10 mg – pink color, with marking of "E241" black on about one colors from the parties; on cross section a tablet of almost white or white color (on 7 or 14 pieces in blisters, 1 or 2 blisters are placed in a cardboard pack);
20 mg – light yellow color, with marking of "E243" red on about one colors from the parties; on cross section a tablet of almost white or white color (on 7 or 14 pieces in blisters, 1 or 2 blisters are placed in a cardboard pack).

Active agent: рабепразол sodium, its contents in 1 tablet makes 10 mg (that corresponds 9,42 mg of a rabeprazol) or 20 mg (that corresponds to 18,85 mg of a rabeprazol).

Additional substances: magnesium oxide, a monoglyceride diacetylized, titanium dioxide (E171), talc, hydroxypropyl cellulose (hypro rod), magnesium stearate, hydroxypropyl cellulose slabozameshchenny (hypro rod), a mannitol (Mannitolum), gipromelloza phthalate, ethyl cellulose, wax of karnaubskiya, dye ferrous oxide red (in tablets of 10 mg) or ferrous oxide yellow (in tablets of 20 mg), blackened food gray F6 (in tablets of 10 mg – ferrous oxide black, shellac white, the ethanol dehydrated 1 Butanol) or blackened food red A1 (in tablets of 20 mg – ferrous oxide red, shellac white, the ester of glyceric acid, karnaubsky wax, ethanol dehydrated 1 Butanol).

Indications to use

Symptomatic treatment of the dyspepsia caused by a hyperoxemia of a gastric juice, including symptoms of a gastroesophageal reflux disease (GERB), such as heartburn and acid eructation;
Anastomosis ulcer;
Aggravation of a peptic ulcer of a stomach and 12-perstny gut;
Reflux esophagitis, erosive and ulcer gastroesophageal reflux disease;
Not erosive gastroesophageal reflux disease (NERB);
Zollingera-Ellison's syndrome and others a state with pathological hypersecretion;
Maintenance therapy of a gastroesophageal reflux disease;
Eradikation Helicobacter pylori at patients with a peptic ulcer.

Contraindications

Absolute:

Age up to 12 years;
Pregnancy;
Feeding period breast;
Hypersensitivity to any component of drug or the replaced benzimidazoles.

Pariyet should be applied with care to patients with a renal/liver failure of heavy degree, and also to teenagers of 12-18 years.

Route of administration and dosage

Drug is intended for oral administration. It is necessary to swallow of tablets entirely, without crushing and without chewing and to wash down with water, it is desirable – in the morning before meal. It is established that time of day and meal do not influence activity of a rabeprazol, however the recommended time of administration of drug promotes observance by patients of schemes of treatment.

The standard modes of dosing for adults depending on indications:

Symptomatic treatment of the dyspepsia caused by a hyperoxemia of a gastric juice, including GERB symptoms: on 10 mg of 1 times a day a course up to 14 days;
Anastomosis ulcer, aggravation of a peptic ulcer: on 20 mg of 1 times a day. Treatment duration – 6 weeks, if necessary a course can be prolonged for 6 weeks;
Aggravation of a peptic ulcer of a 12-perstny gut: on 20 mg of 1 times a day. Treatment duration – 2-4 weeks, if necessary a course prolong for 4 weeks;
Reflux esophagitis, erosive GERB: on 20 mg of 1 times a day within 4-8 weeks, if necessary duration of treatment is increased by 8 weeks;
Maintenance therapy of GERB: on 20 mg of 1 times a day, duration of use is defined individually;
Not erosive reflux disease without esophagitis: on 20 mg of 1 times a day within 4 weeks. If after this time symptoms of a disease do not disappear, it is necessary to conduct additional examination of the patient. At a maintenance therapy (after stopping of symptoms for prevention of a recurrence) accept on 1 tablet of 1 times a day on demand;
Zollingera-Ellison's syndrome and other states which are characterized by pathological hypersecretion: the dose is selected individually. At the beginning of therapy appoint 60 mg a day, further the dose is raised to 100 mg of 1 times a day or on 60 mg by 2 times a day. Duration of treatment is defined by clinical need, in certain cases can reach 1 years;
Eradikation Helicobacter pylori: on 20 mg 2 times a day in a combination with antibiotics. A course of treatment – 7 days.

To children 12 years at GERB are aged more senior appoint 20 mg of 1 times a day a course no more than 8 weeks.

