November 27, 2015
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"Dec. 20, 2010 -- New research suggests that one out of every 200 patients being treated with gastric acid-suppressive drugs for heartburn and other conditions may develop pneumonia.

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Aciphex Side Effects Center

Medical Editor: Charles Patrick Davis, MD, PhD

Last reviewed on RxList 6/19/2015

Aciphex (rabeprazole sodium) is a proton pump inhibitor (PPI) to reduce stomach acid and is used for the treatment of gastroesophageal reflux disease (GERD), duodenal ulcers, and used in combination with antibiotics to treat Helicobacter pylori (H. pylori) bacterial infections in the stomach. Aciphex is available as generic termed rabeprazole sodium. Common side effects of Aciphex may include rash or itching, upset stomach, diarrhea, gas, sore throat, headache, insomnia, or nervousness.

Aciphex is available in 20 mg strength enteric-coated tablets. The usual dose of Aciphex is one 20 mg tablet per day for 4 to 8 weeks. Serious side effects of Aciphex may include hepatitis, encephalopathy, dizziness, edema, arthralgia, and muscle pains. Use of Aciphex may increase the availability of warfarin (Coumadin). Use of Aciphex in combination with amoxicillin and clarithromycin does not apparently change the side effects, but the reader is advised to not combine these drugs to treat Helicobacter without informing their doctor because of other side effects possible from the antibiotics. Pregnant women and their doctors need to balance the need vs the potential problems of Aciphex in pregnancy and breastfeeding. Aciphex has been used in pediatric patients, aged 12 and above for GERD treatment; no studies under age 12 are available.

Our Aciphex Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Aciphex in Detail - Patient Information: Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using rabeprazole and call your doctor at once if you have symptoms of low magnesium such as:

  • dizziness, confusion;
  • fast or uneven heart rate;
  • jerking muscle movements;
  • feeling jittery;
  • diarrhea that is watery or bloody;
  • muscle cramps, muscle weakness or limp feeling;
  • cough or choking feeling; or
  • seizure (convulsions).

Less serious side effects may include:

  • headache;
  • upset stomach, mild diarrhea;
  • insomnia or nervousness; or
  • a rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Aciphex (Rabeprazole Sodium)

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Aciphex Overview - Patient Information: Side Effects

SIDE EFFECTS: Headache may occur. If this effect persists or worsens, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: symptoms of a low magnesium blood level (such as unusually fast/slow/irregular heartbeat, persistent muscle spasms, seizures).

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of bacteria. Do not use anti-diarrhea products or narcotic pain medications if you have any of the following symptoms because these products may make them worse. Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, fever, blood/mucus in your stool.

Rarely, proton pump inhibitors (such as rabeprazole) have caused vitamin B-12 deficiency. The risk is increased if they are taken every day for a long time (3 years or longer). Tell your doctor right away if you develop symptoms of vitamin B-12 deficiency (such as unusual weakness, sore tongue, or numbness/tingling of the hands/feet).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, kidney problems (such as change in the amount of urine).

This is not a complete list of possible side effects. If you notice other effects, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Aciphex (Rabeprazole Sodium)

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Aciphex FDA Prescribing Information: Side Effects
(Adverse Reactions)


Worldwide, over 2900 patients have been treated with rabeprazole in Phase II-III clinical trials involving various dosages and durations of treatment.

Because clinical trials are conducted under varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Clinical Studies Experience


The data described below reflect exposure to ACIPHEX in 1064 adult patients exposed for up to 8 weeks. The studies were primarily placebo-and active-controlled trials in adult patients with Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD), Duodenal Ulcers, and Gastric Ulcers. The population had a mean age of 53 years (range 18-89 years) and had a ratio of approximately 60% male: 40% female. The racial distribution was 86% Caucasian, 8% African American, 2% Asian, and 5% other. Most patients received either 10 mg, 20 mg, or 40 mg/day of ACIPHEX.

