Are there interactions between Pariet (Rabeprazole) and Escitalopram?

From the Guidelines

Pariet (rabeprazole) and escitalopram can be taken together without significant concerns, as the potential interaction is minimal and not typically strong enough to require dose adjustments. The study from 1 provides guidance on the use of SSRIs, including escitalopram, and notes that citalopram/escitalopram may have the least effect on CYP450 isoenzymes compared to other SSRIs, resulting in a lower propensity for drug interactions. Additionally, the study from 1 mentions that escitalopram has been studied in terms of pharmacokinetic interactions with other medications, but does not specifically address interactions with rabeprazole. However, given the lack of significant interaction between escitalopram and other medications, it is reasonable to assume that the interaction with rabeprazole would also be minimal.

Some key points to consider when taking these medications together include:

• Monitoring for signs of increased escitalopram levels, such as anxiety, tremors, or heart rhythm changes
• Informing your healthcare provider about all medications you're taking
• Taking the medications as prescribed
• Being aware that individual responses can vary based on factors like age, liver function, and other medications

It's always a good idea to consult with your healthcare provider if you have any concerns about taking Pariet and escitalopram together. They can provide personalized guidance and help you weigh the potential benefits and risks of taking these medications concurrently.

From the Research

Interactions between Pariet (Rabeprazole) and Escitalopram

• There is evidence to suggest that selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, may increase the risk of abnormal bleeding, including upper gastrointestinal (GI) bleeding 2.
• The risk of SSRI-associated GI bleeding is increased with the concurrent use of NSAIDs, anticoagulants, and antiplatelet agents, but is decreased by concurrent proton pump inhibitors (PPIs) such as rabeprazole 2.
• Escitalopram has been shown to inhibit platelet activity, which may contribute to its antiplatelet effects 3, 4.
• Rabeprazole, a PPI, has been shown to have a similar effect on platelet measures as famotidine, an H2 receptor antagonist, in patients taking dual antiplatelet therapy with clopidogrel and aspirin 5.
• There is no direct evidence of interactions between rabeprazole and escitalopram, but the combination of these two medications may increase the risk of bleeding due to their individual effects on platelet activity and gastric acid secretion 2, 3, 4, 5.

Mechanisms of Interaction

• Escitalopram may increase the risk of bleeding by inhibiting platelet activity and increasing gastric acid secretion 2, 3, 4.
• Rabeprazole may decrease the risk of bleeding by reducing gastric acid secretion, but may also interact with escitalopram to increase the risk of bleeding due to their combined effects on platelet activity 2, 5.

Clinical Implications

• Patients taking escitalopram and rabeprazole concurrently should be monitored for signs of bleeding, particularly upper GI bleeding 2.
• The combination of these two medications may be beneficial in patients at high risk of cardiovascular events, but may also increase the risk of bleeding in these patients 3, 4, 5.