Rabeprazole

What it is

Rabeprazole is a proton pump inhibitor: it shuts down the acid-producing pumps in the stomach lining, so much less acid is made until new pumps are built. Lower acid gives inflamed tissue a chance to heal. It is used for heartburn and for stomach and duodenal ulcers.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Heartburn
• Ulcer

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It is taken in the morning on an empty stomach, before the first meal of the day, because the pumps to be blocked are the ones switched on by eating. Because stomach acid is needed to free vitamin B12 from food and to absorb iron, long use can lower both, and magnesium can also drift down, which is why B12 and magnesium are worth checking on extended courses. The need for a long course should be reassessed rather than repeated indefinitely; in Japan, where the health ministry has approved a pharmacy version supplied under pharmacist guidance for short self-treatment, the pack itself caps how long it may be taken before a doctor is seen.

When to see a doctor

Persistent muscle cramps, twitching, palpitations, unusual tiredness, numbness or tingling, or heartburn that keeps coming back despite treatment are reasons to see a doctor rather than continue on one's own.

Worth knowing

• Reassess the need for long courses

Markers to watch

• Magnesium
• Vitamin B12

Nutrients affected

• vitaminB12 — depleted by (Hemoglobin, Homocysteine, Mean cell volume (MCV))
• iron — absorption blocked with (Ferritin, Hematocrit, Hemoglobin)