Rabeprazole and Domperidone 20mg/30mg Capsules IP (Rabtaj DSR) Taj Pharma

1. COMPOSITION:
   (a) Each hard gelatin capsule contains;
   Rabeprazole Sodium IP (as enteric coated granules) 20mg + Domperidone IP (as sustained release granules) 30mg
   (b) Each hard gelatin capsule contains;
   Rabeprazole Sodium IP (as enteric coated granules) 20mg + Domperidone IP (as sustained release granules) 10mg
2. DOSAGE FORM:
   Hard gelatin capsules
3. DESCRIPTION:
   Rabtaj DSR capsule is an anti-ulcerant and anti-emetic combination that addresses acid-reflux issues, different types of ulcers, nausea and vomiting. Rabeprazole is a proton pump inhibitor, while domperidone is a dopamine antagonist. Studies show that the combination of rabeprazole and domperidone effectively addresses gastroesophageal reflux disorder than rabeprazole alone.
4. PHARMACOLOGY:
   Rabtaj DSR Capsule is a combination of two medicines: Domperidone and Rabeprazole. Domperidone is a prokinetic which works on the upper digestive tract to increase the movement of the stomach and intestines, allowing the food to move more easily through the stomach. Rabeprazole is a proton pump inhibitor (PPI) which works by reducing the amount of acid in the stomach which helps in the relief of acid-related indigestion and heartburn.
   Rabeprazole is a substituted benzimidazole and it works as a proton pump inhibitor (PPI). After the administration, rabeprazole is absorbed by the parietal cells. Rabeprazole is activated in the acidic environment only. The activated rabeprazole binds to the H+/ K+ ATPase system present on the parietal cells and prevents the inward movement of H+ ions into the stomach and inhibits the gastric acid production.
   Domperidone is a strong anti-emetic and anti-ulcerant agent that controls nausea and vomiting along with the suppression of acid-reflux. On peripheral levels, it increases the lower esophageal pressure, improves the motility in the upper GI tract or peristalsis. Centrally, domperidone acts as an antagonist of D2 and D3 dopamine receptors in the area postrema of the brain where the chemoreceptor trigger zone for nausea and vomiting is present.

4.1 INDICATIONS:           
Helicobacter pylori infection and eradication
Heartburn
Gastroesophageal Reflux Disease (GERD)
Non-erosive Reflux Disease (NERD)
Zollinger-Ellison Syndrome
Duodenal and gastric ulcers
Intractable nausea and vomiting

4.2 DOSAGE AND ADMINISTRATION:
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rabtaj DSR Capsule is to be taken empty stomach.

4.3 CONTRAINDICATIONS:          
Hypersensitivity to Rabeprazole+Domperidone capsule is a contraindication.
In addition, Rabeprazole + Domperidone capsule should not be used if you have the following conditions:

• Breastfeeding
• Co-administration with potent CYP3A4 inhibitors
• Concomitant use with medicines that prolong the QT interval
• Congestive heart failure
• Hypersensitivity
• Hypersensitivity to domperidone
• Moderate or severe hepatic impairment
• Patients with significant electrolyte disturbances
• Pregnant
• Presence of gastrointestinal haemorrhage

4.4 WARNINGS AND PRECAUTIONS:      
Before using Rabtaj DSR capsule, inform your doctor about your current list of medications, over the counter products (e.g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e.g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side-effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below.

• Avoid driving or operating machinery
• Concurrent use with QT prolongating agents
• Discontinue use if experiencing signs or symptoms associated with cardiac arrhythmia
• Helps treat GERD or reflux
• May increase risk for lupus
• May increase risk for osteoporosis
• Notify doctor if taking atazanavir, nelfinavir, or rilpivirine
• Older patients
• Patients with bradycardia
• Patients with cardiac diseases

4.5 UNDESIRABLE EFFECTS:
The following is a list of possible side-effects that may occur from all constituting ingredients of Rabtaj DSR capsule. This is not a comprehensive list. These side-effects are possible, but do not always occur. Some of the side-effects may be rare but serious. Consult your doctor if you observe any of the following side-effects, especially if they do not go away.

• Nausea
• Pruritus
• Abdominal pain
• Sleeplessness
• Constipation
• Headache
• Somnolence
• Akathisia
• Diarrhea
• Rash
• Rabtaj DSR capsule may also cause side-effects not listed here.

4.6 INCOMPATIBILITY:  
If you use other drugs or over the counter products at the same time, the effects of Rabtaj DSR capsule may change. This may increase your risk for side-effects or cause your drug not to work properly. Tell your doctor about all the drugs, vitamins, and herbal supplements you are using, so that you doctor can help you prevent or manage drug interactions. Rabtaj DSR capsule may interact with the following drugs and products:

• Amiodarone
• Amprenavir
• Antacids
• Aprepitant
• Atazanavir
• Atropine
• Clarithromycin
• Diltiazem
• Erythromycin
• Fluconazole

5. SHELF-LIFE:
   3 years
6. STORAGE AND HANDLING INSTRUCTIONS:
   Store in a cool and dry place. Keep out of reach of children.

6.1 PACKAGING INFORMATION:
Blister packs containing: 14, 28, 56, 84 hard capsules.
Pack sizes of: 30, 100 and 200 capsules

7. MANUFACTURED IN INDIA BY:
   TAJ PHARMACEUTICALS LTD;
   Plot No. 220, Mahagujarat Industrial Estate,
   Moraiyya, Tal-Sanand, Dist-Ahmedabad, Gujarat.