Summary:
Indications of Xorel 20 mg
Gastro-resistant tablets of rabeprazole are recommended for the treatment of: Active ulcer in the duodenum. benign stomach ulcer that is active. Symptomatic gastroesophageal reflux illness that is erosive or ulcerative (GERD).
Disorder of the Gastro-esophageal Reflux Long-Term Planning (GERD Maintenance) Moderate to extremely severe gastroesophageal reflux disease symptoms (symptomatic GERD) Syndrome of Zollinger-Ellison. Helicobacter pylori removal in patients with peptic ulcer disease in conjunction with suitable antibacterial therapy regimens.
Theropeutic Class
Proton Pump Inhibitor
Pharmacology
The gastric H plus/K plus-ATPase at the secretory surface of the stomach parietal cell is inhibited by rabeprazole, which reduces gastric acid secretion.
It has been said that Rabeprazole acts as an inhibitor of the gastric proton pump since this enzyme is thought to be the acid (proton) pump within the parietal cell.
Dosage and Administration of Xorel 20 mg
Duodenal ulcer: Rabeprazole 20 mg in the morning for 4 weeks. Most patients heal within 4 weeks.Healing of erosive or ulcerative Gastroesophageal Reflux Disease (GERD): Rablet 20 mg daily in the morning for 4 to 8 weeks.
Those patients who have not healed after 8 weeks of treatment, an additional 8-week course of Rabeprazole may be considered.Treatment of symptomatic GERD: The recommended adult oral dose of Rabeprazole is 20 mg once daily in the morning for 4 weeks.
If symptoms do not resolve completely after 4 weeks, an additional course of treatment may be considered.Maintenance of healing of erosive or ulcerative GERD: The recommended adult oral dose of Rabeprazole is 20 mg once daily.
Controlled studies do not extend beyond 12 months.Zollinger-Ellison Syndrome: The recommended adult oral starting dose is 60 mg once a day. Doses should be adjusted according to individual patient needs and should continue for as long as clinically indicated.
Some patients may require divided doses. Doses up to 100 mg once daily and 60 mg twice daily have been administered.Helicobacter pylori eradication to reduce the risk of Duodenal Ulcer recurrence: Rabeprazole 20 mg, Amoxicillin 1000 mg, Clarithromycin 500 mg twice daily in the morning and evening with meals for 7 days.
Dosage of Xorel 20 mg
Active Duodenal Ulcer and Active Benign Gastric Ulcer: The recommended oral dose for both bioactive duodenal ulcer and active benign gastric ulcer is 20 mg to be taken once daily in the morning.
Most patients with active duodenal ulcer heal within four weeks. However, a few patients may require an additional four weeks of therapy to achieve healing. Most patients with active benign gastric ulcer heal within six weeks.
However, again a few patients may require an additional six weeks of therapy to achieve healing.Erosive or Ulcerative Gastro-Esophageal Reflux Disease (GERD): The recommended oral dose for this condition is 20 mg to be taken once daily for four to eight weeks.
Gastro-Esophageal Reflux Disease Long-term Management (GERD Maintenance): For long-term management, a maintenance dose of Xorel 20 mg or 10 mg once daily can be used depending upon patient response.
Symptomatic treatment of moderate to very severe Gastro-Esophageal Reflux Disease (symptomatic GERD): 10 mg once daily in patients without oesophagitis. If symptom control has not been achieved during four weeks, the patient should be further investigated. Once symptoms have resolved, subsequent symptom control can be achieved using an on-demand regimen taking 10 mg once daily when needed.
Treatment of GERD in pediatric patients 1 to 11 years of age (Less than 15 kg): 5 mg once daily for 12 weeks with the option to increase to 10 mg if inadequate response.Treatment of GERD in pediatric patients 1 to 11 years of age (15 kg or more): 10 mg once daily for 12 weeks.
Zollinger-Ellison Syndrome: The recommended adult starting dose is 60 mg once a day. The dose may be titrated upwards to 120 mg/day based on individual patient needs. Single daily doses up to 100 mg/day may be given. 120 mg dose may require divided doses, 60 mg twice daily.
