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Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
PPIs effectively suppress gastric acid secretion by inhibiting the H+/K+ ATPase on the surface of the parietal cell. PPIs are highly effective in the treatment of PUD. Omeprazole is rated as category C during pregnancy because of embryotoxicity without teratogenicity in animal studies (19). All other PPIs, including lansoprazole, rabeprazole, pantoprazole, and esomeprazole, are classified as FDA pregnancy category B drugs. Lansoprazole is the preferred PPI during pregnancy because of lack of clinical data regarding the safety of newer PPIs. Treatment with PPIs during pregnancy should be reserved only for patients with refractory or complicated PUD, which does not respond to alternative medical therapies, including H2RAs.
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 60-year-old woman presented with a pruriginous centrifugally spreading maculopapular erythematous eruption affecting her trunk and arms, which had been evolving over the previous week. Ibuprofen and rabeprazole were suspected, but patch tests were negative. However, a positive reaction was observed (++) at D2 and D4 to caine mix III, which contains benzocaine 5%, tetracaine HCl 2.5%, and dibucaine HCl 2.5%. Upon a more thorough questioning, the patient now reported that she had used two ointments for hemorrhoids, which both caused local reactions in the perianal area controlled by corticosteroids. Both ointments contained dibucaine HCl and a patch test to this anesthetic 5% pet. was positive. Ibuprofen and rabeprazole were re-introduced without problems (26).
R
Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Rabeprazole is mainly metabolised via nonenzymatic reduction and, to a lesser extent, via the cytochrome P450 isoenzymes CYP2C19 and CYP3A4. Metabolites are excreted principally in the urine (about 90%) with the remainder in the faeces.
Identification and genotoxicity evaluation of potential impurities in rabeprazole sodium using in silico and in vitro analyses
Published in Drug and Chemical Toxicology, 2022
Yi Du, Yinnan Wu, Yang Liu, Changhong Meng, Li Tan, Tiantian Cai, Yuxin Wang, Yihong Lu
Cumulative assays suggest that drugs for the treatment of gastroesophageal diseases may exert genotoxic and mutagenic effects. It has been reported that almost all prazoles (lansoprazole, omeprazole, pantoprazole, and rabeprazole) can induce chromosomal damages (Giovanni et al.2010, Paz et al.2020). Rabeprazole sodium, with a chemical formula of 2-[[[4-(3-methoxypropoxy)-3-methyl-2-pyri-dinyl] methyl sulfinyl]-1H-benzimidazole sodium salt, is extensively used for the treatment of duodenal ulcers, gastric ulcers, Zollinger–Ellison syndrome, anastomotic ulcer, and gastroesophageal reflux syndrome (Robinson and Horn 2003, NLM 2020a, Frazzoni et al.2017). Several analytical methods for the identification of rabeprazole sodium and its impurities have been reported (Reddy et al.2007, Rao et al.2010, Yenugu et al.2018). These impurities may originate from the active pharmaceutical ingredients or during the manufacturing and storage processes. However, only few studies have discussed the genotoxicity of impurities in rabeprazole and set a limit for these impurities (Yenugu et al. 2018). In the study, they only quantified the known genotoxic impurities, but not evaluate the genotoxicity of other impurities in rabeprazole.
High plasma mycophenolate acid concentration in the early phase of induction therapy predicts good renal outcome in lupus nephritis
Published in Modern Rheumatology, 2020
Tomofumi Kiyokawa, Hironari Hanaoka, Harunobu Iida, Kana Ishimori, Yukiko Takakuwa, Takahiro Okazaki, Shoichi Ozaki, Kimito Kawahata
We prospectively enrolled 10 Japanese patients with biopsy-proven LN class III or IV according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification, who were hospitalized at St. Marianna University Hospital between April 2016 and October 2017. All the patients completed the 6-month observation during the induction phase. Patients were enrolled if they fulfilled all the following criteria: disease that met the American College of Rheumatology (ACR) classification criteria for SLE [10], no intake of drugs known to interact with MMF, including acyclovir, ganciclovir, metronidazole, cholestyramine [11], tacrolimus, cyclosporine [12,13], magnesium- or aluminium-containing antacid [14] and rifampicin [15], and not pregnant or breastfeeding [16]. Rabeprazole was used to prevent gastric ulcer with less influence on the blood concentration of MMF and orally taken at a dose of 10 mg once a day after breakfast [17]. The study protocol was approved by the local ethics committee (Approval No. 3423), and written informed consent was obtained from all the patients before the study began.
Psoriasiform eruption caused by teriflunomide in a patient with multiple sclerosis
Published in Clinical Toxicology, 2019
Senay Agirgol, Murat Kurtuncu, Mihriban Gurbuzel, Ilay Tasyurek, Tuncay Gunduz
Patients with MS display both increased prevalence and incidence of psoriasis [8]. It is possible that this patient's psoriasis developed as a comorbid condition of her underlying MS; but psoriasiform lesions slowly resolved after drug interruption and histopathologically eosinophilia refer to a drug eruption. Rabeprazole and Levothyroxine may cause skin side effects [9]. These are different (e.g. erythema multiforme and alopecia respectively) from those reported in the patient; this aspect together with clinical improvement after Teriflunomide discontinuation may strengthen the correlation between the drug and the skin effects observed. Rabeprazole and Levothyroxine do not interact with teriflunomide. This strengthens the potential unique role of the teriflunomide in the side effect.