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rabeprazole

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Brand names: Aciphex

Proton Pump Inhibitor (PPI) Rx

Rabeprazole (Aciphex) is a medicine that reduces the amount of acid your stomach makes. It belongs to a class of drugs called proton pump inhibitors (PPIs).

Drug Pricing (NADAC)

Generic Price

$0.20/unit

Generic Available

Yes (6 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine can treat several conditions caused by too much stomach acid.

Common side effects

Pain, Sore throat, Gas

Key warnings

Taking PPIs like rabeprazole may hide signs of stomach cancer, so tell your doctor if your symptoms don't improve.

How It Works

Rabeprazole works by blocking the enzyme in your stomach that produces acid. This helps to lower the amount of acid in your stomach. Lowering stomach acid helps to heal damage and relieve symptoms.

How to Take It

Take rabeprazole tablets exactly as your doctor tells you. Swallow the tablets whole; do not chew, crush, or split them. For duodenal ulcers, take this medicine after your morning meal. For H. pylori, take it with food. For all other conditions, you can take it with or without food.

Pregnancy & Breastfeeding

It is not known if rabeprazole is safe to use during pregnancy. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store rabeprazole tablets at room temperature, away from moisture.

Side Effects (from patient reports)

Based on 13,990 FDA adverse event reports.

The medicine is not working
1,859
Using the medicine for a condition it's not approved for
1,771
Feeling sick to your stomach
1,543
Loose, watery stools
1,318
Aches or soreness
1,314
Pain in your head
1,284
Difficulty breathing
1,276
Joint pain
1,267
Feeling very tired
1,209
General feeling of discomfort or illness
1,149

FDA Adverse Event Report Analysis

Detailed analysis of 21,352 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

21,352

Death-Related Reports

2,472

Hospitalization Reports

9,750

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 11,212 (58%)
Male 8,211 (42%)

Age Distribution

0–17 239
18–44 1,982
45–64 5,301
65–74 4,059
75+ 4,243

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 1,860
2 OFF LABEL USE 1,771
3 NAUSEA 1,541
4 DIARRHOEA 1,319
5 PAIN 1,314
6 HEADACHE 1,284
7 DYSPNOEA 1,276
8 ARTHRALGIA 1,266
9 FATIGUE 1,210
10 MALAISE 1,149
11 PNEUMONIA 1,096
12 FALL 952
13 COUGH 922
14 DIZZINESS 869
15 PYREXIA 822

Reactions in Death Reports

DEATH 535
PNEUMONIA 219
DYSPNOEA 145
OFF LABEL USE 137
DIARRHOEA 125
NAUSEA 116
SEPSIS 114
PYREXIA 111
FATIGUE 109
DECREASED APPETITE 108

Reactions in Hospitalization Reports

PNEUMONIA 777
DYSPNOEA 685
DIARRHOEA 666
NAUSEA 639
MALAISE 583
PYREXIA 579
FALL 569
OFF LABEL USE 541
DRUG INEFFECTIVE 539
VOMITING 468

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Taking PPIs like rabeprazole may hide signs of stomach cancer, so tell your doctor if your symptoms don't improve. This medicine may also increase your risk of bone fractures, especially if you take it for a long time or at high doses. Long-term use may also cause low vitamin B12 or magnesium levels. Contact your doctor right away if you experience signs of hypersensitivity.

Known Drug Interactions

Combination Therapy with Clarithromycin and Amoxicillin Clinical Impact: Concomitant administration of clarithromycin with other drugs can lead to serious adverse reactions, including potentially fatal arrhythmias, and are contraindicated. Amoxicillin also has drug interactions. See Drug Interactions in prescribing information for amoxicillin.

Mechanism: Rabeprazole changes the acid levels in your stomach, which can affect how the antibiotic amoxicillin is absorbed and used by your body.

What to do: Consult your healthcare provider to ensure these medications are taken correctly for your specific treatment plan.

Combination Therapy with Clarithromycin and Amoxicillin Clinical Impact: Concomitant administration of clarithromycin with other drugs can lead to serious adverse reactions, including potentially fatal arrhythmias, and are contraindicated. Intervention: See Contraindications and Warnings and Precautions in prescribing information for clarithromycin.

