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Aciphex Side Effects

Generic Name: rabeprazole

Note: This page contains information about the side effects of rabeprazole. Some of the dosage forms included on this document may not apply to the brand name Aciphex.

In Summary

Common side effects of Aciphex include: atrophic gastritis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to rabeprazole: oral capsule delayed release, oral tablet enteric coated

In addition to its needed effects, some unwanted effects may be caused by rabeprazole (the active ingredient contained in Aciphex). In the event that any of these side effects do occur, they may require medical attention.

Severity: Major

You should check with your doctor immediately if any of these side effects occur when taking rabeprazole:

Less common:
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • cough or hoarseness
  • dark urine
  • dry mouth
  • fever or chills
  • general tiredness and weakness
  • light-colored stools
  • lower back or side pain
  • nausea and vomiting
  • painful or difficult urination
  • rapid weight gain
  • tingling of the hands or feet
  • unusual weight gain or loss
  • yellow eyes and skin
  • Bloody urine
  • continuing ulcers or sores in the mouth
  • convulsions (seizures)
  • difficulty with breathing
  • sore throat
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Incidence not known:
  • Back, leg, or stomach pains
  • bleeding gums
  • blood in the urine or stools
  • bloody, black, or tarry stools
  • change in consciousness
  • clay-colored stools
  • cloudy urine
  • confusion about identity, place, person, and time
  • continuing nausea or vomiting
  • difficulty with swallowing
  • dizziness
  • drowsiness
  • fast heartbeat
  • general body swelling
  • general feeling of tiredness or weakness
  • greatly decreased frequency of urination or amount of urine
  • headache
  • high fever
  • hives
  • holding false beliefs that cannot be changed by fact
  • increase in the frequency of seizures
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • loss of consciousness
  • mood or mental changes
  • muscle cramps
  • muscle pain or stiffness
  • muscle spasms (tetany) or twitching
  • no blood pressure
  • no breathing
  • no pulse
  • nosebleeds
  • pale skin
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seeing, hearing, or feeling things that are not there
  • seizures
  • skin blisters
  • skin rash
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • tightness in the chest
  • trembling
  • unpleasant breath odor
  • unusual excitement, nervousness, or restlessness
  • vomiting of blood

Severity: Minor

Some of the side effects that can occur with rabeprazole may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Bad, unusual, or unpleasant (after) taste
  • change in taste
Less common
  • Body aches or pain
  • congestion
  • constipation
  • diarrhea
  • excess air or gas in the stomach or intestines
  • feeling weak
  • full feeling
  • heartburn
  • numbness, tingling, pain, or weakness in the hands or feet
  • pain
  • passing gas
  • runny nose
  • sleepiness
  • swollen joints
  • tender, swollen glands in the neck
  • voice changes
Incidence not known:
  • Blistering, peeling, or loosening of the skin
  • red, irritated eyes
  • red skin lesions, often with a purple center

For Healthcare Professionals

Applies to rabeprazole: oral delayed release capsule, oral delayed release tablet, oral tablet extended release


Rabeprazole (the active ingredient contained in Aciphex) is generally well tolerated. The adverse event rates were generally similar between the 10 and 20 mg doses.[Ref]


Any drug which increases gastric pH would be anticipated to stimulate release of gastrin. Animal studies have demonstrated an increase in plasma gastrin concentrations following the administration of rabeprazole (the active ingredient contained in Aciphex) In addition, lifelong high-dose animal studies have revealed a dose-related increase in the incidence of gastric enterochromaffin-like (ECL) cell carcinoids (especially in female rats). However, to date, human studies of up to 1 year have not found any suggestion of gastric carcinoid formation due to rabeprazole use.[Ref]

Oncologic side effects have not been reported.[Ref]


Gastrointestinal side effects have included diarrhea, nausea, abdominal pain, vomiting, dyspepsia, flatulence, constipation, dry mouth, eructation, gastroenteritis, rectal hemorrhage, melena, anorexia, cholelithiasis, mouth ulceration, stomatitis, dysphagia, gingivitis, cholecystitis, increased appetite, abnormal stools, colitis, and esophagitis. Rarely, cholangitis, duodenitis, salivary gland enlargement, and thirst have also been reported.[Ref]

Nervous system

Nervous system side effects have included headache (2.4%), insomnia, anxiety, dizziness, depression, nervousness, somnolence, hypertonia, neuralgia, vertigo, convulsion, abnormal dreams, decreased libido, neuropathy, and tremor. Agitation, amnesia, confusion, extrapyramidal syndrome, and hyperkinesia have rarely been reported. Hand and facial numbness have also been reported.[Ref]


Endocrine side effects have included gynecomastia, breast enlargement in females, and breast tenderness.[Ref]


