Aciphex is also used to treat duodenal ulcers, and used in combination with antibiotics to treat <i>Helicobacter pylori (H. pylori)</i> bacterial infections in the stomach. ED is often a symptom of another health problem or health-related factor. Major symptoms, compliance, and adverse events were recorded. ** The Controlled Substances Act (CSA) schedule information displayed applies to substances regulated under federal law. A single intragastric pH electrode does not accurately measure intragastric acidity. Aciphex (rabeprazole sodium) is a proton pump inhibitor (PPI) to reduce stomach acid and is used for the treatment of gastroesophageal reflux disease (GERD), duodenal ulcers, and used in combination with antibiotics to treat Helicobacter pylori (H. pylori) bacterial infections in the stomach. The patient was questioned about the principal symptoms, i.e. Due to mis-calibration, intragastric pH was inaccurately recorded over significant periods in 6 patients so that intragastric pH analysis was completed only in 9 study subjects. It is used to treat erosive esophagitis or "heartburn" caused by gastroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus. We study millions of patients and 5,000 more each day. Erectile dysfunction (ED) is often a symptom . Department of Gastroenterology and Hepatology, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California, USA. Omeprazole was less effective than the three other PPIs also in patients with grade 2 esophagitis (healing rates: 81.8% vs 96.5% vs 90% vs 95.8%, respectively) and than pantoprazole and rabeprazole in grade 3-4 esophagitis (healing rates: 78.9% vs 94.1% vs 84.6%, respectively); probably due to the low number of patients, however, the differences were no statistically significant (Table (Table33). Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Horn J. Demographic and clinical characteristics of the study population. An official website of the United States government. No significant differences in the healing rates of esophagitis were observed between successfully and unsuccessfully treated H pylori patients (negative H pylori vs still-positive after treatment: 89.9% vs 92.3%, P = NS) (Table (Table44). What Are Possible Side Effects of Aciphex? Review article: relationship between the metabolism and efficacy of proton pump inhibitors--focus on rabeprazole. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. H pylori infection did not influence the healing rates of esophagitis after a short-term treatment with PPI. rabeprazole may The mean difference in pH between pantoprazole and rabeprazole over the entire time-period was -0.3248. After 8 wk, endoscopy and clinical evaluation were repeated. being able to get an erection sometimes, but not every time you want to have sex. The treatment of esophagitis is based on gastric acid suppression with antisecretory drugs. Mean percentage of time over the nocturnal hours on day 1 that gastric acid output is greater than each specified threshold level by treatment group. A statistically significant difference was . All threshold differences for pantoprazole and rabeprazole were statistically significant except for AO <0.5. AIM: To compare efficacy and tolerability of four proton pump inhibitors (PPIs) commonly used in the short-term therapy of esophagitis in elderly patients. What Are Possible Side Effects of Protonix? Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. Tel: 310-268-4069, Fax: 310-268-4096. After 6 weeks the healing rates were identical in both groups at 91%. Hiatus hernia was diagnosed when the Z-line and the gastric folds extended 2 cm or more above the diaphragmatic hiatus[9]. 413 ratings on Drugs.com. Subjects were randomly assigned to one of two treatment groups. Federal government websites often end in .gov or .mil. Similarly, patients with the lowest levels of pH detected did not have the highest levels of acid output measured. The mean number of evaluable hours from the baseline examination, rabeprazole treatment group and pantoprazole treatment group was 10 h 45 m, 10 h 30 m, and 10 h 45 m, respectively. After two months of PPI treatment, a significant reduction of symptoms as compared to baseline was observed both in healed and in unhealed patients. Rabeprazole or pantoprazole is given 12 hours prior to measurement of gastric acid output. Hourly acid output was derived by extrapolating the 30 minute acid output value. Healing rates of esophagitis in elderly patients divided according to H pylori infection. Also, rabeprazole had a significantly higher percentage of subjects with pH > 3 for at least 16 h of the 24h period on day 3 . Why pantoprazole and rabeprazole were more effective than omeprazole in healing esophagitis and than omeprazole and lansoprazole in improving symptoms in elderly patients is not clear. The effect of each drug regimen on the 12-hr mean acid output was compared using a two-treatment, two-period (22) cross-over design model using SAS software. Breaking this down, they used 40 mg of active drug esomeprazole versus 10 mg of active drug omeprazole (the dosage is actually 20 mg, but since omeprazole is a racemic mixture, that is only 10 mg. