Enteric coated rabeprazole sodium and levosulpiride sustained release capsules uses
Enteric Coated Rabeprazole Sodium & Levosulpiride
Rabeprazole 20 mg + Levosulpiride (SR) 75 mg
Rabeprazole 20 mg + Levosulpiride 75 mg
●Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD).
●Maintenance of Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD)
●Healing of Duodenal Ulcers
●Treatment of Pathological Hypersecretory Conditions, Including Zollinger-Ellison Syndrome.
●Irritable bowel syndrome
Mechanism of Action:
Rabeprazole belongs to a class of anti secretory compounds (substituted benzimidazole proton-pump inhibitors) that do not exhibit anticholinergic or histamine
H2-receptor antagonist properties, but suppress gastric acid secretion by inhibiting the gastric H+/K+ATPase (hydrogen-potassium adenosine triphosphatase) at
the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been
characterized as a gastric proton-pump inhibitor. Rabeprazole blocks the final step of gastric acid secretion. In gastric parietal cells, rabeprazole is protonated,
accumulates, and is transformed to an active sulfenamide. When studied in vitro, rabeprazole is chemically activated at pH 1.2 with a half-life of 78 seconds.
Levosulpiride is more selective and acts primarily as a dopamine D2 antagonist.
The prokinetic effect of Levosulpiride is mediated through the blockade of enteric (neuronal and muscular) inhibitory dopamine D2 receptors. Results also show
that levosulpiride also acts as a moderate agonist at the 5-HT receptor. The serotonergic (5-HT4) component of Levosulpiride may enhance its therapeutic
efficacy in gastrointestinal disorders. This property, together with antagonism at D2 receptors, may contribute to its gastrointestinal prokinetic effect.
The effects on gastric motility can be antagonized by anticholinergic drugs, that is, if administered together, Levosulpiride's
gastroprokinetic efficacy can be decreased.
Association with psycho pharmaceutical drugs require special precautions and monitoring to avoid undesired and unexpected effects because of interactions.
High doses can produce hyperprolactinemia, therefore special control during treatment is advised.
Rabeprazole produces a profound increase in gastric pH and may affect drugs whose absorption is pH dependant, such as ketoconazole and digoxin. Concomitant
administration decreases ketoconazole levels by 33% and increases digoxin trough levels by up to 22%.