Rabiros- D (Rabeprazole + Domperidone).

• Composition :
  Each capsule contains Rabeprazole 20 mg Enteric coated and Domperidone BP 30 mg SR
• Indications :
  For the treatment of Gastroesophageal Reflux Disease (GERD).
• Dosage and administration :
  One capsule once daily before food, for 4-8 weeks or as directed by the physician.
• Contraindications :
  In patients with known hypersensitivity to rabeprazole sodium, domperidone, or to any excipient used in the formulation.
• Precautions and warnings :
  Symptomatic response to therapy with rabeprazole does not preclude the presence of gastric malignancy, Acute interstitial nephritis has been observed in patients taking PPIs PPI therapy may be associated with increased risk of Clostridium difficile associated diarrhea, Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. Since the elimination half-life of domperidone is prolonged in severe renal impairment, dose should be reduced. Domperidone is not recommended for chronic use or for the routine prophylaxis of postoperative nausea and vomiting.
• Use in pregnancy, lactation & pediatrics :
  The safety and efficacy in this population has not been established. Hence not recommended in these population.
• Drug interactions :
  Rabeprazole - Monitor for increases in INR and prothombin time, inhibits cyclosporine metabolism, inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability, may reduce the plasma levels of atazanavir and may increase serum level of methotrexate. Domperidone - Coadministration with oral ketoconazole, erythromycin, or other potent CYP3A4 inhibitors which prolong the QTc interval such as fluconazole, voriconazole, clarithromycin, amiodarone, and telithromycin is not recommended. Antacids and antisecretory drugs should not be given simultaneously with oral formulations of domperidone as they lower its oral bioavailability. Concomitant administration of anticholinergic drugs may antagonise the anti-dyspeptic effect of Domperidone, hence not recommended.
• Adverse reactions :
  Most common side effects are somnolence, dizziness and dry mouth.
• Therapy Area :
  Anti-ulcerants_Gastroenterologicals
• Mechanism of Action :
  Rabeprazole belongs to a class of antisecretory compounds (substituted benzimidazole proton-pump inhibitors- PPI) that suppress gastric acid secretion by inhibiting the gastric H+, K+ATPase at the secretory surface of the gastric parietal cell. Domperidone is a dopamine antagonist (blocking both D1 & D2 receptors). Domperidone facilitates gastrointestinal smooth muscle activity by inhibiting dopamine at the D1 receptors and inhibiting the release of neural acetylcholine by blocking D2 receptors.