How does it work?
Pariet tablets contain the active ingredient rabeprazole, which is a type of medicine called a proton pump inhibitor. Rabeprazole is also available without a brand name, ie as the generic medicine. Rabeprazole acts in the stomach to decrease the production of stomach acid.
Proton pumps are found on cells that line the stomach and are used by these cells to produce stomach acid. Rabeprazole works by inhibiting the action of the proton pumps, which reduces the production of stomach acid.
Stomach acid is produced in the stomach as a normal part of the digestive process. Normally the linings of the stomach and duodenum (an area of the small intestine directly after the stomach) are protected by a layer that resists attack from this acid. However, if this layer is damaged, or large amounts of stomach acid are formed, an ulcer can develop on the lining of the stomach or duodenum. This is called a peptic ulcer.
Acid produced in the stomach can also sometimes flow back into the food pipe (oesophagus). This is called gastro-oesophageal reflux, and can cause pain and a burning sensation known as heartburn. It can also irritate and damage the lining of the oesophagus, causing a condition called reflux oesophagitis.
By reducing the production of stomach acid and hence the amount of acid in the stomach and duodenum, rabeprazole can be used to treat these and other conditions.
Rabeprazole stops excess acid flowing back into the foodpipe and can be used to relieve heartburn symptoms associated with acid reflux. It allows the oesophagus to heal in reflux oesophagitis. It also allows peptic ulcers to heal.
Rabeprazole is also given together with antibiotics to help eradicate a type of bacteria called Helicobacter pylori from the stomach of people with a peptic ulcer. These bacteria can contribute to the formation of peptic ulcers. Rabeprazole allows the ulcers to heal and helps create an environment in the gut in which the antibiotics can be more effective at killing the bacteria.
Rabeprazole is used in varying doses and for varying lengths of time depending on the condition being treated.
What is it used for?
- Gastro oesophageal reflux disease, including treatment of symptoms such as heartburn, acid regurgitation and pain on swallowing and long-term management of reflux oesophagitis.
- Treating peptic ulcers.
- Eradicating a type of bacteria called Helicobacter pylori from the gut of people with a peptic ulcer (in combination with antibiotics).
- Excessive secretion of stomach acid due to a tumour or enlargement of the pancreas (Zollinger-Ellison syndrome).
How do I take it?
- The number of tablets to take, how often and for how long will depend on the condition being treated. It is important to follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine.
- Rabeprazole tablets should be swallowed whole with a drink of water. Do not chew, crush or break the tablets.
- Rabeprazole tablets can be taken either with or without food.
- If you forget to take a dose take it as soon as you remember. However, if it is almost time for your next dose just skip the missed dose and take your next dose as normal. Don't take a double dose to make up for a missed dose.
- Stomach cancer can have similar symptoms to stomach ulcers, and these symptoms can be relieved by rabeprazole. For this reason, if it is suspected that you have a stomach ulcer, your doctor should exclude the possibility of stomach cancer before you start treatment with this medicine. Otherwise, this medicine could mask the symptoms of stomach cancer and therefore delay diagnosis of this condition. This is particularly important if you are middle aged or older and have new or recently changed symptoms.
- As rabeprazole decreases the acidity in the stomach, it may lead to a slightly increased risk of getting stomach infections such as Salmonella and Campylobacter.
- If you are taking a proton pump inhibitor medicine such as this one for longer than three months it may cause the level of magnesium in your blood to fall. This is more likely if you are also taking digoxin or a diuretic medicine (see end of factsheet). Symptoms of low magnesium can include fatigue, muscle spasms or twitching, convulsions, disorientation, dizziness and increased heart rate. You should tell your doctor if you experience any of these symptoms, as your level of magnesium may need to be checked and corrected.
- Proton pump inhibitor medicines such as this one, particularly if taken in high doses for longer than a year, may slightly increase the risk of breaking a bone in your hip, wrist or spine. If you are elderly, or have osteoporosis or risk factors for getting osteoporosis, it is important to make sure that you have an adequate intake of calcium and vitamin D to avoid any problems with your bones. Your doctor may want you to take calcium and vitamin D supplements if you don't get enough in your diet. Ask your doctor for further advice.
- In people having long-term treatment with this medicine, eg for Zollinger-Ellison syndrome, the medicine may reduce the absorption of vitamin B12 (cyanocobalamin) from the gut into the bloodstream. Ask your doctor for more information or advice about this.
Use with caution in
- Severely decreased liver function.
- People with osteoporosis or who are at risk of osteoporosis, for example people taking long-term corticosteroid medicines and women who have passed the menopause. (This medicine may increase the risk of breaking a bone - see the warning section above.)
- Vitamin B12 deficiency.
Not to be used in
- This medicine is not recommended for children, as it has not been studied in this age group.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. It should not be used by pregnant women. Ask your doctor for further advice.
- It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.
- This medication is to be swallowed whole, not chewed.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Common (affect between 1 in 10 and 1 in 100 people)
- Difficulty sleeping (insomnia).
- Inflammation of the throat (pharyngitis).
- Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose.
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting, abdominal pain or wind.
- Weakness or loss of strength (asthenia).
- Back pain.
- Flu-like symptoms.
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Dry mouth.
- Inflammation of the sinuses (sinusitis).
- Flushing of the skin due to widening of the small blood vessels (erythema).
- Pain in the muscles or joints.
- Leg cramps.
- Chest pain.
- Fever or shivering.
- Increased liver enzymes.
Rare (affect between 1 in 1000 and 1 in 10,000 people)
- Decreased number of white blood cells or platelets in the blood (leucopenia, neutropenia or thrombocytopenia).
- Inflammation of the stomach (gastritis).
- Inflammation of the mouth (stomatitis).
- Taste disturbance.
- Loss of appetite.
- Visual disturbances.
- Weight gain.
- Inflammation of the liver (hepatitis).
- Kidney inflammation (interstitial nephritis).
Very rare or frequency not known
- Swollen ankles due to fluid retention (peripheral oedema).
- Breast swelling in men.
- Decreased level of sodium in the blood (hyponatraemia).
- Decreased level of magnesium in the blood (hyponatraemia) - see warning section above.
- Severe skin reactions.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
Rabeprazole should not be taken by people taking the anti-HIV medicines atazanavir or rilpivirine. This is because rabeprazole decreases the blood level of these medicines and could make them less effective at treating HIV infection.
Proton pump inhibitors such as rabeprazole are not recommended for people taking the anti-HIV medicines raltegravir or saquinavir, because they may increase the blood level of these medicines and may therefore increase the risk of their side effects.
Due to its effect on the acidity in the stomach, rabeprazole may reduce the absorption of the following medicines from the stomach, which could make them less effective:
There may be a greater chance of the level of magnesium in your blood falling too low if you are taking this medicine with digoxin, diuretics (such as bendroflumethiazide or furosemide) or other medicines that can lower blood magnesium levels. If you are taking one of these your doctor may want you to have a blood test to check your magnesium levels before you start taking rabeprazole and then regularly during treatment.
Other medicines containing the same active ingredient
Rabeprazole tablets are also available without a brand name, ie as the generic medicine.