Rabeprazole 10 mg twice daily is superior to 20 mg once daily for night‐time gastric acid suppression

Abstract

Rabeprazole 10 mg twice daily, not 20 mg once daily, should be administered to achieve more potent and long-lasting acid suppression.

Comparison of the effects of fasting morning, fasting evening and fed bedtime administration of tenatoprazole on intragastric pH in healthy volunteers: a randomized three‐way crossover study

“…has been proposed. [5][6][7][8][9][10][11] While b.d. administration has generally been shown to better control night-time acid secretion, a significant percentage of subjects still experience NAB.…”

Therapeutic Options in the Treatment of Nighttime Gastroesophageal Reflux

“…Several trials of PPIs have investigated the efficacy of this tactic [35,36,37,38]. A study of healthy volunteers who were each given 3 regimens of omeprazole (40 mg before breakfast, 40 mg before dinner, or 20 mg before breakfast and dinner) showed that dosing omeprazole at dinner or split dosing twice a day is significantly more efficacious in controlling nighttime gastric acidity than dosing before breakfast [35].…”

“…Two studies of once-daily vs. twice-daily rabeprazole have also demonstrated the superiority of the twice-daily regimen in controlling nighttime acid breakthrough [37, 38]. A recent study in healthy subjects comparing the efficacy of rabeprazole 20 mg dosed in the morning vs. rabeprazole 10 mg dosed in the morning and the evening showed that the twice-daily regimen was associated with more effective inhibition of nighttime acid secretion [37].…”

“…A recent study in healthy subjects comparing the efficacy of rabeprazole 20 mg dosed in the morning vs. rabeprazole 10 mg dosed in the morning and the evening showed that the twice-daily regimen was associated with more effective inhibition of nighttime acid secretion [37]. In another study of healthy volunteers, investigators reported that twice-daily administration of rabeprazole 10 mg was associated with higher median nighttime pH values and greater nighttime acid suppression compared with rabeprazole 10 mg or 20 mg once daily [38]. …”

Can Nocturnal Acid-breakthrough Be Reduced by Long-acting Proton Pump Inhibitors?

“…In addition, investigators have also attempted to eliminate NAB by targeting the night time histamine surge, with administration of histamine H2 receptor antagonists (H2RA) ( Table). 2,[4][5][6][7][8][9][10][11][12] What is the treatment effect of PPIs, which are known to have a longer plasma half-life on NAB? In this issue of the Journal of Neurogastroenterology and Motility, Karyampudi et al 13 evaluated esophageal acidification during NAB with ilaprazole, versus omeprazole in patients with uncomplicated GERD, in a prospective manner.…”