Rebamipide

# Rebamipide ## Overview - **Classification**: Mucosal protectant, anti-ulcer agent. - **Mechanism**: Increases endogenous prostaglandin synthesis, promotes mucus secretion, enhances gastric blood flow, and scavenges free radicals to protect GI mucosa. ## Primary Indications 1. **Gastric Ulcer** - Treatment of active gastric ulcers. 2. **Gastritis** - Improvement of gastric mucosal lesions (erosion, bleeding, redness, edema) in acute gastritis and acute exacerbation of chronic gastritis. 3. **NSAID-induced Gastropathy** - Prevention and treatment of gastrointestinal damage caused by NSAID use. ## Adult Dosing ### Standard Dosing **Gastric Ulcer / Gastritis / NSAID-induced Gastropathy** - **Dose**: **100 mg** - **Frequency**: Three times daily (TID) - **Route**: Oral (PO) - **Duration**: Typically 6-8 weeks for ulcers, or as needed for gastritis/prevention. ### Dose Adjustments - **Renal Impairment**: No specific adjustment typically recommended; use with caution due to potential accumulation. - **Hepatic Impairment**: No specific adjustment recommended. - **Elderly Patients**: No specific dose adjustment needed; generally well-tolerated. ## Pediatric Dosing *Rebamipide's use in pediatric populations is not well-established in many regions, and specific pediatric dosing guidelines are generally lacking.* ### Neonates (0-28 days) - **Dose**: No established dosing. - **Frequency**: Not recommended. - **Maximum**: Not applicable. - **Special Notes**: Safety and efficacy not studied. ### Infants (1-12 months) - **Dose**: No established dosing. - **Frequency**: Not recommended. - **Maximum**: Not applicable. ### Children (1-12 years) - **Dose**: No established dosing. - **Frequency**: Not recommended. - **Maximum**: Not applicable. - **Special Notes**: Use only if potential benefits outweigh risks, and under specialist supervision. ### Adolescents (13-18 years) - **Dose**: No established dosing for this age group. - **Maximum**: Not applicable. - **Special Notes**: If used, adult dosing of **100 mg** TID might be considered after careful risk-benefit assessment, but generally not recommended without specific indication and data. ## Safety Information ### Contraindications - **Absolute**: Hypersensitivity to Rebamipide or any component of the formulation. - **Absolute**: Pregnancy (due to lack of sufficient data, avoid if possible). - **Absolute**: Lactation (excreted in breast milk in animal studies; avoid). ### Common Adverse Effects - **Very Common (>10%)**: None typically listed. - **Common (1-10%)**: Constipation, diarrhea, nausea, vomiting, abdominal bloating, rash, pruritus. - **Serious but Rare**: Leukopenia, thrombocytopenia, hepatic dysfunction (elevated LFTs), anaphylactoid reactions. ### Key Drug Interactions - **Antacids**: May theoretically decrease absorption; separate administration by 1-2 hours if concerned, but usually not clinically significant. - **NSAIDs**: No negative interaction; often co-administered to protect GI mucosa. ## Monitoring & Follow-up - **Before Treatment**: Assess baseline GI symptoms and overall health status. - **During Treatment**: Monitor for symptom improvement, adverse effects (especially GI discomfort). - **Clinical Signs**: Watch for persistent GI bleeding, severe abdominal pain, or new skin reactions. ## Clinical Pearls - 💡 **Tip 1**: Rebamipide can be taken with or without food. - 💡 **Tip 2**: Full therapeutic effect on mucosal healing may take several weeks of consistent use. - 💡 **Tip 3**: Often used as an add-on therapy, especially for NSAID-induced gastropathy or refractory gastritis. - 💡 **Tip 4**: More commonly prescribed in Asian countries. > **⚠️ Important**: This information is for educational purposes only. Always consult current prescribing information, local guidelines, and clinical judgment before prescribing.