Rabeprazole through «metabolism – efficiency» prism
Kareva E.N.

Pirogov Russian National Research Medical University, Moscow
I.M. Sechenov First Moscow State Medical University

Proton pump inhibitors (PPIs) are nowadays the base of acid disorders treatment. Although PPIs are highly effective, antisecretory action of various drugs may vary from patient to patient. One of the reasons is different metabolism of PPIs. 
The paper focuses on pharmacological evaluation of role of drugs metabolism, influencing their efficacy and safety, mechanisms of induction and inhibition of drug metabolism enzymes, influence of genetic polymorphisms of cytochrome P450 (CYP) 2C19 on PPIs pharmacokinetics and pharmacodynamics. Drugs, that are not substrates for CYP, do not influence the metabolism of concomitant treatment and independent from their action. 
Rabeprazole metabolism and pharmacokinetics significantly differs from other PPIs. Rabeprazole clearance is largely performed non-enzymatically and slightly dependent on activity of microsomal liver enzymes. Therefore rabeprazole effects are predictable, and it is safe for patients taking multiple drugs at the same time (there is no risk of drug-drug interactions). Main distinctive effects of rabeprazole also include activation in a wide pH range.

Key words: metabolism, microsomal enzymes, cytochrome P450, proton pump inhibitors, rabeprazole, risk of drug-drug interactions.

For citation: Kareva E.N. Rabeprazole through «metabolism - efficiency» prism // RMJ. 2016. № 17. P. 1172–1176.