Paricel 20mg Tablet 1 Strip

✔️ Pharmacological Action:

Rabeprazole is a proton pump inhibitor (PPI) that works by irreversibly inhibiting the H⁺/K⁺-ATPase enzyme system on gastric parietal cells, significantly reducing gastric acid secretion at the source.

✔️ Recommended Dosage:

Peptic Ulcers:

• Duodenal Ulcer & Benign Gastric Ulcer: 20 mg once daily (morning).
• Duodenal ulcers typically heal within 4 weeks; gastric ulcers may take up to 6 weeks.

GERD:

• Erosive/Ulcerative GERD: 20 mg once daily for 4–8 weeks
• GERD Maintenance Therapy: 10–20 mg once daily, based on individual response
• Symptomatic GERD (without esophagitis): 10 mg once daily; if symptoms persist beyond 4 weeks, further evaluation is advised

Pediatric GERD (1–11 years):

• <15 kg: 5 mg daily, may increase to 10 mg
• ≥15 kg: 10 mg once daily for 12 weeks

Zollinger-Ellison Syndrome:

• Start with 60 mg once daily; may be titrated up to 120 mg/day depending on the patient's needs (given in divided doses if required)

H. pylori Eradication (7-day course):

• Rabeprazole 20 mg twice daily, with:
• Clarithromycin 500 mg twice daily
• Amoxicillin 1 g twice daily

• Take once daily doses in the morning before food to ensure compliance
• Tablets must be swallowed whole—do not chew or crush

✔️ Possible Side Effects:

Generally well tolerated. Occasionally may cause:

• Headache, dizziness, drowsiness
• Diarrhea, constipation, nausea, abdominal pain
• Vomiting, dry mouth, altered appetite
• Muscular pain

✔️ Drug Interactions:

• May reduce the absorption of ketoconazole, itraconazole, and atazanavir due to increased gastric pH
• No interaction with liquid antacids noted
• Avoid combining with atazanavir due to pH-dependent absorption issues

✔️ Contraindications:

• Hypersensitivity to rabeprazole or any tablet component
• Use is not advised during pregnancy or breastfeeding

✔️ Precautions & Warnings:

• Exclude malignancy prior to treatment initiation
• Long-term use (>1 year) may increase fracture risk (hip, wrist, spine)
• Risk of hypomagnesaemia and associated symptoms (tetany, arrhythmias, seizures)
• May reduce vitamin B12 absorption over prolonged use
• Potential association with SCLE (subacute cutaneous lupus erythematosus)
• Increased risk of GI infections (e.g., C. difficile, Salmonella, Campylobacter)
• Discontinue 5 days prior to Chromogranin A testing for accurate results
• Use caution in severe hepatic impairment

✔️ Use in Special Populations:

• Renal or mild-to-moderate hepatic impairment: No dosage adjustment required
• Pediatrics: Not recommended for children under 1 year or without clinical safety data

✔️ Overdose Management:

• Doses up to 160 mg/day have been reported without serious outcomes
• Supportive and symptomatic treatment is advised
• Rabeprazole is not dialyzable due to high plasma protein bindin

✔️ Storage Conditions:

• Store below 30°C, protect from light and moisture
• Keep out of reach of children