Dermatologic side effects have included rash, pruritus, sweating, urticaria, photosensitivity, and alopecia. Rare reports of dry skin, psoriasis, and skin discoloration have also been reported.[Ref]


Hepatic side effects have included rare cases of hepatic encephalopathy, hepatitis, hepatoma, and fatty deposits in liver.[Ref]


Respiratory side effects have included dyspnea, asthma, epistaxis, laryngitis, hiccup, and hyperventilation. Rare reports of apnea and hypoventilation have also been reported.[Ref]


Genitourinary side effects have included cystitis, urinary frequency, dysmenorrhea, and dysuria. Rare reports of impotence, hematuria, orchitis, and urinary incontinence have also been reported.[Ref]


Cardiovascular side effects have included rare reports of angina, tachycardia, sinus bradycardia, palpitations, hypertension, myocardial infarction, syncope, angina pectoris, bundle branch block, palpitations, supraventricular tachycardia, and peripheral edema. Electrocardiogram abnormalities have also been reported.[Ref]


Hematologic side effects have included rare reports of anemia, ecchymosis, lymphadenopathy, and hypochromic anemia.[Ref]


Hypersensitivity side effects have included fever, allergic reaction, chills, malaise, and face edema.[Ref]


Metabolic side effects have included weight gain, gout, dehydration, and weight loss. FDA warns that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year). Patients who develop hypomagnesemia may experience seizures, dizziness, abnormal or fast heart beat, or skipped heartbeat, jitteriness, jerking movements or tremors, muscle weakness, spasms of the hands and feet, cramps or muscle aches, and spasm of the voice box.[Ref]


Musculoskeletal side effects have included myalgia, arthritis, leg cramps, muscle spasm (tetany) bone pain, bone fracture, arthrosis, bursitis, and rarely rhabdomyolysis. Hip fracture and muscle stiffness have also been reported.[Ref]

An increased risk of hip fracture has been reported. This risk is significantly increased among patients prescribed long-term high dose PPIs.[Ref]


Ocular side effects have included cataract, amblyopia, glaucoma, dry eyes, and abnormal vision. Cornea opacity, blurry vision, diplopia, eye pain, and retinal degeneration have been reported rarely. Ocular lesions have also been reported.[Ref]


Psychiatric side effects have included insomnia, anxiety, depression, nervousness, somnolence, abnormal dreams, decreased libido, agitation, amnesia, confusion, and panic reaction. A least one case of marked anxiety associated with panic attacks, night terror (pavor nocturnus), episodic mental confusion, and attention deficit has been reported.[Ref]

A 55-year-old female with dyspepsia experienced marked anxiety associated with panic attacks, night terror (pavor nocturnus), episodic mental confusion, and attention deficit coincident with rabeprazole therapy. She presented with the neuropsychiatric manifestations 10 days after being administered rabeprazole 20 mg per day. Within two days of discontinuing rabeprazole, she recovered completely.[Ref]


Renal side effects have included at least one case of interstitial nephritis.[Ref]

A 57-year-old male with diverticulosis, esophageal reflux due to diaphragmatic hernia, and eczema experienced interstitial nephritis coincident with rabeprazole therapy. He was administered rabeprazole 20 mg daily for esophagitis. Renal biopsy revealed interstitial nephritis with unspecified glomerular sclerosis with predominantly interstitial changes. His condition improved when rabeprazole was withdrawn.[Ref]


1. "Product Information. Aciphex (rabeprazole)" Janssen Pharmaceuticals, Titusville, NJ.

2. Richardson P, Hawkey CJ, Stack WA "Proton pump inhibitors. Pharmacology and rationale for use in gastrointestinal disorders." Drugs 56 (1998): 307-35

3. Prakash A, Faulds D "Rabeprazole." Drugs 55 (1998): 261-7;disc. 268

4. Martin de Argila C "Safety of potent gastric acid inhibition." Drugs 65 Suppl 1 (2005): 97-104

5. Stack WA, Knifton A, Thirlwell D, Cockayne A, Jenkins D, Hawkey CJ, Atherton JC "Safety and efficacy of rabeprazole in combination with four antibiotic regimens for the eradication of Helicobacter pylori i patients with chronic gastritis with or without peptic ulceration." Am J Gastroenterol 93 (1998): 1909-13

6. Polimeni G, Cutroneo P, Gallo A, Gallo S, Spina E, Caputi AP "Rabeprazole and psychiatric symptoms." Ann Pharmacother 41 (2007): 1315-7

7. Yang YX, Lewis JD, Epstein S, Metz DC "Long-term proton pump inhibitor therapy and risk of hip fracture." JAMA 296 (2006): 2947-53

8. Harmark L, van der Wiel HE, de Groot MC, van Grootheest AC "Proton pump inhibitor-induced acute interstitial nephritis." Br J Clin Pharmacol (2007):

Not all side effects for Aciphex may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.