An analysis of adverse reactions appearing in ≥ 2% of ACIPHEX patients (n=1064), and with a greater frequency than placebo (n=89) in controlled North American and European acute treatment trials, revealed the following adverse reactions: pain (3% vs. 1%), pharyngitis (3% vs. 2%), flatulence (3% vs. 1%), infection (2% vs. 1%), and constipation (2% vs. 1%).

Three long-term maintenance studies consisted of a total of 740 adult patients; at least 54% of adult patients were exposed to rabeprazole for 6 months and at least 33% were exposed for 12 months. Of the 740 adult patients, 247 (33%) and 241 (33%) patients received 10 mg and 20 mg of ACIPHEX, respectively, while 169 (23%) patients received placebo and 83 (11%) received omeprazole.

The safety profile of rabeprazole in the maintenance studies in adults was consistent with what was observed in the acute studies.

Other adverse reactions seen in controlled clinical trials, which do not meet the above criteria ( ≥ 2% of ACIPHEX-treated patients and greater than placebo) and for which there is a possibility of a causal relationship to rabeprazole, include the following: headache, abdominal pain, diarrhea, dry mouth, dizziness, peripheral edema, hepatic enzyme increase, hepatitis, hepatic encephalopathy, myalgia, and arthralgia.

Combination Treatment with Amoxicillin and Clarithromycin: In clinical trials using combination therapy with rabeprazole plus amoxicillin and clarithromycin (RAC), no adverse reactions unique to this drug combination were observed. In the U.S. multicenter study, the most frequently reported drug related adverse reactions for patients who received RAC therapy for 7 or 10 days were diarrhea (8% and 7%) and taste perversion (6% and 10%), respectively.

No clinically significant laboratory abnormalities particular to the drug combinations were observed.

For more information on adverse reactions or laboratory changes with amoxicillin or clarithromycin, refer to their respective package prescribing information, Adverse Reactions section.


In a multicenter, open-label study of adolescent patients 12 to 16 years of age with a clinical diagnosis of symptomatic GERD or endoscopically proven GERD, the adverse event profile was similar to that of adults. The adverse reactions reported without regard to relationship to ACIPHEX that occurred in ≥ 2% of 111 patients were headache (9.9%), diarrhea (4.5%), nausea (4.5%), vomiting (3.6%), and abdominal pain (3.6%). The related reported adverse reactions that occurred in ≥ 2% of patients were headache (5.4%) and nausea (1.8%). There were no adverse reactions reported in this study that were not previously observed in adults.

In a two-part, randomized, multicenter, double-blind, parallel-group study, 127 pediatric patients 1 to 11 years of age with endoscopically proven GERD received either 5 mg or 10 mg ( < 15 kg body weight) or 10 mg or 20 mg ( > 15 kg body weight) rabeprazole. In this study, some patients were exposed to rabeprazole for 36 weeks. Adverse reactions that occurred in ≥ 5% of patients included abdominal pain (5%), diarrhea (5%), and headache (5%). There were no adverse reactions reported in this study that were not previously observed in trials of adolescents and adults.

Postmarketing Experience

The following adverse reactions have been identified during post approval use of ACIPHEX. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure: sudden death; coma, hyperammonemia; jaundice; rhabdomyolysis; disorientation and delirium; anaphylaxis; angioedema; bullous and other drug eruptions of the skin; severe dermatologic reactions, including toxic epidermal necrolysis (some fatal), Stevens-Johnson syndrome, and erythema multiforme; interstitial pneumonia; interstitial nephritis; TSH elevations; bone fractures; hypomagnesemia and Clostridium difficile associated diarrhea. In addition, agranulocytosis, hemolytic anemia, leukopenia, pancytopenia, and thrombocytopenia have been reported. Increases in prothrombin time/INR in patients treated with concomitant warfarin have been reported.

Read the entire FDA prescribing information for Aciphex (Rabeprazole Sodium)

Aciphex - User Reviews

Aciphex User Reviews

Now you can gain knowledge and insight about a drug treatment with Patient Discussions.

Here is a collection of user reviews for the medication Aciphex sorted by most helpful. Patient Discussions FAQs

Report Problems to the Food and Drug Administration


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