Not reported

GERD- gastroesophageal rerflux disease

Both rabeprazole and itopride are generally well tolerated and the adverse events which are frequently reported are headache, diarrhoea, dizziness and rash.

Reports not available

Special precautions-

Itopride should be used with caution because it enhances the action of acetylcholine and rebeprazole should be used with caution in patients with severe hepatic impairment

Indication-

GERD- gastroesophageal rerflux disease

Dosage-

Rabeprazole at the dose of 20 mg and itopride 150 mg is the daily recommended dosage

Pharmacology-

Rabeprazole- Rabeprazole belongs to the class of antisecretory compounds that do not exhibit anticholinergic histamine H2-receptor antagonist property, but suppresses gastric acid secretion by inhibiting the gastric H+, K+ AT Pase at the secretory surface of gastric parietal cell.

Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as gastric PPIs. It blocks the final step of gastric secretion.

Itopride- Itopride has a dual mode of action. It inhibits the D2 receptor at the parasympathetic nerve ends and thereby increases the release of acetylcholine and decreases the metabolism of acetylcholine by inhibiting the enzyme acetylcholineterase (AChE) .

By maintaining higher acetylcholine levels itopride increases the esophageal and gastrointestinal peristalsis, increases the lower esophageal sphincter pressure, stimulates gastric motility, accelrates gastric emptying and improves gastro-duodenal coordination.

Combination- PPI and prokinetic combination was found to produce 83% cure rate and was better than PPI or prokinetic alone. Itopride maintains higher acetylcholine levels and increases the esophageal and gastro-intestinal peristalsis, increases the lower esophageal sphincter pressure, stimulates gastric motility, accelrates gastric emptying and improves gastro- duodenal co-ordination. Rabeprazole blocks the final step of gastric acid sceretion and therefore reduces the quantity of gastric acid. In combination the two drugs will benefit the patient by increeasing the rates of healing of gastro-esophageal erosion by reducing the exposure of the gastric acid and esophageal mucosa to the acid.