Rabeprazole

359.44

359.44

1592732-453-0

DTXSID3044122

White crystals from CH2Cl2/ether

A02BC04|A - Alimentary tract and metabolism

96.3

1.9

Solid

1.33±0.1 g/cm3(Predicted)

99-100 °C (decomp)

603.9±65.0 °C(Predicted)

319.1±34.3 °C

1.655

Store in original container in a cool dark place.

2.2X10-15 mm Hg at 25 deg C /Estimated/

Henry's Law constant: 1.2X10-17 atm-cu m/mole at 25 °C /Estimated/

pKa1 = 1.9; pKa2 = 3.2; pKa3 = 4.2 (amines) (est)

White crystals from ether, mp 140-141 °C (decomposes) /Sodium salt/|White to yellowish white solid. Very soluble in water and methanol. Freely soluble in alcohol, chloroform and ethyl acetate. Insoluble in ether and n-hexane. /Sodium salt/|Hydroxy radical reaction rate constant = 4.4X10-11 cu cm/molec-sec at 25 °C /Estimated/

36/38

26-37/39

Xi

P261, P264, P271, P280, P302+P352, P304+P340, P305+P351+P338, P312, P321, P332+P313, P337+P313, P362, P403+P233, P405, P501

H315

SRP: The most favorable course of action is to use an alternative chemical product with less inherent propensity for occupational exposure or environmental contamination. Recycle any unused portion of the material for its approved use or return it to the manufacturer or supplier. Ultimate disposal of the chemical must consider: the material's impact on air quality; potential migration in soil or water; effects on animal, aquatic, and plant life; and conformance with environmental and public health regulations.

The Approved Drug Products with Therapeutic Equivalence Evaluations List identifies currently marketed prescription drug products, incl rabeprazole sodium, approved on the basis of safety and effectiveness by FDA under sections 505 of the Federal Food, Drug, and Cosmetic Act. /Rabeprazole Sodium/

|Warning|H315 (92.86%): Causes skin irritation [Warning Skin corrosion/irritation]|P261, P264, P271, P280, P302+P352, P304+P340, P305+P351+P338, P312, P321, P332+P313, P337+P313, P362, P403+P233, P405, and P501|Aggregated GHS information provided by 42 companies from 4 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

Despite its wide use, rabeprazole has only rarely been associated with hepatic injury. In large scale, long term trials of rabeprazole, serum ALT elevations occurred in less than 1% of patients and at rates similar to those with placebo or comparator drugs. In large case series of drug induced liver injury, rabeprazole has accounted for few instances of symptomatic acute liver injury. Only a few cases of clinically apparent liver disease due to rabeprazole have been published and the characteristics of the injury have not been well defined, but appear to be similar to the features of hepatic injury associated with other proton pump inibitors. Clinically apparent liver injury due to proton pump inhibitors typically arises within the first 4 weeks of treatment with symptoms of jaundice, nausea and fatigue and a hepatocellular or mixed pattern of serum enzyme elevations. Recovery is typically rapid upon withdrawal of the agent. Rash, fever and eosinophilia are rare, as is autoantibody formation. Instances of recurrence on rechallenge have been reported.

Warfarin: Potential pharmacokinetic interaction. Proton-pump inhibitors may inhibit warfarin metabolism. No clinically important interaction in single-dose studies, but increased international normalized ration (INR) and prothrombin time (PT) have been reported in patients receiving these drugs concomitantly; may need to monitor INR and PT during concomitant use with rabeprazole.|Rabeprazole may increase gastrointestinal pH; concurrent use /of digoxin/ with rabeprazole resulted in increase of the serum peak concentration by 29% in normal subjects.|Rabeprazole may increase gastrointestinal pH; concurrent use /of ketoconazole/ with rabeprazole resulted in 30% reduction in bioavailability.|In vitro incubations employing human liver microsomes indicated that rabeprazole inhibited cyclosporine metabolism with an IC50 of 62 micromolar, a concentration that is over 50 times higher than the Cmax in healthy volunteers following 14 days of dosing with 20 mg of rabeprazole. This degree of inhibition is similar to that by omeprazole at equivalent concentrations.|Combined administration consisting of rabeprazole, amoxicillin, and clarithromycin resulted in increases in plasma concentrations of rabeprazole and 14-hydroxyclarithromycin.

96.3% (bound to human plasma proteins)

Rabeprazole's production and use in the preparation of the antiulcerative, rabeprazole calcium(1), may result in the release to the environment through various waste streams(SRC).

