Rabeprazole Sodium 10 Mg Gastro-Resistant Tablets
Package leaflet: Information for the patient
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Rabeprazole sodium 10 mg gastro-resistant tablets Rabeprazole sodium 20 mg gastro-resistant tablets
Rabeprazole sodium
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Rabeprazole sodium is and what it is used for
2. What you need to know before you take Rabeprazole sodium
3. How to take Rabeprazole sodium
4. Possible side effects
5. How to store Rabeprazole sodium
6. Contents of the pack and other information
Rabeprazole sodium tablets contain rabeprazole. It belongs to a class of medicines called proton pump
inhibitors. They act by reducing the amount of acid made by the stomach.
Rabeprazole sodium tablets are used for:
• Active duodenal ulcer or active benign gastric/stomach ulcer (peptic ulcers).
• Symptomatic erosive or ulcerative gastro-oesophageal reflux disease (GORD) commonly referred to as inflammation of the gullet caused by acid and associated with heartburn, or for long-term treatment of GORD (GORD maintenance).
• The symptomatic treatment of moderate to very severe gastrooesophageal reflux disease (symptomatic GORD) also associated with heartburn.
• Zollinger-Ellison syndrome, a rare condition in patients whose stomachs make extremely high amounts of acid.
• In combination with two antibiotics (clarithromycin and amoxycillin) Rabeprazole sodium tablets are used for the eradication of H pylori infection in patients with peptic ulcer disease.
Do not take Rabeprazole sodium:
• if you are allergic to rabeprazole sodium or any of the other ingredients of this medicine (listed in section 6)
• if you are pregnant, you think you might be pregnant or if you are breast feeding (please see Pregnancy and breast-feeding)
Warnings and precautions
Talk to your doctor or pharmacist before taking Rabeprazole sodium.
Tell your doctor or pharmacist:
• if you are allergic to other proton pump inhibitors
• if you have been told you have a stomach tumour
• if you have a history of liver disease
• if you are taking atazanavir (a drug used to treat HIV)
If you are taking this medicine for a long time, your doctor will want to monitor you.
Blood and liver problems have been seen in some patients but often get better when rabeprazole treatment is stopped.
If you experience severe (watery or bloody) diarrhoea with symptoms such as fever, abdominal pain or tenderness, stop taking Rabeprazole sodium and see a doctor straight away.
Taking a proton pump inhibitor like Rabeprazole sodium, especially over a period of more than one year, may slightly increase your risk of fracture in the hip, wrist or spine. Tell your doctor if you have osteoporosis or if you are taking corticosteroids (which can increase the risk of osteoporosis).
Children and adolescents
Rabeprazole sodium should not be used in children.
Other medicines and Rabeprazole sodium
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Tell your doctor or pharmacist:
• if you are taking ketoconazole or itraconazole (drugs used to treat fungal infections)
• if you are taking atazanavir (a drug used to treat HIV)
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Do not take Rabeprazole sodium tablets if you are pregnant or think you may be pregnant.
Do not take Rabeprazole sodium tablets if you are breast-feeding or planning to breast-feed.
Driving and using machines
You may feel sleepy while taking Rabeprazole sodium. If this happens, do not drive or use any tools or machines.
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. DPMockUp050312 1
YOU MUST SWALLOW THE RABEPRAZOLE SODIUM TABLET WHOLE. DO NOT CRUSH OR CHEW IT.
The dosages below are those usually recommended for adults and the elderly. Do not change the dose or length of the treatment yourself.
Use in children
Rabeprazole sodium should not be used in children.
Active duodenal ulcer and active benign gastric ulcer
The usual dose is one Rabeprazole sodium 20 mg tablet once a day.
If you have an active duodenal ulcer, your treatment is expected to continue for four weeks; but after that time your doctor may decide to continue your treatment for a further four weeks.
If you have an active benign gastric ulcer, your treatment is expected to continue for six weeks; but after that time your doctor may decide to continue your treatment for a further six weeks.
Erosive or ulcerative gastro-oesophageal reflux disease
The usual dose is one Rabeprazole sodium 20 mg once a day. Your treatment is expected to continue for four weeks; but after that time your doctor may decide to continue your treatment for a further four weeks.
GORD maintenance
The usual dose is one Rabeprazole sodium 10 mg or 20 mg once a day. Your doctor will advise you on how long to take your tablets. You need to see your doctor at regular intervals for review of your tablets and symptoms.
Symptomatic GORD
The usual dose is one Rabeprazole sodium 10 mg once a day. Your once daily treatment is expected to continue for up to four weeks. If your symptoms do not resolve within four weeks consult your doctor. Following this initial four week treatment, if your symptoms return, your doctor may then tell you to take one Rabeprazole sodium 10 mg tablet as and when you require it in order to control your symptoms.
Zollinger-Ellison syndrome
The usual recommended dose is three Rabeprazole sodium 20 mg tablets once a day to start with. The dose may then be adjusted by your doctor depending on how you respond to the treatment. Your doctor will tell you how many tablets to take and when to take them. You need to see your doctor at regular intervals for review of your tablets and symptoms.
Eradication of H. pylori
The usual recommended dose is Rabeprazole sodium 20 mg to be taken (in combination with two antibiotics -clarithromycin 500 mg and amoxycillin 1 g) twice each day and normally for 7 days. Relief of symptoms will normally occur before the ulcer has completely healed. Therefore it is important that you do not stop taking the tablets until told to do so by your doctor. For further information on the other components of the H. pylori eradication therapy see the individual product information leaflets.
