Category Name Gastro / Proton Pump Inhibitor (PPI) & Prokinetic / Anti-Reflux
Common Indications RBM-DSR is indicated for the management of acid-related gastrointestinal disorders requiring both sustained acid suppression and improved gastric motility. It is commonly prescribed for:
- Gastroesophageal reflux disease (GERD) with symptoms of heartburn and acid regurgitation
- Acid reflux with associated stomach pain, burning, and irritation
- Symptomatic relief of dyspepsia, indigestion, and upper abdominal discomfort
- Gastric and duodenal ulcers associated with acid hypersecretion
- Nausea and vomiting associated with delayed gastric emptying or gastroparesis
- Bloating, flatulence, and upper abdominal discomfort due to impaired gastric motility
- Erosive oesophagitis and reflux oesophagitis requiring combined acid suppression and prokinetic therapy
- Helicobacter pylori eradication as part of combination antibiotic therapy
Common Dosings One sustained-release (SR) capsule (Rabeprazole 20 mg + Domperidone 30 mg) orally, once daily — preferably 30 to 60 minutes before the first meal of the day — or as directed by your physician. Swallow the capsule whole with a full glass of water. Do not crush, chew, open, or break the capsule as the sustained-release formulation is essential for proper drug delivery and efficacy. The dose and duration of therapy should be determined by the treating physician based on the diagnosis, severity of symptoms, and clinical response.
Common Side Effects The following side effects may occur during the course of treatment. Consult your doctor if any of these persist or worsen:
- Flatulence or excessive gas
- Abdominal pain or discomfort
- Diarrhoea or loose stools
- Vomiting or nausea
- Headache
- Dizziness or lightheadedness
- Cough or upper respiratory discomfort
- Nasal inflammation or rhinitis
- Back pain
- Skin rash or itching — inform your doctor promptly
- Rarely, abnormal heart rhythms (palpitations) associated with Domperidone — seek immediate medical attention if experienced
- With prolonged use — risk of hypomagnesaemia (low magnesium) and Vitamin B12 deficiency — regular monitoring is recommended
- Serious allergic reactions such as facial swelling, difficulty breathing, or severe skin reactions — seek immediate medical attention if severe
Common Interactions Inform your doctor about all medications, supplements, and herbal products you are currently taking. Notable interactions include:
- Ketoconazole, Itraconazole & Atazanavir: Rabeprazole reduces gastric acidity, significantly decreasing the absorption and plasma levels of these drugs and reducing their therapeutic effectiveness — concurrent use should be avoided where possible or managed with appropriate adjustments under medical supervision
- Warfarin: Concomitant use may increase the anticoagulant effect of Warfarin, elevating the risk of bleeding complications — regular INR monitoring is strongly recommended during concurrent therapy
- Methotrexate: At high doses, Rabeprazole may reduce renal excretion of Methotrexate, increasing its plasma concentration and the risk of serious toxicity — close clinical and laboratory monitoring is mandatory during concurrent use
- QT-Prolonging Drugs (Antiarrhythmics, Certain Antipsychotics, Macrolide Antibiotics): Concurrent use with Domperidone may increase the risk of serious cardiac arrhythmias including QT prolongation — avoid combination use without strict medical supervision
- CYP3A4 Inhibitors (Ketoconazole, Erythromycin): May increase plasma levels of Domperidone, enhancing its effects and the risk of cardiac adverse reactions — concurrent use should be avoided
- Other Proton Pump Inhibitors / Acid-Suppressing Agents: Concurrent use may cause excessive acid suppression — use only under strict medical supervision
- Iron Salts & Calcium Supplements: Elevated gastric pH due to Rabeprazole may reduce the absorption of iron and calcium — maintain appropriate time gaps between administration
- Digoxin: Elevated gastric pH may increase Digoxin absorption — monitor Digoxin levels closely during concurrent use
Special Instructions
| Condition | Guidance |
|---|---|
| Pregnancy | Highly unsafe during pregnancy. May cause serious harm to the unborn baby including birth defects and pregnancy loss. Strictly contraindicated — do not use without explicit medical direction. Consult your doctor immediately if pregnancy is detected during therapy. |
| Breastfeeding | Unsafe to use during lactation. Both Rabeprazole and Domperidone may pass into breast milk and may harm the infant. Consult your doctor before use and consider a safer alternative during breastfeeding. |
