Pariet: Advanced Proton Pump Inhibitor for Effective Acid Control
Pariet
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Pariet (rabeprazole sodium) is a next-generation proton pump inhibitor (PPI) designed for the targeted management of gastric acid-related disorders. As a potent and selective inhibitor of the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells, it offers superior acid suppression with a rapid onset of action. Clinically proven to provide sustained relief and promote mucosal healing, Pariet represents a cornerstone therapy in gastroenterological practice, combining pharmacological innovation with demonstrated therapeutic efficacy across multiple indications including erosive GERD, duodenal ulcers, and Zollinger-Ellison syndrome. Its optimized pharmacokinetic profile ensures consistent 24-hour acid control with minimal fluctuation between doses.
Features
- Contains rabeprazole sodium as the active pharmaceutical ingredient
- Available in 10 mg and 20 mg delayed-release tablet formulations
- Utilizes enteric coating to ensure drug delivery beyond the stomach
- Exhibits high bioavailability with minimal impact from food intake
- Demonstrates linear pharmacokinetics across therapeutic doses
- Features pH-dependent dissolution for targeted release in the small intestine
- Manufactured under cGMP standards with consistent purity ≥99%
- Packaged in blister strips with desiccant for stability assurance
Benefits
- Provides rapid and sustained suppression of gastric acid secretion through irreversible inhibition of proton pumps
- Promotes complete healing of erosive esophagitis with proven efficacy versus comparator PPIs
- Effectively controls nighttime acid breakthrough through consistent pharmacokinetic performance
- Reduces dependency on antacids and offers predictable symptom relief within 24 hours of initial dosing
- Enables flexible dosing regimens due to minimal drug interaction profile and consistent absorption
- Supports long-term maintenance therapy with established safety data spanning over 15 years of clinical use
Common use
Pariet is primarily indicated for the treatment of conditions mediated by gastric acid hypersecretion. Its most frequent application is in the management of gastroesophageal reflux disease (GERD), including both erosive and non-erosive variants. In erosive GERD, Pariet demonstrates particular efficacy in healing mucosal damage and preventing recurrence. Additionally, it is employed in the treatment of active duodenal ulcers, both as monotherapy and in combination with antibiotic regimens for Helicobacter pylori eradication. Off-label uses include management of NSAID-induced gastric ulcers, prevention of stress-related mucosal damage in critically ill patients, and adjunctive therapy in certain cases of functional dyspepsia. The medication is also indicated for long-term maintenance therapy in patients requiring continuous acid suppression.
Dosage and direction
The recommended adult dosage for most indications is 20 mg once daily, though 10 mg may be sufficient for maintenance therapy or milder cases. For active duodenal ulcer treatment, administer 20 mg daily for 4 weeks. Erosive GERD typically requires 20 mg daily for 4-8 weeks based on endoscopic healing assessment. For H. pylori eradication, Pariet 20 mg is administered twice daily as part of combination therapy (typically with amoxicillin and clarithromycin) for 7-14 days. Tablets must be swallowed whole with water, without crushing or chewing, and may be taken with or without food. Morning administration is generally preferred to align with circadian acid secretion patterns. Dosage adjustment in hepatic impairment (Child-Pugh classes A and B) is not routinely required, though caution is advised in severe hepatic dysfunction.
Precautions
Patients should be evaluated for malignant neoplasms prior to initiating therapy, as symptom relief may mask gastric malignancy. Long-term use (particularly beyond one year) requires periodic assessment of magnesium levels, as hypomagnesaemia may occur. Bone fracture risk may be increased with high-dose, long-term PPI therapy, particularly in elderly patients. Vitamin B12 absorption may be impaired during prolonged treatment due to hypochlorhydria. Patients should be monitored for signs of Clostridium difficile-associated diarrhea, particularly in hospital settings. Use with caution in patients with osteoporosis or those receiving concomitant corticosteroids. Periodic endoscopic monitoring is recommended for patients with Barrett’s esophagus or those requiring maintenance therapy beyond 12 months.