TERRESTRIAL FATE: Based on a classification scheme(1), an estimated Koc value of 2,500(SRC), determined from a structure estimation method(2), indicates that rabeprazole is expected to have slight mobility in soil(SRC). Volatilization of rabeprazole from moist soil surfaces is not expected to be an important fate process(SRC) given an estimated Henry's Law constant of 1.2X10-17 atm-cu m/mole(SRC), using a fragment constant estimation method(3). Rabeprazole is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 2.2X10-15 mm Hg(SRC), determined from a fragment constant method(4). Biodegradation data were not available(SRC, 2005).|AQUATIC FATE: Based on a classification scheme(1), an estimated Koc value of 2,500(SRC), determined from a structure estimation method(2), indicates that rabeprazole is expected to adsorb to suspended solids and sediment(SRC). Volatilization from water surfaces is not expected(3) based upon an estimated Henry's Law constant of 2.1X10-17 atm-cu m/mole(SRC), developed using a fragment constant estimation method(4). According to a classification scheme(5), an estimated BCF of 1.6(SRC), from an estimated log Kow of 1.17(6) and a regression-derived equation(7), suggests the potential for bioconcentration in aquatic organisms is low(SRC). Biodegradation data were not available(SRC, 2005).|ATMOSPHERIC FATE: According to a model of gas/particle partitioning of semivolatile organic compounds in the atmosphere(1), rabeprazole, which has an estimated vapor pressure of 2.2X10-15 mm Hg at 25 °C(SRC), determined from a fragment constant method(2), is expected to exist solely in the particulate phase in the ambient atmosphere. Particulate-phase rabeprazole may be removed from the air by wet and dry deposition(SRC). Rabeprazole does not contain chromophores that absorb at wavelengths >290 nm and therefore should not be susceptible to direct photolysis from sunlight.

Rabeprazole is not expected to undergo hydrolysis in the environment due to the lack of hydrolyzable functional groups(1). Based on the UV specta of 1H-benzimidazole(2), rabeprazole does not contain chromophores that absorb UV light at wavelengths >290 nm and therefore should not be susceptible to direct photolysis from sunlight(SRC).

An estimated BCF of 1.6 was calculated for rabeprazole(SRC), using an estimated log Kow of 1.17(1) and a regression-derived equation(2). According to a classification scheme(3), this BCF suggests the potential for bioconcentration in aquatic organisms is low(SRC), provided the compound is not altered physically or chemically once released into the environment(SRP).

Using a structure estimation method based on molecular connectivity indices(1), the Koc for rabeprazole can be estimated to be 2,500(SRC). According to a classification scheme(2), this estimated Koc value suggests that rabeprazole is expected to have slight mobility in soil.

The Henry's Law constant for rabeprazole is estimated as 1.2X10-17 atm-cu m/mole(SRC) using a fragment constant estimation method(1). This Henry's Law constant indicates that rabeprazole is expected to be essentially nonvolatile from moist soil and water surfaces(2). Rabeprazole is not expected to volatilize from dry soil surfaces(SRC) based upon a an estimated vapor pressure of 2.2X10-15 mm Hg(SRC), determined from a fragment constant method(3).

Occupational exposure to rabeprazole may occur through inhalation and dermal contact with this compound at workplaces where rabeprazole is produced or used. Exposure to the drug among the general population may be limited to those being administered rabeprazole calcium, (an antiulcerative). (SRC)

For the treatment of acid-reflux disorders (GERD), peptic ulcer disease, H. pylori eradication, and prevention of gastroinetestinal bleeds with NSAID use.|FDA Label

Rabeprazole is a proton pump inhibitor (PPI) and a potent inhibitor of gastric acidity used in the therapy of gastroesophageal reflux and peptic ulcer disease. Rabeprazole therapy is associated with a low rate of transient and asymptomatic serum aminotransferase elevations and is a rare cause of clinically apparent liver injury.

