Rabeprazole with Domperidone: July 2012

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RABEPRAZOLE prevents the production of acid in the stomach. It reduces symptoms and prevents injury to the esophagus or stomach in patients with gastro esophageal reflux disease 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. Generic rabeprazole tablets are not yet available. Rabeprazole is an antiulcer drug in the class of proton pump inhibitors. Rabeprazole decreases the concentration of ketoconazole in the plasma (in 33%), increases the concentration of digoxin (in 22%), and does not interact with liquid antacids. Rabeprazole is compatible with any medicine metabolized by the CYP450.

The main metabolic pathway of domperidone is through CYP3A4. In vitro data suggest that the concomitant use of drugs that significantly inhibit this enzyme may result in increased plasma levels of domperidone. In vivo interaction studies with ketoconazole revealed a marked inhibition of domperidone's CYP3A4 mediated first pass metabolism by ketoconazole. Domperidone is a derivative of benzimidazole that possesses both prokinetic and antiemetic properties due to its inhibitory action at dopamine D2 receptors. Domperidone is a dopamine antagonist with anti-emetic properties domperidone does not readily cross the blood-brain barrier.

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

- Diarrhea

- Dizziness

- Headache

- Nausea / Vomiting

- Rash

- Tiredness