Contraindications
Pariet is contraindicated in patients with known hypersensitivity to rabeprazole, substituted benzimidazoles, or any component of the formulation. Concomitant use with rilpivirine-containing products is contraindicated due to potential for reduced antiviral efficacy. Should not be administered to patients taking atazanavir due to significant reduction in atazanavir exposure. Avoid use in patients with hereditary fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency due to sorbitol content in tablet formulation. Not recommended during third trimester of pregnancy due to potential fetal effects based on animal data.
Possible side effect
Common adverse reactions (≥1% incidence) include headache, diarrhea, nausea, vomiting, abdominal pain, flatulence, and constipation. Less frequently observed effects (0.1-1% incidence) comprise dry mouth, dizziness, insomnia, rash, leukopenia, and elevated liver enzymes. Rare but serious adverse events (<0.1% incidence) may include anaphylaxis, Stevens-Johnson syndrome, interstitial nephritis, hepatic failure, and Clostridium difficile-associated colitis. Long-term use associations include hypomagnesaemia, vitamin B12 deficiency, iron deficiency, increased risk of community-acquired pneumonia, and possible increased risk of gastric neoplasia in patients with H. pylori infection. Most adverse effects are mild to moderate and transient in nature.
Drug interaction
Pariet may decrease the absorption of drugs requiring acidic gastric environment for optimal bioavailability, including ketoconazole, itraconazole, iron salts, and dabigatran etexilate. May increase exposure to digoxin through pH-dependent absorption alteration. Concomitant use with methotrexate may potentially increase methotrexate levels. Rabeprazole inhibits CYP2C19 and may increase concentrations of drugs metabolized by this enzyme, including phenytoin, warfarin, and diazepam. Plasma concentrations of tacrolimus may be increased. Avoid concomitant use with clopidogrel due to potential reduction in antiplatelet activity. No significant interactions observed with theophylline, warfarin (at stable doses), or cyclosporine in clinical studies.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In such case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistency in dosing time is recommended to maintain steady-state acid suppression, though the medication’s prolonged duration of action provides some buffer against occasional missed doses. For patients on combination therapy for H. pylori eradication, strict adherence to the dosing schedule is critical to prevent treatment failure and antibiotic resistance.
Overdose
Experience with rabeprazole overdose is limited. Expected manifestations would be consistent with the pharmacological action and may include hypochlorhydria, nausea, vomiting, dizziness, headache, and gastrointestinal disturbances. No specific antidote exists. Management should be supportive and symptomatic, including gastric lavage if presented within one hour of ingestion. Hemodialysis is not effective due to high protein binding. Serum electrolyte monitoring is recommended, particularly for magnesium and potassium. Cases of extreme overdose should be managed in a critical care setting with continuous monitoring of vital signs and appropriate supportive measures.
Storage
Store at controlled room temperature between 15-30°C (59-86°F). Protect from moisture and light. Keep in original blister packaging until time of use. Do not remove desiccant from bottle packaging. Keep out of reach of children and pets. Do not use tablets that show signs of damage to the enteric coating or discoloration. Properly dispose of expired medication through take-back programs or according to local regulations. Do not flush medications down the toilet or pour into drains unless specifically instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Healthcare professionals should exercise their own professional judgment when treating patients. Always refer to the full prescribing information and local guidelines before initiating therapy. Dosage and administration may vary based on individual patient characteristics, regional approvals, and clinical context. The prescribing physician remains ultimately responsible for determining appropriate therapy based on individual patient assessment.
Reviews
Clinical studies demonstrate Pariet’s efficacy in achieving complete endoscopic healing in 85-93% of erosive esophagitis patients after 8 weeks of therapy. Maintenance therapy studies show relapse rates of less than 15% at 52 weeks with 20 mg daily dosing. Comparative trials indicate non-inferiority to omeprazole and lansoprazole in healing rates and symptom control. Patient-reported outcomes indicate significant improvement in quality of life scores related to GERD symptoms. Real-world evidence supports sustained effectiveness in long-term management, with favorable tolerability profiles maintained over extended treatment periods. Post-marketing surveillance data from over 30 countries confirms the established safety profile observed in clinical trials.