Zarirab-D Capsule is used to treat symptoms of acid reflux due to hyperacidity, stomach ulcer (Peptic ulcer disease), and Zollinger-Ellison syndrome (overproduction of acid due to a pancreatic tumour). Besides this, it is used short-term to treat gastroesophageal reflux disease (GERD) symptoms. GERD is a condition in which the sphincter (valve) located at the uppermost part of the stomach gets irritated and damaged due to excessive stomach acid production. As a result, the stomach acid and juice flow back into the food pipe, leading to stomach upset and heartburn. Heartburn is the post-effect of acid reflux with a burning-like feeling that rises from the stomach towards the neck.

Zarirab-D Capsule contains two medicines, namely Rabeprazole and Domperidone. Rabeprazole is a proton pump inhibitor that helps reduce stomach acid by blocking the actions of an enzyme (H+/K+ ATPase or gastric proton pump). This gastric proton pump lies in the cells of the stomach wall. It is responsible for releasing gastric acid secretion and damaging tissues in the food pipe, stomach, and duodenum (uppermost part of the small intestine). On the other hand, Domperidone is a prokinetic agent that increases the motility of the upper gastrointestinal tract and blocks the vomiting-inducing centre (chemoreceptor trigger zone-CTZ).

It is better to take Zarirab-D Capsule an hour before a meal or without a meal for its best results. Zarirab-D Capsule should be swallowed whole with a glass of water. Do not chew, crush, or break it. You should keep taking this medicine for as long as your doctor recommends. If you stop treatment too early, your symptoms may come back, and your condition may worsen. An adult taking Zarirab-D Capsule might have common side effects like headache, diarrhoea, nausea, abdominal pain, vomiting, flatulence, dizziness, and arthralgia (joint pain). In the case of children taking Zarirab-D Capsule , they might report upper respiratory tract infections (URI), headache, fever, diarrhoea, vomiting, rash, and abdominal pain. These side effects are temporary and may resolve after some time; however, if this persists, contact the doctor.

You can increase the efficacy of Zarirab-D Capsule by taking a small meal or snacks frequently. Avoid caffeine-containing beverages (coffee, tea), spicy/deep-fried/processed foods, carbonated drinks, and acidic foods like citrus fruits/vegetables (tomatoes). Tell your doctor if you have stomach or intestinal cancer, liver problems, are allergic to Zarirab-D Capsule or will have an endoscopy in the future. Prolonged intake of Zarirab-D Capsule may cause a deficiency of Vitamin B-12 and low levels of calcium, magnesium, and Vitamin D, leading to osteoporosis (brittle or weak bones).

Zarirab-D Capsule helps in reducing the excess amount of stomach. In turn, it prevents the formation of an ulcer in the upper part of the intestine (duodenal ulcer), gastro-esophagal reflux disease (GERD) with or without ulcer and Zollinger-Ellison Syndrome, in which the stomach makes exceptionally high amounts of acid. Besides, the Zarirab-D Capsule also treats symptoms of nausea and vomiting in adults and children over 12 years of age (with at least 35 kg or more).

• Rash

• Brittle bones

• Low vitamin B-12

• Loss of libido (sexual desire)

• Cough

• Sore throat

• Runny nose

• Flatulence (gas formation)

• Back pain

• Weakness or loss of strength

• Sleeplessness

• Headache

• Dizziness

• Benign polyps in the stomach

You should avoid taking Zarirab-D Capsule if you are allergic to Zarirab-D Capsule or proton pump inhibitors, have gastric cancer, liver disease, low magnesium level (osteoporosis), low vitamin B12, are pregnant or planning for pregnancy, and breastfeeding mothers. Zarirab-D Capsule may interact with a blood thinner (warfarin), antifungal (ketoconazole), anti-HIV drug (atazanavir, nelfinavir), iron supplements, ampicillin antibiotic, anti-cancer drug (methotrexate). Let your doctor know if you are taking these medicines. Prolonged intake of Zarirab-D Capsule may cause lupus erythematosus (an inflammatory condition in which the immune system attacks its tissues), Vitamin B-12, and magnesium deficiency. Intake of Zarirab-D Capsule may mask the symptom of gastric cancer, so if you have any severe stomach pain or gastric bleeding (blood in mucous or stool), immediately consult the doctor. Tell your doctor that you are using before having a specific blood test known as Chromogranin A.

