The prevalence of acid-related disorders is substantially increasing globally due to the changing lifestyles adopted by the people. During the previous two decades, significant progress has been made in the diagnosis and management of acid-related disorders. The initiation of proper therapy is necessary to withstand the deleterious effect of gastric acid on the mucosal lining. Among the various antisecretory drugs available, those included under the class of proton pump inhibitors have proven to be most effective in treating acid-related disorders. Pantoprazole and rabeprazole are the ones commonly advised by clinicians to curtail the excess gastric acid secretion either in gastric, duodenal ulcers, or reflux disease. Despite being similar in their mechanism of action, both drugs differ in their pharmacological and clinical properties. The high pKa value of rabeprazole enabled it to have a rapid activation rate and hence faster onset of action and quick symptom control in contrast to pantoprazole. However, the duration of action is relatively shorter for rabeprazole as it readily dissociates from the H+K+ATPase system. Further, rabeprazole maintains higher intragastric pH throughout the 24 hours post its first and subsequent single-dose administration than pantoprazole. These factors entitle rabeprazole to be more efficient than pantoprazole. Nonetheless, the clinician has to determine which drug to be selected depending on the degree and duration of acid suppression required for an individual patient.
