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Rabeprazole emerges as preferred PPI for GERD patients on polypharmacy

Polypharmacy Polypharmacy
Polypharmacy Polypharmacy

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Rabeprazole is the most preferred PPI for GERD patients on polypharmacy, driven by its minimal drug–drug interactions and favorable safety profile.

Tackling gastroesophageal reflux disease (GERD) in patients with multiple comorbidities and concurrent medications remains a clinical challenge, largely due to the risk of drug–drug interactions (DDIs). A recent survey of Indian healthcare professionals highlights growing confidence in rabeprazole as a safer and more effective option in such complex cases.

The cross-sectional survey gathered responses from healthcare professionals experienced in prescribing proton-pump inhibitors (PPIs). The questionnaire focused on prescribing patterns and challenges associated with polypharmacy in GERD management.

Key findings

  • Strong preference for rabeprazole: A significant 91.9% of healthcare professionals reported favoring rabeprazole over other PPIs for those receiving multiple medications.
  • Focus on drug interactions: About 73.3% of respondents consider cytochrome P450 (CYP450) enzyme interactions when choosing a PPI, underscoring the importance of minimizing DDIs.
  • Metabolic advantage: Rabeprazole’s nonenzymatic metabolism and limited reliance on the CYP450 system were cited as major reasons for its preference in polypharmacy settings.
  • Cardiovascular considerations: Around 70% of clinicians indicated that rabeprazole may help optimize outcomes in those on antiplatelet therapy, potentially supporting cardiovascular management.
  • Safety with antiplatelets: Approximately 74.4% of respondents endorsed its safety in patients receiving antiplatelet drugs.

The findings suggest that rabeprazole is widely perceived as a suitable PPI for GERD patients with comorbidities requiring multiple medications. Its reduced potential for drug interactions may yield a practical advantage, particularly in those on antiplatelet therapy or those at risk of adverse pharmacological interactions.

Source:

Journal of the Association of Physicians of India

Article:

Optimizing Proton-pump Inhibitor Therapy in Patients with Comorbidities Receiving Polypharmacy Treatment: Insights from Clinical Practice in India

Authors:

Hemant T Juneja et al.

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