| Alcohol | The safety of concurrent alcohol use has not been fully established. Alcohol may worsen acid reflux symptoms and gastrointestinal irritation — it is strongly advisable to avoid alcohol during therapy for optimal therapeutic benefit. |
| Driving & Machinery | May cause dizziness, drowsiness, or visual disturbances in some patients. Avoid driving or operating heavy machinery if these symptoms occur. |
| Liver Disease | Unsafe to use in patients with liver disease and should be avoided. Both components are extensively metabolised in the liver — use is contraindicated in significant hepatic impairment. Consult your physician immediately if liver disease is diagnosed during therapy. |
| Kidney Disease | Use with caution in patients with severe renal impairment. Dose adjustment and regular renal function monitoring may be required — consult your physician before use. |
Mechanism of Action RBM-DSR combines two active ingredients, each working through a distinct and complementary mechanism to provide comprehensive relief from acid-related gastrointestinal disorders:
Rabeprazole Sodium (20 mg): A third-generation proton pump inhibitor (PPI) that provides potent and sustained suppression of gastric acid secretion. Rabeprazole is a prodrug that is absorbed from the small intestine and selectively concentrated in the acidic secretory canaliculi of the gastric parietal cells. Here, it is rapidly converted to its active sulphenamide form, which covalently and irreversibly binds to the hydrogen-potassium ATPase enzyme system — the gastric proton pump — blocking the final step of hydrochloric acid secretion into the stomach lumen. This results in a profound and prolonged reduction in both the volume and acidity of gastric secretions, creating an optimal environment for relief of reflux symptoms and healing of acid-damaged mucosal tissue. Rabeprazole's rapid activation in the gastric canaliculi provides a faster onset of acid suppression compared to some other PPIs
Domperidone (30 mg): A selective peripheral dopamine D2 receptor antagonist and prokinetic agent that works by blocking dopamine receptors in the upper gastrointestinal tract and at the chemoreceptor trigger zone (CTZ). In the gastrointestinal tract, this enhances gastric motility, accelerates gastric emptying, strengthens lower oesophageal sphincter tone, and coordinates antro-duodenal peristalsis — collectively preventing the backward reflux of stomach contents into the oesophagus and relieving bloating and discomfort. At the CTZ, Domperidone effectively suppresses nausea and vomiting without crossing the blood-brain barrier, minimising central side effects such as sedation and extrapyramidal reactions
Together, by combining sustained acid suppression (Rabeprazole) with enhanced gastric motility and antiemetic action (Domperidone), RBM-DSR provides a comprehensive dual-mechanism approach to the management of GERD and associated gastrointestinal disorders — delivering faster, more complete, and more durable symptom relief than acid suppression alone.
Instructions to Take
- Take this capsule exactly as prescribed by your doctor
- Take 30 to 60 minutes before the first meal of the day (breakfast) for optimal acid suppression and prokinetic effect
- Swallow the sustained-release (SR) capsule whole with a full glass of plain water — do not crush, split, open, or chew as the sustained-release formulation is essential for proper drug delivery
- Take at the same time each day to maintain consistent gastric acid control and motility support
- Do not take antacids within 2 hours of taking this medicine unless specifically advised by your doctor
- Do not self-medicate, adjust the dose, or discontinue therapy without medical advice — even if symptoms improve significantly
- If a dose is missed, take it as soon as you remember — however, skip the missed dose if it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one
- Avoid trigger foods and beverages that worsen acid reflux including spicy foods, citrus, caffeine, and carbonated drinks
- Avoid large meals close to bedtime — eating at least 2 to 3 hours before lying down helps reduce reflux symptoms
- Avoid alcohol throughout the course of treatment
- Keep out of reach of children
- Store in a cool, dry place away from direct sunlight and moisture
Disclaimer: This information is intended for general reference purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before starting, changing, or stopping any medication.
