rabeprazole + bismuth

Rabeprazole + bismuth is a combination of two active pharmaceutical ingredients used primarily as part of multi-drug regimens for the eradication of *Helicobacter pylori* infection. Rabeprazole is a proton pump inhibitor that suppresses gastric acid secretion by inhibiting the gastric H+/K+ ATPase enzyme in parietal cells, thereby increasing gastric pH and enhancing the effectiveness of antibiotics against *H. pylori*. Bismuth compounds (such as bismuth subcitrate or subsalicylate) have antimicrobial activity against *H. pylori* and also protect the gastric mucosa by forming a protective barrier and exerting mild antisecretory effects. This combination is not typically marketed as a fixed-dose product but is widely used in clinical practice as part of quadruple therapy regimens with additional antibiotics (e.g., amoxicillin, tetracycline, clarithromycin, or furazolidone) for first-line or rescue treatment of *H. pylori*-associated peptic ulcer disease[1][6]. The combination leverages both acid suppression and direct antimicrobial action to improve eradication rates.