Treatment should continue for as long as clinically indicated.Eradication of H. pylori: Patients with H. pylori infection should be treated with eradication therapy. The following combination given for 7 days is recommended. Rabeprazole sodium 20 mg twice daily, clarithromycin 500 mg twice daily and amoxicillin 1g twice daily.
Administration of Xorel 20 mg
Although neither the time of day nor food intake was demonstrated to have any effect on Xorel 20 mg activity, taking these pills in the morning before eating will make it easier for patients to adhere to the treatment plan.
Patients should be informed that the pills of rabeprazole should not be chewed or mashed but rather consumed whole.
Interaction of Xorel 20 mg
Significant and persistent inhibition of stomach acid output is brought about by respite. A compound whose absorption is pH-dependent may interact with another substance.
Itraconazole or ketoconazole co-administration with Xorel 20 mg may cause a considerable drop in antifungal plasma levels. Consequently, when ketoconazole or itraconazole are used concurrently with Respite, individual patients may need to be watched to determine if a dosage adjustment is warranted.
There was no apparent interaction with liquid antacids. Atazanavir is pH-dependently absorbed. As a result, PPIs, such as rabeprazole, shouldn't be taken alongside atazanavir.
Contraindications
Hypersensitivity to any excipient or active ingredient. The use of Xorel 20 mg during pregnancy and breastfeeding is not advised.
Side Effects of Xorel 20 mg
In both short- and long-term studies, Xorel 20 mg is generally well tolerated. In some cases, rabeprazole may result in headache, nausea, vomiting, constipation, dry mouth, increased or decreased appetite, muscle pain, sleepiness, and dizziness.
Pregnancy and Lactation
FDA pregnancy category "C" in the US. There is no proof that Rabeprazole affects fertility or causes harm to the fetus, according to studies done on animals. Nevertheless, there isn't any good, controlled research on pregnant women.
Since that rabeprazole is probably excreted in human milk, a choice should be made regarding whether to stop breastfeeding or to stop the medication, taking into account the significance of the medication to the mother.
Precautions and Warnings
Before starting treatment with Xorel 20 mg Gastro-resistant Tablets, the risk of malignancy should be ruled out because the presence of stomach or oesophageal malignancy is not precluded by the symptomatic response to therapy with rabeprazole.
Long-term patients should be regularly monitored, especially those who have been on medication for more than a year.
Proton pump inhibitors, particularly when used in high dosages and for extended periods of time (>1 year), may slightly increase the risk of hip, wrist, and spine fracture, mostly in elderly patients or when other known risk factors are present.
Proton pump inhibitors may raise the total risk of fracture by 10 percent to 40 percent, according to observational studies. Other risk factors could account for some of this increase. Individuals who are at risk for osteoporosis should be looked after and should consume enough calcium and vitamin D.
Overdose Effects of Xorel 20 mg
The highest exposure that has been determined has never gone above 60 mg twice daily or 160 mg once daily. Effects are often mild, typical of recognized adverse event profiles, and reversible without additional medical help.
There is no known particular antidote. Due to its high protein binding, rabeprazole cannot be dialyzed. Treatment for overdose should be symptomatic, as with any overdose, and broad supportive techniques should be used.
Storage Conditions
Keep away from light and moisture at a temperature below 30°C. Keep out of children's reach.
Use In Special Populations
It is unknown whether rabeprazole is safe and effective for use in children.
Drug Classes
Proton Pump Inhibitor
Mode Of Action
The gastric H plus/K plus-ATPase at the secretory surface of the stomach parietal cell is inhibited by rabeprazole, which reduces gastric acid secretion.
It has been said that Rabeprazole acts as an inhibitor of the gastric proton pump since this enzyme is thought to be the acid (proton) pump within the parietal cell.
Pediatric Uses
Hepatic and renal impairment: Patients who have these conditions don't require dosage adjustments. Rabeprazole is not advised for usage in pediatric populations since there are insufficient data on its safety and effectiveness. 
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