1. What is Rebamipide?

Rebamipide is a gastroprotective agent primarily used to treat various gastrointestinal (GI) disorders, including gastritis and peptic ulcers. It belongs to a class of medications known as mucosal protective agents, which work by enhancing the production of mucus in the gastrointestinal tract, thus providing a protective barrier to the lining of the stomach and intestines. Rebamipide has anti-inflammatory properties and can promote the healing of mucosal injuries caused by irritation, ulcers, or inflammatory conditions.

2. Dosage Forms and Strengths

Rebamipide is commonly available in the following dosage forms and strengths:

• Tablets: 100 mg
• Oral Suspension: Available in some formulations but less common than the tablet form.

The specific dosage and form prescribed depend on the patient's condition, age, and medical requirements.

3. Brand and Generic Names

• Generic Name: Rebamipide
• Brand Names: Mucosta (widely marketed in countries like Japan, China, and South Korea)

Other brand names may vary depending on the country and manufacturer.

4. Indications for Use

Rebamipide is primarily indicated for:

• Gastritis: Inflammation of the stomach lining, characterized by symptoms such as indigestion, nausea, and vomiting.
• Peptic Ulcers: Both gastric and duodenal ulcers, which are sores that develop on the lining of the stomach or small intestine.
• Mucosal Protection: Rebamipide can also be used to treat mucosal injuries caused by non-steroidal anti-inflammatory drugs (NSAIDs) or stress-induced ulcers.
• Dry Eye Syndrome: Some research supports the use of rebamipide in ophthalmic solutions for treating dry eyes by promoting mucin production on the ocular surface.

5. Mechanism of Action

Rebamipide works by promoting the production of prostaglandins in the gastric mucosa, which enhances mucus secretion and increases the flow of blood to the gastric lining. This helps protect the stomach's mucous membrane from damage caused by acid, bile, or medications such as NSAIDs.

The key mechanisms of rebamipide include:

• Increasing mucus production: This strengthens the mucosal barrier and prevents acid from eroding the stomach lining.
• Reducing inflammation: Rebamipide inhibits the release of inflammatory cytokines, which helps in healing mucosal injuries.
• Antioxidant properties: It reduces the damage caused by free radicals in the gastric lining, contributing to its protective effects.

6. Administration and Dosage

The typical administration of rebamipide is oral, with the following dosage guidelines:

• Standard adult dose: 100 mg taken orally three times a day (morning, afternoon, and evening) after meals.

The duration of treatment may vary based on the specific condition being treated. For gastritis, treatment is typically shorter, while peptic ulcers may require longer administration. The medication is generally well-tolerated and does not require dose adjustments for elderly patients or those with mild to moderate renal impairment. However, patients with severe kidney issues should consult their healthcare provider.

7. Side Effects and Precautions

While rebamipide is generally considered safe, it can have some side effects. These include:

• Common side effects:
  • Constipation
  • Diarrhea
  • Nausea
  • Abdominal pain
  • Headache
• Rare but serious side effects:
  • Hypersensitivity reactions, including rash and itching
  • Liver enzyme abnormalities
  • Blood disorders such as leukopenia (low white blood cell count)

Precautions:

• Pregnancy and breastfeeding: Limited data are available on the use of rebamipide during pregnancy and breastfeeding. It is advised to avoid use unless the potential benefits outweigh the risks.
• Drug interactions: Rebamipide has a low potential for drug interactions, but it may alter the effects of certain medications, including those that affect the gastrointestinal system.
• Renal impairment: Caution should be exercised in patients with severe renal impairment.

8. Conclusion

Rebamipide is a useful therapeutic agent for treating gastritis, peptic ulcers, and mucosal damage caused by various irritants. Its mechanism of action, centered on enhancing mucus production and reducing inflammation, makes it particularly effective for protecting the gastric mucosa. With its favorable safety profile and efficacy, rebamipide is a valuable medication in gastroenterology. However, as with any drug, it must be used under the guidance of a healthcare provider to minimize the risk of side effects and ensure proper treatment outcomes.

INDICATION AND DOSAGE OF REBAMIPIDE