Mechanism: Taking these drugs together can change how they are processed, potentially leading to serious and life-threatening heart rhythm issues.

What to do: Talk to your doctor about safer alternatives or close monitoring, as this combination can be very dangerous.

Warfarin Clinical Impact: Increased INR and prothrombin time in patients receiving PPIs, including rabeprazole, and warfarin concomitantly. Dose adjustment of warfarin may be needed to maintain target INR range. See prescribing information for warfarin.

Mechanism: Rabeprazole can cause warfarin to stay in your system longer, which increases the risk of bleeding.

What to do: Your doctor should monitor your blood clotting levels closely and may need to adjust your warfarin dose.

Methotrexate Clinical Impact: Concomitant use of rabeprazole with methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities. No formal drug interaction studies of methotrexate with PPIs have been conducted [see Warnings and Precautions ( 5.9 )]. Intervention: A temporary withdrawal of rabeprazole sodium delayed-release tablets may be considered in some patients receiving high dose methotrexate administration.

Mechanism: Rabeprazole can keep methotrexate in your body longer than usual, which might lead to dangerous levels of the drug in your blood.

What to do: Your doctor might have you stop taking rabeprazole for a short time if you are receiving high doses of methotrexate.

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole, itraconazole) Clinical Impact: Rabeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.

Mechanism: Ketoconazole needs stomach acid to be absorbed into your body, but rabeprazole reduces the amount of acid in your stomach.

What to do: Your doctor may need to monitor you closely to make sure the ketoconazole is still working effectively.

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Common Questions

Can I crush or chew the rabeprazole tablet?
No, swallow the tablet whole. Do not crush, chew, or split it.
Can I take rabeprazole with food?
For most conditions, you can take it with or without food. If you are taking it for duodenal ulcers, take it after your morning meal. If you are taking it to treat H. pylori, take it with food.
How long does it take for rabeprazole to work?
It may take several days for rabeprazole to fully reduce stomach acid and relieve your symptoms.
What should I do if I still have heartburn while taking rabeprazole?
Talk to your doctor if your heartburn does not improve after taking rabeprazole for the prescribed time.
Can I take rabeprazole long-term?
Rabeprazole is often used for short-term treatment. Your doctor will decide if you need to take it for a longer period.
Are there any foods I should avoid while taking rabeprazole?
Some foods and drinks can worsen heartburn. These include coffee, chocolate, alcohol, and spicy or fatty foods.
Can I take other medications with rabeprazole?
Tell your doctor about all the medicines you take, including over-the-counter drugs, vitamins, and herbal products.
What if I accidentally take too much rabeprazole?
Call your doctor or go to the nearest emergency room right away.
Can rabeprazole cause any serious side effects?
Yes, but serious side effects are rare. Tell your doctor right away if you have severe stomach pain, diarrhea that doesn't stop, or signs of an allergic reaction.
Is it safe to drive or operate machinery while taking rabeprazole?
Rabeprazole can sometimes cause dizziness. Be careful driving or operating machinery until you know how this medicine affects you.
What are the common side effects of rabeprazole?
The most commonly reported side effects of rabeprazole include Pain, Sore throat, Gas, Infection, Constipation. Based on 13,990 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does rabeprazole interact with other medications?
Yes, rabeprazole has 7 known drug interactions. Notable interactions include amoxicillin, clarithromycin, warfarin. Always inform your doctor about all medications you are taking.
What drug class is rabeprazole?
rabeprazole belongs to the Proton Pump Inhibitor (PPI) drug class. It requires a prescription (Rx). This medicine can treat several conditions caused by too much stomach acid.
Is rabeprazole safe during pregnancy?
It is not known if rabeprazole is safe to use during pregnancy. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for rabeprazole

The FDA label for rabeprazole (sold under brand names such as Aciphex) classifies it as a prescription-only medication in the Proton Pump Inhibitor (PPI) class. This medicine can treat several conditions caused by too much stomach acid. Official labeling lists 10 commonly reported side effects, including Pain, Sore throat, Gas.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 13,990 voluntary reports. The database also lists 7 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.20.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: January 7, 2025

All federal data sources used on this page