Dexrabeprazole + Domperidone Pharmacology

Dexrabeprazole + Domperidone

About Dexrabeprazole + Domperidone
N/A
Mechanism of Action of Dexrabeprazole + Domperidone
Rabeprazole inhibits the H+-K+-ATPase enzyme and thereby decreases gastric acid secretion.
Domperidone increases lower esophageal sphincter tone and enhances upper GI motility, thereby preventing reflux of gastric contents into esophagus.
Pharmacokinets of Dexrabeprazole + Domperidone
N/A
Onset of Action for Dexrabeprazole + Domperidone
N/A
Duration of Action for Dexrabeprazole + Domperidone
N/A
Half Life of Dexrabeprazole + Domperidone
N/A
Side Effects of Dexrabeprazole + Domperidone
1.Headache
2.Abdominal pain
3.Diarrhea, flatulence
4.Constipation
5.Dry mouth
6.Dizziness
7.Rash
8.Peripheral edema
Contra-indications of Dexrabeprazole + Domperidone
1.Patients with known hypersensitivity to rabeprazole, domperidone, or substituted benzimidazoles or to any excipient used in the formulation.
2.Hepatic and/or renal impairment, prolactin-releasing pituitary tumour (prolactinoma).

Special Precautions while taking Dexrabeprazole + Domperidone
N/A
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Not recommended for use in children under 16 years of age.
Indications for Dexrabeprazole + Domperidone
Gastroesophageal reflux disease (GERD) not responding to rabeprazole alone.
Interactions for Dexrabeprazole + Domperidone
N/A
Typical Dosage for Dexrabeprazole + Domperidone
Capsule(Rabeprazole sodium lP 20 mg+ Domperidone BP 30 mg) is to be taken once daily for 4 to 8 weeks, before breakfast in the morning.
Schedule of Dexrabeprazole + Domperidone
N/A
Storage Requirements for Dexrabeprazole + Domperidone
N/A
Effects of Missed Dosage of Dexrabeprazole + Domperidone
N/A
Effects of Overdose of Dexrabeprazole + Domperidone
N/A

Dexrabeprazole

About Dexrabeprazole
Dexrabeprazole is the R+-isomer of racemate rabeprazole that is more effective than the recemate and s-rabeprazole.
Mechanism of Action of Dexrabeprazole
Rabeprazole is a PPI that suppresses gastric acid secretion by inhibiting the gastric H+/K+ ATPase at the secretory surface of the gastric parietal cell.
Pharmacokinets of Dexrabeprazole
1.Absorption: Oral bioavailability: about 52% and peak plasma concentrations are reached about 3.5 hr after oral admin.
2.Distribution: Protein-binding: 97%.
3.Metabolism: Extensively metabolised in the liver by cytochrome P450 isoenzymes.
4.Excretion: Metabolites are mainly excreted in the urine (90%).
Onset of Action for Dexrabeprazole
1 hr.
Duration of Action for Dexrabeprazole
24 hr.
Half Life of Dexrabeprazole
About 1 hr.
Side Effects of Dexrabeprazole
1.Nausea
2.Headache
3.Diarrhoea nausea
4.Rhinitis
5.Abdominal pain
6.Asthenia
7.Flatulence
8.Pharyngitis
9.Nausea&vomiting
10.Non-specific pain-back pain
11.Dizziness
12.Flu syndrome
13.Infection
14.Cough
15.Constipation
16.Insomnia
Contra-indications of Dexrabeprazole
N/A
Special Precautions while taking Dexrabeprazole
1.Caution required in administration to patient with severe hepatic dysfunction.
2.Gastric or oesophageal malignancy should be excluded.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
>12yrs use with caution
NEONATES>>Contraindicated
Indications for Dexrabeprazole
1.Gastroesophageal reflux disease (GERD)
2.Gastric and duodenal ulcer
3.Acid peptic disease

Interactions for Dexrabeprazole
1.Dexrabeprazole Sodium can interact with blood thinners.
2.It produce a intensive increase in drugs whose absorption is pH dependent (e.g digoxin, ketoconazole)

Typical Dosage for Dexrabeprazole
Adults- 10 mg once daily for 4-8 weeks depending upon condition and response. Maintenance ? 5 -10 mg once daily.
Schedule of Dexrabeprazole
H
Storage Requirements for Dexrabeprazole
Store it at room temperature.
Effects of Missed Dosage of Dexrabeprazole
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Effects of Overdose of Dexrabeprazole
Seek emergency medical attention.

Domperidone

About Domperidone
Antidopaminergic, Motility stimulant,Piperidine derivative, Antiemetic, anti-vertigo.
Mechanism of Action of Domperidone
Domperidone is a potent dopamine receptor antagonist. It acts centrally and blocks the Dopamine receptor in the Chemoreceptor trigger zone and produces Antiemetic effect.
Domperidone acts peripherally in the gastrointestinal system and increases oesophageal peristalsis, oesophageal sphincter pressure and gastric motility. These all facilitates gastric emptying. Domperidone is used in migraine to relieve nausea and vomiting.
Anaesthetic adjuncts: It is used preoperatively in order to reduce the post operative vomiting.
Pharmacokinets of Domperidone
Absorption: Domperidone is rapidly absorbed after oral administration. Since it undergoes first pass metabolism oral bioavailability is only 15 %. Distribution: It is widely distributed in the body in protein bound form. Metabolism: Domperidone undergoes metabolism in the liver. Excretion: It is excreted mainly in the faeces and also in the urine.
Onset of Action for Domperidone
30 - 60 minutes
Duration of Action for Domperidone
6 - 8 hours
Half Life of Domperidone
7.5 hours
Side Effects of Domperidone
1.Diarrhoea
2.Dry mouth
3.Galactorrhoea
4.Gynaecomastia
5.Skin rash
6.Abdominal discomfort
7.Dystonic reactions
Contra-indications of Domperidone
1.Hypersensitivity to Domperidone
2.Prolactin releasing pituitary tumour(prolactinoma)
3.Gastrointestinal obstruction
Special Precautions while taking Domperidone
1.Hepatic impairment
2.Renal impairment
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Domperidone
1.Nausea and vomiting associated with gastrointestinal disorder and migraine.
2.Delayed gastric emptying of functional origin
3.As an Antiemetic in patient receiving cytotoxic drugs
4.Preanaesthetic medication

Interactions for Domperidone
Digoxin: Oral dose of digoxin needs to be reduced.
Aspirin, Paracetamol & Oral Diazepam: Increases absorption of these agents.
Anticholinergic agents: Antagonize the effects of domperidone.
Phenothiazines: CNS depression enhanced by domperidone.
Antimuscarinic agents and opioids: Antagonize GI effects of domperidone.
Suxamethonium: Neuromuscular blockade enhanced by domperidone.
Typical Dosage for Domperidone
Adults: 30 - 40 mg / day in 3 - 4 divided doses 30 minutes before meals and at bed time if required. After 2 weeks dose can be increased to 60 - 80 mg / day if needed.
Migraine: 20 mg by mouth may be taken up to every 4 hours with Paracetamol, as required up to a maximum of 4 doses in 24 hours.
Children: 300 mcg / kg body weight 3 - 4 times daily 30 minutes before meals and at bed time if required
Schedule of Domperidone
H
Storage Requirements for Domperidone
Store at room temperature (15 - 30 degree C). Protect from direct sun light and moisture
Effects of Missed Dosage of Domperidone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Domperidone
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage and absorption of the drug can be reduced by administration of activated charcoal. To control Extrapyramidal reactions give antiparkinsonian or anticholinergic agents.

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