Aciphex

OB/GYN News, Oct 15, 1999 by Elizabeth Mechcatie

(rabeprazole, Eisai and Janssen)

A proton pump inhibitor (PPI) for healing erosive or ulcerative gastroesophageal reflux disease (GERD) and duodenal ulcers, maintenance of healing of GERD, and treatment of pathologic hypersecretory conditions.

* Recommended Dosage: 20 mg once daily for healing GERD and duodenal ulcers and GERD maintenance. Higher doses for hypersecretory conditions.

* Special Considerations: The PPIs as a class are "remarkably well tolerated," said Dr. Malcolm Robinson, medical director of the Oklahoma Foundation for Digestive Research, Oklahoma City. Rabeprazole interacts with fewer drugs than other PPIs. All PPIs can be expected to interact with drugs like digoxin and ketoconazole, whose absorption is affected by gastric acidity.

* Comment: Aciphex is "substantially more potent" than Prilosec (omeprazole), according to Dr. Robinson, an Aciphex investigator. It is also distinguished by its rapid onset of action, similar to [H.sub.2] receptor antagonists, with an antisecretory effect that begins within a few hours of the first dose, he said. Still, there is no reason to switch patients doing well on an older PPI to Aciphex, he noted.

Dr. Robinson is on Janssen's international advisory board and has received research funds from Janssen; he has similar ties to other antisecretory medication manufacturers.