Use In Combination With Antibacterial Agents
Patients who are allergic to antibacterial agents (clarithromycin and amoxicillin) should take precaution when using with Rabeprazole.
Stomach Cancer (Gastric Malignancy)
Treatment withRabeprazoledoes not prevent the presence of stomach ulcers
in these patients.
Patients on prolonged treatment (at least three months or years) or who are takingRabeprazolewith digoxin or may cause the deficiency of magnesium are at an increased risk. This may cause harmful effects like seizures
, muscle spasm, increase or decrease in heartbeat, dizziness
, disturbance in mental abilities and fatigue
. Treatment of low magnesium level in the blood can be improved by magnesium replacement or discontinuation of Rabeprazole.
Use With Methotrexate
WhenRabeprazoleis used with methotrexate, it may increase the level of methotrexate in the blood. In case of high dose intake of methotrexate, a temporary withdrawal ofRabeprazoleshould be considered.
Stomach And Intestinal Infection
Patients who are takingRabeprazoleare at an increased risk.Rabeprazoleincreases the count of bacteria in the stomach and intestine. It may increase the risk of infection caused by Salmonella
and Clostridium difficile.
Interference With Laboratory Tests
Increased Chromogranin A (protein) level may interfere with the test for both neural and endocrine cancer
). To avoid this interference,Rabeprazoleshould be discontinued for at least 5 days before chromogranin A measurements.
Subacute Cutaneous Lupus Erythematosus
Rabeprazole may cause subacute cutaneous lupus
erythematosus, lesion and pain
in a joints (arthralgia). Immediate medical help and discontinuation of proton pump inhibitors should be considered on the occurrence of lesions and pain in joints (arthralgia).
Use With Warfarin
Use ofRabeprazolewith warfarin increases the levels of blood parameters such as blood clotting time which may lead to abnormal bleeding
and may cause a fatality. Blood parameters should be monitored in patients takingRabeprazolewith warfarin.
Inflammation Within The Kidneys
Patients who are takingRabeprazoleare at an increased risk.Rabeprazolemay cause inflammation in the kidneys which lead to unknown harmful allergic reactions in the body. If a patient develops inflammation in the kidneys, discontinue the use of Rabeprazole.
Vitamin B-12 Deficiency
Patients who are takingRabeprazoleare at an increased risk. Long-term (more than 3 years) use of acid-suppressing agents may lead to vitamin
B-12 deficiency due to the absence of hydrochloric acid in the stomach. Diagnosis should be considered if these clinical symptoms persist.
Bacteria (Clostridium difficile) Associated Diarrhea
Patients who are takingRabeprazoleare at an increased risk. The use ofRabeprazolewith clarithromycin or amoxicillin may cause bacteria associated diarrhea
. Patients with bacteria associated diarrhea should take the lowest dose ofRabeprazolefor short period of time.
Patients with bone weakness related fractures
are at an increased risk when usingRabeprazolefor the longer period of time or taking its high doses. Long-term use or high doses ofRabeprazolemay increase the risk of fractures of the wrist, hip, or spine. Patients with bone weakness related fractures should take the lowest dose ofRabeprazolefor the shorter duration of time. Also, patients should have an adequate intake of calcium