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 90073, USA. Please try after some time. Therefore, over the first 8.33 hours, rabeprazole maintains a pH that is greater than that of pantoprazole when matched by patient and time. Furthermore, the mean time-matched pH values differed significantly over the first 8.3 hours (p<0.05). You can use the study as a second opinion to make health care decisions. If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date. eHealthMe is studying from 26,164 Rabeprazole users for its effectiveness, alternative drugs and more. Family Medicine 32 years experience. Pilotto A, Salles N. Helicobacter pylori infection in geriatrics. Inclusion in an NLM database does not imply endorsement of, or agreement with, Dividing patients according to treatments, the PP and ITT healing rates of esophagitis were: omeprazole = 81.0% and 75.0%, lansoprazole = 90.7% (P = 0.143 vs omeprazole) and 85% (P = 0.167 vs omeprazole), pantoprazole = 93.5% (P = 0.04 vs omeprazole) and 90.0% (P = 0.02 vs omeprazole), rabeprazole = 94.6% (P = 0.02 vs omeprazole) and 88.8% (P = 0.04 vs omeprazole) respectively (Table (Table2).2). Short-term side effects of the four agents are similar. A trend line imposed on the data indicates that rabeprazole maintains a significantly greater intragastric pH over the first 8.33 hours as compared to pantoprazole (p<.04). CONCLUSION: In elderly patients, pantoprazole and rabeprazole were significantly more effective than omeprazole in healing esophagitis and than omeprazole or lansoprazole in improving symptoms. It is important to go over these with your healthcare provider to . Proton pump inhibitors (PPIs) are widely used and their effectiveness and safety have been demonstrated also in patients of old age[6]. Effect of a single oral dose of rabeprazole on nocturnal acid breakthrough and nocturnal alkaline amplitude. The large p-value provides sufficiently strong evidence that the two treatments cannot be declared to have different effects in raising the pH of acid output when observed over the entire 12-hour period. Wang WH, Huang JQ, Zheng GF, Xia HH, Wong WM, Lam SK, Wong BC. Acid inhibition on the first day of dosing: comparison of four proton pump inhibitors. The study had a double-blinded, randomized, two-way crossover design, and involved 15 patients with a history of mild reflux. To display intragastric pH against time in a meaningful fashion, the median intragastric pH of every fourth second was plotted against time in Fig. The study was designed as a double-blinded, randomized two-way crossover study whereby all enrolled patients underwent three total (baseline, treatment 1, treatment 2) nocturnal 12 hour measurements of gastric acid output and intragastric pH. Aciphex may interact with atazanavir, blood thinners, digoxin, diuretics (water pills), ketoconazole, or methotrexate. Inhibition of pentagastrin-stimulated gastric acid secretion by pantoprazole and omeprazole in healthy adults. Results were evaluated using both "per protocol" (PP) and "intention-to-treat" (ITT) analyses; the 95% confidence intervals (95% CI) were also calculated. The inclusion criteria were: (1) age 65 years or over and (2) endoscopic diagnosis of esophagitis grade I to IV according to the Savary-Miller classification[8]. acid regurgitation, heartburn, and other symptoms of reflux esophagitis, i.e. Always consult your healthcare provider. Significant differences were observed in the daytime and nighttime intervals. Pantoprazole, which is in the final stages of approval for marketing in the United States, will be available in both an oral and injectable formulation. 77% of reviewers reported a positive effect, while 13% reported a negative effect. As a library, NLM provides access to scientific literature. Pantoprazole is a proton pump inhibitor that decreases acid secretion in the stomach and may be given to relieve the symptoms of heartburn or to allow inflamed tissue in the gastrointestinal tract to This study was conducted to evaluate the effectiveness of two FDA-approved proton pump inhibitors, pantoprazole and rabeprazole, to control gastric acidity during the nocturnal hours when a single oral dose was taken prior to breakfast in the morning. The 30 minute collection volume output was then multiplied by the acid concentration of that collection to calculate a 30 minute acid output. On day 1, oral rabeprazole inhibited acid output to a greater extent and for a longer period than pantoprazole, and the intragastric pH was significantly higher for rabeprazole than for pantoprazole over the first 8.3 hours. Another 5 patients failed to complete both treatment periods due to discomfort caused by the NG tube. HHS Vulnerability Disclosure, Help However, none of the studies included in these meta-analyses were carried out specifically in elderly patients. Acid output may be a more relevant clinical outcome to assess PPI therapy because it depends on both acid concentration and volume whereas intragastric pH is measured from a random gastric sample that may not reflect the true acidity of the stomach's contents. 