dexrabeprazole / domperidone

Action and Spectrum

Actions and Spectrum: 

Action: 

dexrabeprazole 

dexrabeprazole action involves diminishing the synthesis of gastric acid. More precisely, it acts by inhibiting the H+/K+ ATPase enzyme found in the parietal cells of the stomach, which are responsible for the secretion of acid. 

domperidone 

domperidone is a prokinetic agent. It works by blocking the action of dopamine in the brain. Dopamine typically inhibits the release of a prolactin hormone, which can slow down gastrointestinal motility. domperidone increases prolactin release by blocking dopamine’s action and promotes food movement through the digestive system. This helps relieve symptoms like nausea, vomiting, bloating, and discomfort associated with gastroparesis and reflux. 

Spectrum: 

dexrabeprazole 

dexrabeprazole primarily targets the acid-producing cells in the stomach and is used to treat acid-related disorders. It’s ineffective against other gastrointestinal issues like motility problems, where domperidone comes into use. 

domperidone 

domperidone primarily acts on the gastrointestinal tract to enhance motility and treats slow or impaired gastric emptying conditions. It is often used with acid-suppressing medications like dexrabeprazole in cases where both excessive acid production and motility problems contribute to gastrointestinal symptoms. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Peripheral edema 

Rash 

Dizziness 

Dry mouth 

Constipation 

Diarrhea, flatulence 

Abdominal pain 

Headache 

Black Box Warning

Black Box Warning:  

None

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: Individuals who have a known hypersensitivity or allergy to dexrabeprazole, domperidone, or any of the inactive ingredients in the medications should avoid their use. 

Gastrointestinal Bleeding: If you have a history of gastrointestinal bleeding, this combination may not be suitable for you, as it can increase the risk of bleeding or worsen an existing condition. 

Liver Disease: Both dexrabeprazole and domperidone can affect liver function. If you have severe liver disease, before initiating these medications, it is crucial to seek guidance from your healthcare professional. 

Renal Impairment: If you have kidney problems, especially severe renal impairment, you should use this combination with caution and under close medical supervision. 

Pregnancy and Breastfeeding: The safety of dexrabeprazole and domperidone during pregnancy and breastfeeding has not been well-established. Pregnant or nursing individuals should seek guidance from their healthcare professional before utilizing these medications. 

Interaction with Other Medications: dexrabeprazole and domperidone can interact with other medications. Inform your healthcare provider about all your drugs to avoid potential interactions. 

Age: These medications may not be suitable for infants, very young children, or the elderly without careful consideration and appropriate dosing adjustments. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:  

dexrabeprazole is a proton pump inhibitor. domperidone is a dopamine receptor antagonist. 

Pharmacodynamics:  

dexrabeprazole 

dexrabeprazole works by binding irreversibly to the gastric parietal cells’ hydrogen-potassium adenosine triphosphatase (H+/K+ ATPase) enzyme system. This inhibition reduces the secretion of gastric acid, leading to decreased acidity in the stomach. 

domperidone 

domperidone acts by blocking dopamine receptors (specifically D2 and D3 receptors) in the chemoreceptor trigger zone (CTZ) and in the gastrointestinal tract. Doing so increases the motility of the stomach and upper gastrointestinal tract while reducing nausea and vomiting.  

Pharmacokinetics: 

Absorption 

dexrabeprazole is quickly absorbed within the gastrointestinal tract. 

domperidone is rapidly absorbed from the gastrointestinal tract, but its absorption can be affected by food, as it is best taken on an empty stomach. 

Distribution 

After absorption, dexrabeprazole is distributed throughout the body via the bloodstream. 

It can bind to plasma proteins and may have a relatively high volume of distribution. 

After absorption, domperidone is distributed throughout the body, including the central nervous system. 

Metabolism 

dexrabeprazole undergoes metabolism in the liver, primarily through the enzyme CYP2C19. 

It is converted into active form, inhibiting proton pumps in the stomach lining and reducing acid secretion. 

domperidone undergoes extensive first-pass metabolism in the liver, primarily through the enzyme CYP3A4. 

Excretion and Elimination 

The metabolites of dexrabeprazole and any unmetabolized drug are excreted primarily in the urine. 

The half-life of dexrabeprazole is relatively short and usually eliminated within a few hours. 

The metabolites of domperidone and any unmetabolized drug are excreted mainly in the urine, with some excretion in feces. 

The elimination half-life of domperidone is relatively short and usually excreted within a few hours to days. 

Adminstartion

Administration:  

The combination is usually taken before a meal, typically in the morning.  

This helps it work more effectively by reducing stomach acid production before food is consumed. 

These medications are typically taken orally with a glass of water.  

Follow the specific instructions on the medication label or as provided by your healthcare provider. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: dexrabeprazole / domperidone 

Why do we use dexrabeprazole /domperidone?  

The combination of dexrabeprazole and domperidone can be prescribed to relieve symptoms associated with dyspepsia like abdominal pain, bloating, and discomfort. 

The combination of dexrabeprazole and domperidone helps in relieve symptoms of GERD, such as heartburn, acid regurgitation, and chest discomfort.  

The combination of dexrabeprazole and domperidone is sometimes used to treat peptic ulcers, including both gastric and duodenal ulcers. dexrabeprazole helps heal the ulcers by reducing gastric acid production, while domperidone can alleviate symptoms and improve digestion.