Drug-Drug Interactions: Zarirab-D Capsule may interact with a blood thinner (clopidogrel, warfarin), antifungal (ketoconazole, voriconazole, itraconazole, fluconazole, posaconazole), anti-HIV drug (atazanavir, amprenavir, nelfinavir), antacid (magnesium hydroxide, aluminium hydroxide, cimetidine), iron supplements, antibiotics (clarithromycin, erythromycin, ampicillin, rifampicin), heart medicine (atropine, digoxin, amiodarone), blood pressure-lowering medicines (diltiazem), anti-cancer drug (methotrexate) and anti-nausea pills (aprepitant).

Drug-Food Interactions: Zarirab-D Capsule interacts with St John's wort plant that is used as an anti-depressant. This plant may affect the working of Zarirab-D Capsule . So avoid its intake with Zarirab-D Capsule .

Drug-Disease Interactions: Zarirab-D Capsule should not be given in patients with C. difficile-induced colitis, liver disease, bone fractures, low Vitamin B12 (anaemia), and low magnesium (hypomagnesemia).

• CLOPIDOGREL
• WARFARIN
• KETOCONAZOLE
• VORICONAZOLE
• ITRACONAZOLE
• FLUCONAZOLE
• ATAZANAVIR
• AMPRENAVIR
• NELFINAVIR
• MAGNESIUM+ALUMINIUM HYDROXIDE
• CIMETIDINE
• IRON
• ERYTHROMYCIN
• RIFAMPICIN
• ATROPINE
• DIGOXIN
• AMIODARONE
• DILTIAZEM
• METHOTREXATE
• CLARITHROMYCIN

• Avoid intake of acid or heartburn-triggering foods or drinks like onions, peppermint, chocolate, caffeinated beverages, citrus fruits or juices, tomatoes and high-fat and spicy foods.

• Avoid taking alcohol and smoking cigarette. Alcohol can raise the level of production of stomach acid leading to heartburn and acid reflux. On the other hand, nicotine smoking damages the valve (sphincter), preventing stomach acid backflow into the food pipe.

• Avoid regular sitting continuously, as it can increase stomach acid production. Try to take a break of 5 minutes in 1 hour by brisk walking or stretching.

• Before going to sleep, try to raise your bedhead so that your head and chest are higher than your feet. Do not use piles of pillows, instead, one raised block is fine. This will not allow the stomach acid to backflow through your food pipe.

• Include high fibre containing foods, berries, cherries, leafy green veggies (kale, spinach) and black peppers in your meal. These foods are full of antioxidants, calcium and vitamin B 12 that can help cope with the long-term effects of the medicine. Fermented dairy products like miso, sauerkraut, and kimchi contain probiotics which help in the prevention of excess stomach acid production. Cranberry juice can be beneficial in the peptic ulcer and H Pylori infection.

• Do not take Zarirab-D Capsule for more than four weeks of duration without consulting the doctor.

Usually, a thick layer of mucous usually protects the stomach against its acid secretion. But, in the long run, it gets eroded by excessive stomach acid production leading to complications like GERD, peptic ulcer, and Zollinger Ellison syndrome. Gastroesophageal reflux disease (GERD) is a gastrointestinal problem that occurs when stomach acid frequently flows back into the food pipe (oesophagus). This backflow (acid reflux) irritates the food pipe that causes heartburn. On the other hand, a peptic ulcer is a painful condition followed by the development of sores or ulcers in the stomach lining or duodenum (first part of the small intestine) (the duodenum). Zollinger Ellison syndrome is a rare condition in which a gastrin-secreting pancreas tumour causes excessive acid production leading to peptic ulcers.