Gastro 20 Tablet contains Rabeprazole 20 mg, a proton pump inhibitor (PPI) used to reduce gastric acid secretion in the treatment of various acid-related gastrointestinal disorders. Rabeprazole acts by selectively inhibiting the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells, thereby suppressing the final step of acid production. This results in a significant and prolonged decrease in gastric acidity. Gastro 20 is indicated for the management of gastroesophageal reflux disease (GERD), erosive esophagitis, Zollinger-Ellison syndrome, and peptic ulcer disease, including Helicobacter pylori eradication protocols when used in combination with appropriate antibiotics. The tablet is typically administered orally once daily, preferably before meals, to optimize therapeutic outcomes. Rabeprazole is generally well tolerated; common adverse effects may include headache, nausea, abdominal pain, and diarrhea. Caution is advised in patients with hepatic impairment, and long-term use should be monitored due to potential risks such as vitamin B12 deficiency and increased susceptibility to gastrointestinal infections. Gastro 20 should be used under medical supervision, with dosage adjustments as necessary based on clinical response and patient condition.