DEXPURE TABLETS

Indications

• Gastroesophageal reflux disease (GERD)
• Peptic ulcer disease
• Zollinger-Ellison syndrome

Dosage

Children: Refer to BNF for Children for specific dosing guidelines.

Adults: Refer to BNF for specific dosing guidelines.

Mechanism of action

Dexrabeprazole inhibits the hydrogen-potassium ATPase enzyme system (proton pump) at the secretory surface of the gastric parietal cells, leading to a profound and long-lasting reduction in gastric acid secretion.

Pharmacodynamics

As a PPI, dexrabeprazole effectively suppresses both basal and stimulated gastric acid secretion. The onset of action typically occurs within one hour of administration, with peak effects seen within two to four hours. The duration of acid suppression can last up to 24 hours, allowing for once-daily dosing.

Pharmacokinetics

Dexrabeprazole is rapidly absorbed after oral administration, with peak plasma concentrations occurring about one to four hours post-dose. It is extensively metabolized in the liver via cytochrome P450 enzymes, primarily CYP2C19 and CYP3A4. The elimination half-life is approximately one hour, with metabolites excreted primarily in urine.

Contra-indications

• Hypersensitivity to dexrabeprazole or any of its excipients
• Severe liver impairment

Adverse effects

• Headache
• Dizziness
• Nausea
• Diarrhoea
• Abdominal pain
• Constipation
• Flatulence
• Skin rash
• Elevated liver enzymes

Interactions

• May reduce the absorption of drugs requiring an acidic environment for absorption
• Increased risk of gastrointestinal infections with antibiotics
• May interact with anticoagulants and antiplatelet agents

Precautions

• Use with caution in patients with a history of liver disease
• Caution in patients with a known risk of Clostridium difficile infection
• Monitor for signs of hypomagnesemia

Pregnancy

The safety of dexrabeprazole in pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether dexrabeprazole is excreted in human milk. Caution should be exercised when administering to nursing women.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Capsules