5 features a 12 hour acid output tracing plotted against time. Sharma VK, Leontiadis GI, Howden CW. As nouns the difference between rabeprazole and pantoprazole is that rabeprazole is an antiulcer drug in the class of proton pump inhibitors while pantoprazole is a proton pump inhibitor drug, used for treatment of erosion and ulceration of esophagus caused by gastroesophageal reflux disease. to maintaining your privacy and will not share your personal information without This comparison found no differences in healing rates between the two treatments both in patients with moderate-severe esophagitis, i.e. Richter JE. Finally, pantoprazole and rabeprazole (95.2% and 100%) were also more effective vs lansoprazole (82.6%, P < 0.05) in decreasing epigastric pain. pH-level sampling and tests were performed using R 2.1.1 for Windows. One distinct difference noted at 03:30 (8.5 hours into the study), when mean acid output is minimally greater under rabeprazole, most likely represents an anomalous value as subsequent measurements then demonstrate decreased acid output under rabeprazole. Two antral and two body biopsies were used for histological analysis, while one from each site was used for the rapid urease test (CLO test, Delta West Pty Ltd, Western Australia). Acid clearance during sleep in the pathogenesis of reflux esophagitis. the contents by NLM or the National Institutes of Health. Review article: oesophageal complications and consequences of persistent gastro-oesophageal reflux disease. 6, acid output (mEq/hr) as measured at 30 minute intervals for all 9 patients under all three conditions (baseline, rabeprazole, pantoprazole) is plotted against mean intragastric pH calculated per 30 minutes. PPIs help reduce stomach acid by working directly in the stomach to decrease acid production. Protonix IV (pantoprazole sodium) is a proton pump inhibitor (PPI) used for short-term treatment (less than 10 days) of gastroesophageal reflux disease (GERD) and a history of erosive esophagitis in adult patients. Accessibility View more, Prescribed for Barrett's Esophagus, Erosive Esophagitis, Duodenal Ulcer, Duodenal Ulcer Prophylaxis, GERD, Helicobacter Pylori Infection, Stomach Ulcer, Zollinger-Ellison Syndrome. Background: Nocturnal heartburn is common in patients with gastro-oesophageal reflux disease (GERD). omeprazole, lansoprazole, pantoprazole, and rabeprazole, were 86.9%, 82.4%, 100%, and 100% for heartburn, 100%, 75.0%, 92.9%, and 90.1% for acid regurgitation, and 95.0%, 82.6%, 95.2, and 100% for epigastric pain, respectively (Table (Table6).6). Methods: In a double-blind, double-dummy, two-way crossover study, 38 Helicobacter pylori-negative volunteers were randomized to oral rabeprazole 20 mg . Previous studies comparing rabeprazole with other PPIs have been limited and no study has evaluated acid output on proton pump inhibitor therapy during the night-time hours. Men and women of any race, aged 18 to 65 years old, with a history of heartburn and symptoms with a frequency of at least 2 days per month over a 12 month period prior to screening were eligible for enrollment. Results: After 3 weeks, complete healing (ITT analysis) was documented in 58% of patients given rabeprazole and 61% in patients given omeprazole (N.S.). Three meals, considered typical, standardized Western meals in terms of fat (108 gram), carbohydrate (319 gram) and protein (97 gram) composition were provided at 0800, 1200 and 1730. Previously, it has been shown that acid output in normal subjects peaks approximately 1.5 hours after a meal and gradually decreases over the next 2.5 hours so that at 4 hours post meal, acid output remains at 1/4 peak AO production.18 In the current study, rabeprazole suppressed acid output to a greater degree than pantoprazole over the entire observation period, including the post-meal hours (Fig. All patients provided their informed consent to participate in the study. Further studies in assessing PPI efficacy should assess intragastric pH, acid output, and employ a validated questionnaire to evaluate symptomatic improvement of nocturnal complaints. CONCLUSION: In elderly patients, pantoprazole and rabeprazole were significantly more effective than omeprazole in healing esophagitis and than omeprazole or lansoprazole in improving symptoms. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. Careers, Unable to load your collection due to an error. Results were similar for the ITT population (N = 52). Protonix Oral Suspension should not be chewed or crushed. Labenz J, Armstrong D, Lauritsen K, Katelaris P, Schmidt S, Schtze K, Wallner G, Juergens H, Preiksaitis H, Keeling N, et al. Indeed, to our knowledge, this is the first study that compared the efficacy of different PPIs in curing esophagitis and improving symptoms in elderly patients. Fass R, Achem SR, Harding S, Mittal RK, Quigley E. Review article: supra-oesophageal manifestations of gastro-oesophageal reflux disease and the role of night-time gastro-oesophageal reflux. being unable to get an erection at any time. Rabeprazole has an average rating of 8.1 out of 10 from a total of 83 ratings on Drugs.com. Pilotto A, Franceschi M, Leandro G, Rassu M, Bozzola L, Valerio G, Di Mario F. Influence of Helicobacter pylori infection on severity of oesophagitis and response to therapy in the elderly. Furthermore, newer techniques in measuring acid output employing direct visualization of gastric contents during endoscopy may lead to enhanced accuracy and reproducibility.22. Correct tube position was verified by water recovery of > 90% of injected 100 mL sterile water through the NG tube. While heartburn improved significantly more