If you take more Rabeprazole sodium than you should
Do not take more tablets each day than you are prescribed. If you accidentally take more tablets than the prescribed dose, please consult your doctor or go to the hospital straight away. Always take the tablets and the carton with you to the hospital so that the doctor knows what has been taken.
If you forget to take Rabeprazole sodium
If you forget to take a dose, just take it immediately when you remember, and then continue as usual. If you forget to take your medicine for more than 5 days, call your doctor before taking any more medicine.
Do not take a double dose to make up for a forgotten dose.
If you stop taking Rabeprazole sodium
Do not change the dosage or stop the medication without discussing it with your doctor first.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this can cause side effects, although not everybody gets them.
Stop taking Rabeprazole sodium and see a doctor straight away if you notice reddening of the skin with blisters or peeling. There may also be severe blisters and bleeding in the lips, eyes, mouth, nose and genitals. This could be "Stevens-Johnson syndrome" or "toxic epidermal necrolysis".
Other possible side effects:
Common (may affect up to 1 in 10 people):
• Infection
• Insomnia (difficult sleeping)
• Headaches, dizziness
• Cough, pharyngitis (sore throat), rhinitis (runny nose)
• Diarrhoea, vomiting, nausea, abdominal pain, constipation (costiveness), flatulence (wind)
• Pain without any known cause, back pain
• Asthenia (weakness), flu like syndrome
Uncommon (may affect up to 1 in 100 people):
• Nervousness or drowsiness
• Bronchitis, sinusitis
• Dyspepsia (indigestion), dry mouth, eructation (belching)
• Skin rash, redness of the skin
• Muscle or joint pain, leg cramps, fracture of the hip, wrist or spine
• Urinary tract infection
• Chest pain
• Chills, fever
• Changes in liver function test values
Rare (may affect up to 1 in 1,000 people):
• Anorexia (loss of appetite)
• Depression
• Hypersensitivity - a severe immediate allergic reaction for example facial swelling, low blood pressure and shortness of breath which resolve after stopping the treatment.
• Vision disturbances
• Gastritis (upset stomach or stomach pain), stomatitis (sore mouth), taste disturbances
• Liver problems such as hepatitis (inflammation of the liver) and jaundice (yellowing of your skin and whites of your eyes), hepatic encephalopathy (brain damage due to liver disease)
• Itching, sweating, skin blisters (these reactions have usually resolved after discontinuation of therapy)
• Kidney problems such as interstitial nephritis (disorders of the connective tissue within the kidney)
• Weight gain
• Changes in white blood cells:
- Neutropenia (decrease of neutrophils, a type of white blood cell) or leucopenia (decrease of white blood cells) - reductions in white blood cells resulting in frequent infections, such as sore throat or high temperature (fever), or ulcers in your mouth or throat.
- Leucocytosis (increase in white blood cells)
• Thrombocytopenia (decrease of blood platelets) - reduction in blood platelets resulting in bleeding or bruising more easily than normal
Very rare (may affect up to 1 in 10,000 people):
• Severe skin reactions such are:
- Erythema multiforme (reddening of the skin with blisters)
- Toxic epidermal necrolysis (severe skin damage with the detachment of the top layer of skin from the lower layers of the skin over the body)
- Stevens-Johnson syndrome (severe blisters, peeling and bleeding in the skin and also in the lips, eyes, mouth and nose)
Frequency not known (frequency cannot be estimated from available data):
• Confusion
• Swelling of the feet or ankles
• Breast swelling in men
• Hyponatremia (low levels of sodium in the blood) - the symptoms are feeling sick and unwell with weak muscles or confused
If you are on rabeprazole for more than three months it is possible that the levels of magnesium in your blood may fall. Low levels of magnesium can be seen as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, increased heart rate. If you get any of these symptoms, please tell your doctor promptly. Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood. Your doctor may decide to perform regular blood tests to monitor your levels of magnesium.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
You can also report side effects directly via: Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard.
By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the packaging. The expiry date refers to the last day of that month.
Store in the original package in order to protect from moisture and light.
Do not store above 30°C.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
What Rabeprazole sodium contains
• The active substance is rabeprazole sodium.
Rabeprazole sodium 10 mg gastro-resistant tablets
Each gastro-resistant tablet contains 10 mg rabeprazole sodium equivalent to 9.42 mg rabeprazole. Rabeprazole sodium 20 mg gastro-resistant tablets
Each gastro-resistant tablet contains 20 mg rabeprazole sodium equivalent to 18.85 mg rabeprazole.
• The other ingredients are mannitol (E421), light magnesium oxide (E530), hydroxypropylcellulose (E463), low-substituted hydroxypropylcellulose (E463) and magnesium stearate (E572) in the tablet core, and ethylcellulose (E462), light magnesium oxide (E530), hypromellose phthalate, diacetylated monoglycerides (E472a), talc (E553b), titanium dioxide (E171), red iron oxide (E172) (10 mg only) and yellow iron oxide (E172) (20 mg only) in the coating.
What Rabeprazole sodium looks like and contents of the pack
10 mg gastro-resistant tablets are orange-pink, biconvex, round tablets with bevelled edges, tablet diameter approximately 5.7 mm.
20 mg gastro-resistant tablets are slightly brownish yellow, biconvex, round, tablet diameter approximately 7.2 mm.
For both strengths, boxes of 7, 10, 14, 15, 28, 30, 56, 60, 90, 98 and 100 gastro-resistant tablets in blisters are available.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
KRKA, d.d., Novo mesto, Smarjeska cesta 6, 8501 Novo mesto, Slovenia
Distributed by:
Consilient Health (UK) Ltd., No.1 Church Road, Richmond upon Thames, Surrey. TW9 2QE.
P0366