Side effects

According to data of clinical trials, Pariyet is had preferential well. Side effects arise seldom, are usually expressed poorly or moderately and have passing character.

In rare instances there are following undesirable reactions:

From immune system: acute system allergic reactions;
From blood and lymphatic system: neutropenia, thrombocytopenia, leukopenia;
From a metabolism and food: hypomagnesiemia;
From the alimentary system: a diarrhea/lock, a meteorism, an abdominal pain, dryness in a mouth;
From the central nervous system: headache;
From gepatobiliarny system: increase in activity of liver enzymes, jaundice, hepatitis, hepatic encephalopathy;
From kidneys and urinary tract: intersticial nephrite;
From skin and hypodermic fabrics: urticaria, violent rashes, multiformny erythema, Stephens-Johnson's syndrome, toxic epidermal necrolysis;
From a musculoskeletal system: mialgiya, arthralgia;
From reproductive system: gynecomastia.

Special instructions

The response of the patient to therapy by Pariyet does not exclude existence of malignant new growths in a stomach.

At patients who accept Pariyet or it will be received for a long time along with digoxin or drugs which can cause a hypomagnesiemia (for example, diuretics), it is necessary to control magnesium level in blood before purpose of inhibitor of a proton pomp and the entire period of its use.

It is not necessary to accept at the same time other means reducing acidity, including _{H2 receptors} blockers.

On the basis of these observation researches it is possible to assume that IPP increase risk of the fractures of a wrist, hip and backbone connected with osteoporosis. This risk at patients who receive IPP in high doses during the long period is especially high (1 year and more).

Use of IPP can increase risk of development of gastrointestinal infections, such as Clostridium difficile.

Patients who accept Pariyet without appointment of the doctor for a short-term symptomatic treatment of symptoms of GERB and NERB (for example, heartburn) should address the doctor in the following cases:

Change of earlier observed symptoms of a disease or emergence of new symptoms in patients is aged more senior than 55 years;
Prolonged use of drug (within 4 weeks and more) for removal of symptoms of disturbance of digestion and heartburn;
Developing of anemia, pain when swallowing, bleedings in digestive tract, constant vomiting or vomiting with contents of an epigastrium and blood, dysphagies;
Cases of unintentional decrease in body weight, jaundice, and also stomach ulcer or stomach operations in the anamnesis, etc.

Patients with heavy abnormal liver functions have to consult with the doctor before Pariyet's use for a short-term symptomatic treatment of manifestations of GERB and NERB (for example, heartburn).

Patients who a long time suffer from the repeating symptoms of heartburn or disturbance of digestion have to be followed up regularly by a doctor.

People are more senior than 55 years have to tell the attending physician if they daily accept OTC medicines for reduction of heartburn and symptoms of disturbance of digestion (including Pariyet).

Before Pariyet's reception patients who receive any other drugs should consult with the doctor or the druggist.

Patients to whom the endoscopic research is appointed have to warn the doctor if they accept Pariyet without recipe.

It is not necessary to use drug before carrying out the ureal respiratory test.

Considering a pharmacodynamics of a rabeprazol and its profile of side effects, it is improbable that Pariyet exerts a negative impact on the speed of reactions and ability to concentration of attention.

Medicinal interaction

At simultaneous use рабепразол can increase concentration of a methotrexate and/or hydroxymethotrexate (its metabolite) and to increase the period of their semi-removal owing to what increase in toxicity of a methotrexate is possible. In need of appointment of the last in high doses it is necessary to consider the possibility of temporary cancellation of IPP.

Rabeprazol inhibits cyclosporine metabolism.

At simultaneous use of an atazanavir or ritonavir along with omeprazoly or lansoprazoly essential decrease in effect of an atazanavir was noted. And though reactions with rabeprazoly were not studied, expected similar results.

Rabeprazol suppresses secretion of a gastric juice therefore can interact with substances which absorption depends on pH. For example, at simultaneous use рабепразол reduces absorption of a ketokonazol by 30%, increases absorption of digoxin by 22%. For this reason in need of use of similar combinations it is necessary to carry out treatment under careful observation and if there is a need, to adjust doses of drugs.

The food enriched with fats can slow down absorption of a rabeprazol till 4 and more o'clock, however the maximum and total concentration of substance in a blood plasma do not change.