Esomeprazole Actavis Special Precautions

Talk to the physician or pharmacist before taking Esomeprazole Actavis: If the patient has severe liver problems; if the patient has severe kidney problems.
Subacute Cutaneous Lupus Erythematosus (SCLE): Proton pump inhibitors are associated with very infrequent cases of SCLE. If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly and the health care professional should consider stopping Esomeprazole Actavis. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.
Esomeprazole Actavis may hide the symptoms of other diseases. Therefore, if any of the following happen before the patient starts taking Esomeprazole Actavis or while the patient is taking it, talk to the physician straight away: If the patient loses a lot of weight for no reason and has problems swallowing; if the patient gets stomach pain or indigestion; if the patient begins to vomit food or blood; if the patient passes black stools (blood-stained faeces).
If the patient has been prescribed Esomeprazole Actavis "on demand" the patient should contact the physician if the symptoms continue or change in character.
Esomepazole is a CYP2C19 inhibitor. When starting or ending treatment with esomeprazole, the potential for interactions with drugs metabolised through CYP2C19 should be considered. An interactions is observed between clopidogrel and omperazole. The clinical relevance of this interaction is uncertain. As a precaution, concomitant use of esomeprazole and clopidogrel should be discouraged.
Taking a proton pump inhibitor like Esomeprazole Actavis, especially over a period of more than one year, may slightly increase the risk of fracture in the hip, wrist or spine. Tell the physician if the patient has osteoporosis or if the patient is taking corticosteroids (which can increase the risk of osteoporosis).
Long-term (a year or longer) and multiple daily dose PPI therapy may be associated with an increase for osteoporosis-related fractures of the hip, wrist or spine. Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
Hypomagnesemia, symptomatic and asymptomatic, has been reported rarely in patients treated with PPIs for at least three months, in most cases after a year of therapy. Serious adverse events include tetany, arrhythmias, and seizures. In most patients, treatment of hypomagnesemia required magnesium replacement and discontinuation of PPI.
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g. diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically.
Esomeprazole Actavis Contains Sucrose: Esomeprazole Actavis gastro-resistant tablets contain sugar spheres which contain sucrose, which is a type of sugar. If the patient has been told by the physician that the patient has intolerance to some sugars, talk to the physician before taking Esomeprazole Actavis.
Driving and Using Machines: Esomeprazole Actavis is not likely to affect the ability to drive or use any tools or machines. However, side effects such as dizziness and blurred vision may uncommonly or rarely occur (see Adverse Reactions). If affected, the patient should not drive or use machines.
Use in Children: Esomeprazole Actavis should not be used in children younger than 12 years. More appropriate pharmaceutical forms of this medicine may be available.