This is a fixed combination of rabeprazole (a proton pump inhibitor that reduces stomach acid) and domperidone (a prokinetic medicine that helps the stomach empty more quickly and reduces nausea), used together for acid reflux symptoms accompanied by nausea, fullness, or delayed stomach emptying. It is a prescription-only medicine, widely used in India and similar markets.

• Therapeutic Class: Acid-reflux and prokinetic combination therapy.

• Pharmacological Class: Proton pump inhibitor (rabeprazole) plus dopamine D2 receptor antagonist/prokinetic (domperidone).

• Drug Family: Combination gastrointestinal therapy.

• ATC Classification: Not applicable as a single combined code; rabeprazole alone carries A02BC04, domperidone A03FA03.

Approved/established use: Gastro-oesophageal reflux disease (GERD), acid reflux with nausea or fullness, dyspepsia with delayed gastric emptying, and peptic ulcer disease.

Commonly used for: Patients with acid reflux symptoms who also experience nausea, bloating, or a sensation of delayed stomach emptying, where both acid suppression and a prokinetic effect are considered beneficial.

Off-label use (only under medical guidance): Not typically used off-label; use follows standard GERD/dyspepsia management guidance.

• Oral tablets/capsules: commonly rabeprazole 20 mg combined with domperidone 10 mg or 30 mg (sustained-release) — strengths vary by brand.

Rabeprazole blocks the proton pump in stomach cells that produces acid, significantly reducing overall stomach acid levels and allowing irritated tissue in the oesophagus or stomach to heal. Domperidone blocks dopamine receptors in the gut, which increases the strength and coordination of stomach contractions, helping food move through the stomach more quickly and reducing nausea by acting on a separate area involved in the vomiting reflex.

• Standard dose: One tablet/capsule (e.g., rabeprazole 20 mg/domperidone 30 mg sustained-release) taken orally once daily before a meal, typically in the morning.

• Condition-wise dose: Duration of treatment (typically a few weeks) is guided by the treating doctor based on symptom response and the specific condition being treated.

• Route: Oral, generally taken before meals, as directed.

• Missed dose: Take as soon as remembered unless close to the next dose; don't double up.

• Overdose: May worsen known side effects, including heart rhythm changes (from domperidone) or headache; requires medical attention.

• Common: Headache, dry mouth, and mild digestive upset.

• Serious: Heart rhythm changes (QT interval prolongation) with domperidone, particularly at higher doses or with certain risk factors; and, rarely, effects associated with long-term acid suppression (such as reduced vitamin B12 absorption).

• Emergency symptoms: An irregular or rapid heartbeat, fainting, or signs of a severe allergic reaction.

• Recovery advice: This combination is generally intended for short-term use; if symptoms persist beyond the prescribed course, this should be discussed with the doctor rather than continuing indefinitely without review.

• Pregnancy: Used only if clearly needed, under medical guidance.

• Breastfeeding: Used with medical guidance.

• Liver disease: Used with caution; both components are processed by the liver, so dose adjustment or closer monitoring may be needed.

• Kidney disease: Used with caution and medical guidance.

• Elderly: Used with particular caution regarding the domperidone component's heart rhythm effects, given increased cardiac risk in this age group.

• Children: Domperidone use in children is generally more restricted and guided by specific pediatric dosing recommendations; rabeprazole use in children requires specialist guidance.

• Other QT-prolonging medicines (e.g., certain antibiotics, antiarrhythmics, antipsychotics): combining with domperidone increases the risk of serious heart rhythm effects; these combinations are generally avoided.

• Strong CYP3A4 inhibitors (e.g., ketoconazole, certain antifungals): can increase domperidone levels, raising cardiac risk; combined use is generally avoided.

• Clopidogrel: proton pump inhibitors like rabeprazole may reduce the effectiveness of clopidogrel in some patients, though rabeprazole is considered to have a comparatively lower interaction potential than some other PPIs.

• Medicines requiring an acidic stomach for absorption (e.g., certain antifungals like ketoconazole): rabeprazole's acid-suppressing effect can reduce their absorption.

• ECG monitoring in patients with existing heart rhythm risk factors, particularly with longer-term domperidone use.

• Symptom review to confirm this combination remains appropriate and hasn't simply masked an underlying condition needing further investigation.

• Vitamin B12 levels with long-term proton pump inhibitor use, given reduced absorption over time.

Other proton pump inhibitors (e.g., omeprazole, pantoprazole, esomeprazole) combined with or without a prokinetic; Metoclopramide (an alternative prokinetic, though with a different side-effect profile).

This is itself a fixed combination; not typically combined with additional acid-suppressing or prokinetic medicines given overlapping mechanisms.

• GERD & Acid Reflux Medicines

• Proton Pump Inhibitors

• Prokinetic / Anti-Nausea Medicines

1. Stages, Diagnosis & Management Of GERD

2. Foods That Cause Constipation

3. Heartburn, Acid Reflux, Or GERD: What’s The Difference

4. What To Eat When You Have GERD

• https://www.truemeds.in/drug-salts/domperidone-rabeprazole-53

• https://pmc.ncbi.nlm.nih.gov/articles/PMC9505562/

The information on this page is for educational purposes only and is not a substitute for medical advice. Please consult your doctor to know if this treatment is appropriate for your condition.