effectively in healed patients than unhealed patients (rates of heartburn disappearance = 96.7% vs 80%, P = 0.001), other symptoms improved significantly both in healed and unhealed patients (Table (Table5).5). Each difference series was constructed by subtracting the two time series for each patient under the two different treatments. The long-term safety of pantoprazole and rabeprazole appears similar to that of omeprazole and lansoprazole. Ohning GV, Walsh JH, Pisegna JR, et al. As a library, NLM provides access to scientific literature. Correspondence to: Joseph R. Pisegna. Pantoprazole and rabeprazole both are substituted benzimidazole derivatives and irreversible proton pump inhibitors which have been shown to effectively reduce gastric acid secretion. Clinical features of reflux esophagitis in older people: a study of 840 consecutive patients. All patients gave their informed consent prior to participation in the study. This was an open, single-centre, randomized study including elderly subjects that consecutively underwent an upper gastrointestinal endoscopy. A placebo-controlled trial to assess the effects of 8 days of dosing with rabeprazole versus omeprazole on 24-h intragastric acidity and plasma gastrin concentrations in young healthy male subjects. Robinson M. Review article: pH, healing and symptom relief with rabeprazole treatment in acid-related disorders. Previous studies were focused on potential discrepancies in efficacy among the different PPIs used for treatment of reflux esophagitis. Received 2008 Feb 8; Accepted 2008 Apr 15. The .gov means its official. Inclusion in an NLM database does not imply endorsement of, or agreement with, 8600 Rockville Pike Patients with a history of any of the following were excluded from the study: current pregnancy and/or a high likelihood of becoming pregnant during the study; gastric surgery; recent treatment with an histamine H2-receptor antagonists, prostaglandin or sucralfate within 14 days prior to enrollment or with a proton pump inhibitor, prokinetic agent or bismuth subsalicylate within 30 days prior to enrollment; concurrent significant illnesses including cancer and renal or hepatic disease; any history of clinically significant alcohol abuse or other psychiatric illnesses; any predisposing condition that might interfere with the absorption, distribution, metabolism or excretion of any study drug; any history of multiple medication allergies or history of severe drug-associated adverse event. After 2 mo of treatment, endoscopy was repeated to evaluate healing of acute esophagitis. Rabeprazole-treated patients had numerically greater symptom relief at all 12 points of comparison. 1996-2023 RxList, Inc. An Internet Brands company. Pilotto A, Franceschi M, Leandro G, Scarcelli C, D'Ambrosio LP, Seripa D, Perri F, Niro V, Paris F, Andriulli A, et al. (3,4,5) However Rabeprazole has been shown in vitro to be more readily converted to its active form than omeprazole, pantoprazole or lansoprazole. Pilotto A, Franceschi M, Leandro G, Novello R, Di Mario F, Valerio G. Long-term clinical outcome of elderly patients with reflux esophagitis: a six-month to three-year follow-up study. Available for Android and iOS devices. Only patients with a negative H. pylori serology at study enrollment and no prior history of prior H. pylori eradication were included. Lansoprazole was less effective in improving acid regurgitation and epigastric pain than omeprazole (P = 0.0001, P = 0.033, respectively), pantoprazole (P = 0.005, P = 0.028, respectively), and rabeprazole (P = 0.026, P = 0.0001, respectively) (Table (Table66). In total, 15 subjects completed the study. This does not necessarily mean no interactions exist. HHS Vulnerability Disclosure, Help Some error has occurred while processing your request. Overall, rabeprazole maintained mean pH at every threshold measured for a greater percentage of time as compared to pantoprazole (Fig. Ph values differed significantly over the first day of dosing: comparison of four proton pump which! Pylori serology at study enrollment and no prior history of mild reflux based on acid... Healing and symptom relief with rabeprazole treatment in acid-related disorders of gastric acid secretion pantoprazole! 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Safety of pantoprazole and rabeprazole were statistically significant except for AO < 0.5 esophagitis in elderly patients divided according h., Xia HH, Wong WM, Lam SK, Wong BC randomly to. Was questioned about the principal symptoms, compliance, and adverse events were recorded ppis Help stomach. Patients and 5,000 more each day publication, please acknowledge it with a history of prior H. eradication! Wm, Lam SK, Wong WM, Lam SK, Wong WM, Lam SK, Wong BC ed! ( ed ) is often a symptom of another health problem or health-related.... Being Unable to get an erection at any time employing direct visualization of gastric acid output was by. Output tracing plotted against time to your personal circumstances of omeprazole and lansoprazole volume output was by. Use the study positive effect, while 13 % reported a positive effect, while 13 reported. Given 12 hours prior to participation in the study as a library, NLM provides access to scientific literature on... 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