PARIET Gastro-resistant tablet Ref.[50850] Active ingredients: Rabeprazole

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2022  Publisher: Eisai Ltd., European Knowledge Centre, Mosquito Way, Hatfield, Herts, AL10 9SN, United Kingdom

4.1. Therapeutic indications

PARIET tablets are indicated for the treatment of:

  • active duodenal ulcer.
  • active benign gastric ulcer.
  • symptomatic erosive or ulcerative gastro-oesophageal reflux disease (GORD).
  • Gastro-Oesophageal Reflux Disease Long-term Management (GORD Maintenance).
  • Symptomatic treatment of moderate to very severe gastro-oesophageal reflux disease (symptomatic GORD).
  • Zollinger-Ellison Syndrome.
  • In combination with appropriate antibacterial therapeutic regimens for the eradication of Helicobacter pylori (H. pylori) in patients with peptic ulcer disease. See section 4.2.

4.2. Posology and method of administration

Adults / Older people

Active Duodenal Ulcer and Active Benign Gastric Ulcer: The recommended oral dose for both active duodenal ulcer and active benign gastric ulcer is 20 mg to be taken once daily in the morning.

Most patients with active duodenal ulcer heal within four weeks. However a few patients may require an additional four weeks of therapy to achieve healing. Most patients with active benign gastric ulcer heal within six weeks. However again a few patients may require an additional six weeks of therapy to achieve healing.

Erosive or Ulcerative Gastro-Oesophageal Reflux Disease (GORD): The recommended oral dose for this condition is 20 mg to be taken once daily for four to eight weeks.

Gastro-Oesophageal Reflux Disease Long-term Management (GORD Maintenance): For long-term management, a maintenance dose of PARIET 20 mg or 10 mg once daily can be used depending upon patient response.

Symptomatic treatment of moderate to very severe gastro-oesophageal reflux disease (symptomatic GORD): 10 mg once daily in patients without oesophagitis. If symptom control has not been achieved during four weeks, the patient should be further investigated. Once symptoms have resolved, subsequent symptom control can be achieved using an on-demand regimen taking 10 mg once daily when needed.

Zollinger-Ellison Syndrome: The recommended adult starting dose is 60 mg once a day. The dose may be titrated upwards to 120 mg/day based on individual patient needs. Single daily doses up to 100 mg/day may be given. 120 mg dose may require divided doses, 60 mg twice daily. Treatment should continue for as long as clinically indicated.

Eradication of H. pylori: Patients with H. pylori infection should be treated with eradication therapy. The following combination given for 7 days is recommended.

PARIET 20 mg twice daily + clarithromycin 500 mg twice daily and amoxicillin 1 g twice daily.

For indications requiring once daily treatment PARIET tablets should be taken in the morning, before eating; and although neither the time of day nor food intake was shown to have any effect on rabeprazole sodium activity, this regimen will facilitate treatment compliance.

Renal and hepatic impairment

No dosage adjustment is necessary for patients with renal or hepatic impairment.

See section 4.4 in the treatment of patients with severe hepatic impairment.

Children

PARIET is not recommended for use in children, as there is no experience of its use in this group.

Method of administration

Patients should be cautioned that the PARIET tablets should not be chewed or crushed, but should be swallowed whole.

4.9. Overdose

Experience to date with deliberate or accidental overdose is limited. The maximum established exposure has not exceeded 60 mg twice daily, or 160 mg once daily. Effects are generally minimal, representative of the known adverse event profile and reversible without further medical intervention. No specific antidote is known. Rabeprazole sodium is extensively protein bound and is, therefore, not dialysable. As in any case of overdose, treatment should be symptomatic and general supportive measures should be utilised.

6.3. Shelf life

3 years.

6.4. Special precautions for storage

Do not store above 25°C. Do not refrigerate.

6.5. Nature and contents of container

Blister strips (aluminium/aluminium).

Pack sizes: 1, 5, 7, 14, 15, 25, 28, 30, 50, 56, 75, 98, 112 or 120 tablets

Not all pack sizes may be marketed.

6.6. Special precautions for disposal and other handling

No special requirements.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

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