Antiulcer Agents

Antiulcerative|Rabeprazole is indicated for the short-term treatment 4-8 weeks for symptomatic relief and healing of erosive or ulcerative gastroesophageal reflex disease. Rabeprazole may be indicated for an additional 8 weeks of treatment for patients in whom healing has not occurred. Rabeprazole also is indicated to maintain healing of erosive or ulcerative gastroesophageal reflux disease. /Included in US product labeling/|Rabeprazole is indicted for the long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome. /Included in US product labeling/|Rabeprazole is indicated for short-term treatment (up to 4 weeks) in the healing and symptomatic relief of patients with active duodenal ulcers. /Included in US product labeling/

Caution should be exercised in dosing patients with severe hepatic impairment, particularly because of the lack of clinical data in this patient population. However, accumulation of rabeprazole at the usual dosage of 20 mg daily is unlikely, and dosage adjustment is not necessary in those with mild to moderate hepatic impairment.|Symptomatic response to therapy with rabeprazole does not preclude the occult presence of gastric neoplasm. Approximately 4% of patients had no intestinal metaplasia during follow-up (up to 40 months), with no consistent changes noted.|Administration of proton-pump inhibitors has been associated with an increase risk for developing certain infections (e.g., community-acquired pneumonia).|FDA Pregnancy Risk Category: B /NO EVIDENCE OF RISK IN HUMANS. Adequate, well controlled studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals, or, in the absence of adequate human studies, animal studies show no fetal risk. The chance of fetal harm is remote but remains a possibility./|For more Drug Warnings (Complete) data for RABEPRAZOLE (12 total), please visit the HSDB record page.

Rabeprazole prevents the production of acid in the stomach. It reduces symptoms and prevents injury to the esophagus or stomach in patients with gastroesophageal reflux disease (GERD) or ulcers. Rabeprazole is also useful in conditions that produce too much stomach acid such as Zollinger-Ellison syndrome. Rabeprazole may also be used with antibiotics to get rid of bacteria that are associated with some ulcers. Rabeprazole is a selective and irreversible proton pump inhibitor, suppresses gastric acid secretion by specific inhibition of the H⁺, K⁺ -ATPase, which is found at the secretory surface of parietal cells. In doing so, it inhibits the final transport of hydrogen ions (via exchange with potassium ions) into the gastric lumen.

Various agents with different action mechanisms used to treat or ameliorate PEPTIC ULCER or irritation of the gastrointestinal tract. This has included ANTIBIOTICS to treat HELICOBACTER INFECTIONS; HISTAMINE H2 ANTAGONISTS to reduce GASTRIC ACID secretion; and ANTACIDS for symptomatic relief. (See all compounds classified as Anti-Ulcer Agents.)|Compounds that inhibit H(+)-K(+)-EXCHANGING ATPASE. They are used as ANTI-ULCER AGENTS and sometimes in place of HISTAMINE H2 ANTAGONISTS for GASTROESOPHAGEAL REFLUX. (See all compounds classified as Proton Pump Inhibitors.)

Absolute bioavailability is approximately 52%.|Following a single 20 mg oral dose of 14C-labeled rabeprazole, approximately 90% of the drug was eliminated in the urine, primarily as thioether carboxylic acid; its glucuronide, and mercapturic acid metabolites.|Elimination: Normal renal function: Approximately 1 to 2 hours. Hepatic function impairment: 2 to 6 hours.|Protein binding: Very high; approximately 96% bound to human plasma protein.|Since rabeprazole is acid-labile, it is administered as a delayed-release tablet so that it can pass through the stomach relatively intact. Once rabeprazole has left the stomach, absorption occurs within 1 hour of administration. The bioavailability is approximately 52%.|It is unknown whether rabeprazole is distributed into human milk. However, in lactating rats, levels of rabeprazole were 2 to 7 times higher in milk than in blood.|For more Absorption, Distribution and Excretion (Complete) data for RABEPRAZOLE (10 total), please visit the HSDB record page.

Hepatic|Approximately 90% of the rabeprazole dose is excreted in the urine as metabolites. These metabolites are mainly thioether carboxylic acid (TCA), the glucuronide of TCA, and mercapturic acid.|Rabeprazole is extensively metabolized. The thioether and sulphone are the primary metabolites measured in human plasma. These metabolites were not observed to have significant antisecretory activity. In vitro studies have demonstrated that rabeprazole is metabolized in the liver primarily by cytochromes P450 3A (CYP3A) to a sulphone metabolite and cytochrome P450 2C19 (CYP2C19) to desmethyl rabeprazole. The thioether metabolite is formed non-enzymatically by reduction of rabeprazole. CYP2C19 exhibits a known genetic polymorphism due to its deficiency in some sub-populations (e.g. 3 to 5% of Caucasians and 17 to 20% of Asians). Rabeprazole metabolism is slow in these sub-populations, therefore, they are referred to as poor metabolizers of the drug.|Rabeprazole is a known human metabolite of Rabeprazole (rabeprazole_thioether).

