter pylori. Finally, rabeprazole is used for long-term treatment of conditions associated with constant production of excess acid in the stomach, including Zollinger-Ellison syndrome.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The dose of rabeprazole used depends on the condition being treated.

To treat non-erosive reflux disease (NERD), the recommended adult dose of rabeprazole is 10 mg to 20 mg, taken once daily for up to 4 weeks.

To treat gastroesophageal reflux disease (GERD) with esophagitis, the recommended adult dose of rabeprazole is 20 mg, taken once daily. The recommended adult dose for maintaining long-term healing of GERD is 10 mg to 20 mg, taken once daily. The usual length of treatment for GERD is 4 to 8 weeks.

To treat duodenal ulcer, the recommended adult dose of rabeprazole is 20 mg, taken once daily for a period of up to 4 weeks.

To treat gastric or stomach ulcer, the recommended adult dose of rabeprazole is 20 mg, taken once daily for a period of up to 6 weeks.

To treat ulcer caused by Helicobacter pylori infection, the recommended adult dose is 20 mg, taken twice daily for 7 days in combination with 2 antibiotics, usually amoxicillin and clarithromycin. If you are taking rabeprazole in combination with antibiotic drugs, it is important that you take all medications at the correct time of day and for the entire treatment period as recommended by your doctor.

To treat Zollinger-Ellison syndrome, the recommended adult starting dose of rabeprazole is 60 mg, taken once daily. Some people may require higher doses. Your doctor will adjust the dose of this medication as needed.

Rabeprazole delayed-release tablet has been designed to work throughout the day, and therefore needs to be taken only once daily. This medication may be taken with or without food. Swallow the tablets whole with a beverage. Do not chew, crush, or split the tablets.

Most people will experience some improvements in symptoms 1 to 2 weeks after starting rabeprazole. It may take up to 4 weeks for people to experience maximum benefit from this medication.

Keep taking this medication and finish all the tablets as recommended by your doctor even if you start to feel better. If the symptoms that were causing you problems have not gone away by the time you finish your medication or as discussed with your doctor, call your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to rabeprazole or any ingredients of the medication
• are allergic to other proton pump inhibitors
• are taking the medication rilpivirine

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• diarrhea (mild)
• dizziness
• headache
• itchiness
• rash

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal or fast heartbeat
• blood in stool
• a fracture (broken bone)
• jerking movements or shaking
• jitteriness
• muscle weakness
• new joint pain and rash that gets worse in sun
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• sore muscles
• spasms of the hands and feet
• spasm of the voice box

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
• signs of a serious bacterial bowel inflammation or infection (e.g., severe [watery or bloody] diarrhea, fever, abdominal pain or tenderness)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Diarrhea: When gastric acid is decreased, the number of bacteria normally in the digestive system increases. Occasionally, this can cause serious infection in the digestive tract. If you experience watery, foul-smelling bowel movements after starting to take rabeprazole, contact your doctor as soon as possible.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Long-term use: Long-term use of rabeprazole (e.g., every day for over 1 year) has been associated with growths in the stomach called polyps. These growths are usually harmless and do not cause symptoms. Talk to your doctor if you have concerns.

Magnesium levels: Rabeprazole may rarely cause low magnesium levels in people who take this medication for a prolonged period of time. Low magnesium may occur after at least 3 months, but usually after a year of treatment. If you have low magnesium levels in your blood, you should discuss with your doctor about how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Methotrexate interaction: Rabeprazole, like other medications in this group, may interact with methotrexate when the two medications are used at the same time. This combination may lead to higher-than-expected amounts of methotrexate in the body and can cause serious side effects, including kidney damage, irregular heartbeat, anemia, or infection. If you take rabeprazole, and are also going to receive a dose of methotrexate, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Osteoporosis fractures: Long-term use of rabeprazole may be related to an increased risk of bone fractures in the hip, wrist or spine, as a result of weakened bones. This risk is further increased if you are at risk of developing osteoporosis. If you have osteoporosis or have risk factors for developing osteoporosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Skin conditions: Subacute cutaneous lupus erythematosus is a skin condition that may develop in certain people taking rabeprazole or other similar medications. If you develop a rash on areas of skin that are exposed to the sun, such as the face, arms, or shoulders, check with your doctor as soon as possible.

Severe stomach problems: If you have recurrent vomiting, difficulty swallowing, blood in the stool, significant unintentional weight loss, fatigue (anemia), or are coughing up blood, check with your doctor right away. Long-term use of rabeprazole (longer than 1 year) has been associated with growth of polyps (abnormal growths) in the stomach.

Vitamin B12: Long-term use of rabeprazole may lead to vitamin B12 deficiency. If you are a vegetarian or have low vitamin B12 levels, discuss with your doctor whether any special monitoring is required.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if rabeprazole passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children and adolescents less than 18 years of age.

There may be an interaction between rabeprazole and any of the following:

• amphetamines (e.g., dextroamphetamine)
• "azole" antifungal medications (e.g., itraconazole, fluconazole, ketoconazole, posaconazole)
• bisphosphonates (e.g., alendronate, clodronate, risedronate)
• capecitabine
• cefuroxime
• certain protein kinase inhibitors (e.g., bosutinib, dasatinib, erlotinib, nilotinib)
• cyclosporine
• doxycycline
• HIV protease inhibitors (e.g., atazanavir, tipranavir)
• ledipasvir
• lumacaftor and ivacaftor
• methotrexate
• multivitamins and minerals
• mycophenolate
• octreotide
• rilpivirine
• riociguat
• tacrolimus
• thiazolidinediones (e.g., pioglitazone, rosiglitazone)
• velpatasvir
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.