1-2 hours (in plasma)|The plasma half-life ranges from 1 to 2 hours.|The study was designed to determine the absolute bioavailability of 20 mg rabeprazole tablets in normal, healthy subjects in comparison with intravenous administration of 20 mg rabeprazole. ... Each subject was randomized at the beginning of the study to receive either a single 20 mg dose of rabeprazole intravenously or orally during Period 1. ... Intravenous dose was given in constant infusion over five minutes. ... The elimination half-life of rabeprazole sodium (1.47 +/- 0.82 hr) after oral administration was significantly longer than the elimination half-life after intravenous administration (1.02 +/- 0.63 hr), probably due to slower rate of absorption than that of elimination.

Rabeprazole belongs to a class of antisecretory compounds (substituted benzimidazole proton-pump inhibitors) that do not exhibit anticholinergic or histamine H2-receptor antagonist properties, but suppress gastric acid secretion by inhibiting the gastric H⁺/K⁺ATPase (hydrogen-potassium adenosine triphosphatase) at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as a gastric proton-pump inhibitor. Rabeprazole blocks the final step of gastric acid secretion. In gastric parietal cells, rabeprazole is protonated, accumulates, and is transformed to an active sulfenamide. When studied in vitro, rabeprazole is chemically activated at pH 1.2 with a half-life of 78 seconds.|Rabeprazole is a selective and irreversible proton pump inhibitor. Rabeprazole suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium adenosine triphosphatase (H+, K+-ATPase) enzyme system found at the secretory surface of parietal cells. It inhibits the final transport of hydrogen ions (via exchange with potassium ions) into the gastric lumen. Since the H+, K+-ATPase enzyme system is regarded as the acid (proton) pump of the gastric mucosa, rabeprazole is known as a gastric acid pump inhibitor. Rabeprazole does not have anticholinergic or histamine H2-receptor antagonist properties.|Rabeprazole binds to hydrogen-potassium ATPase in gastric parietal cells; inactivation of this enzyme system (also known as the proton, hydrogen, or acid pump) blocks the final step in the secretion of hydrochloric acid secretion. The antisecretory effect is apparent within 1 hour following oral administration with the median inhibitory effect on 24-hour gastric acidity being 88% of maximal after the first dose.

There is no specific antidote for rabeprazole. Treatment is essentially symptomatic and supportive. Rabperazole is not appreciably removed by dialysis.|Basic treatment: Establish a patent airway. Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if needed. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary ... . Monitor for shock and treat if necessary ... . Anticipate seizures and treat if necessary ... . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with normal saline during transport ... . Do not use emetics. For ingestion, rinse mouth and administer 5 ml/kg up to 200 ml of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool ... . Cover skin burns with dry sterile dressings after decontamination ... . /Poison A and B/|Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in respiratory arrest. Positive pressure ventilation techniques with a bag valve mask device may be beneficial. Monitor cardiac rhythm and treat arrhythmias as necessary ... . Start an IV with D5W /SRP: "To keep open", minimal flow rate/. Use lactated Ringer's if signs of hypovolemia are present. Watch for signs of fluid overload. Consider drug therapy for pulmonary edema ... . For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload ... . Treat seizures with diazepam (Valium) ... . Use proparacaine hydrochloride to assist eye irrigation ... . /Poison A and B/

/HUMAN EXPOSURE STUDIES/ No large overdose with rabeprazole has been reported. There were no clinical signs or symptoms associated with the 7 reported overdoses of up to 80 mg.

1H-Benzimidazole, 2-(((4-(3-methoxypropoxy)-3-methyl-2-pyridinyl)methyl)sulfinyl)-, sodium salt

Information available in 2005 indicated that Rabeprazole sodium was used in the manufacture of pharmaceutical preparations in the following countries: Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Chile, Colombia, Costa Rica, Denmark, Dominican Republic, El Salvador, Finland, France, Germany, Greece, Guatemala, Honduras, Hong Kong, Hungary, India, Indonesia, Ireland, Italy, Japan, Malaysia, Mexico, Netherlands, Nicaragua, Panama, Poland, Portugal, Romania, South Africa, Singapore, Spain, Sweden, Switzerland, Thailand, United Kingdom, United States(1,2).

Human Drugs -> FDA Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book) -> Active Ingredients