Esomeprazole Normon Special Precautions

Before giving Esomeprazole NORMON, check if patient has severe liver problems; severe kidney problems; if patient has ever had a skin reaction after treatment with a medicine similar to Esomeprazole NORMON that reduces stomach acid.
Esomeprazole NORMON may hide symptoms of other diseases. Therefore, be advised if any of the following happen to the patient before giving Esomeprazole NORMON or after it was given: Patient loses a lot of weight for no reason and has problems swallowing; patient gets stomach pain or indigestion; patient begins to vomit food or blood; patient passes black stools (blood-stained faeces).
Risk of bone fracture: Taking a proton pump inhibitor like Esomeprazole NORMON, especially over a period of more than one year, may slightly increase the risk of fracture in the hip, wrist or spine. Be advised if patient has osteoporosis or if he/she is taking corticosteroids (which can increase the risk of osteoporosis). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
Potential risk of low serum magnesium levels: Hypomagnesemia, symptomatic and asymptomatic, has been reported rarely in patients treated with proton pump inhibitors (PPIs) for at least three months, in most cases after a year of therapy. Serious adverse effects include tetany, arrhythmias, and seizures. In most patients, treatment of hypomagnesemia required magnesium replacement and discontinuation of the 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.
Clostridium difficile associated diarrhoea: Decreased gastric acidity due to any means, including proton pump inhibitors, increases gastric counts of bacteria normally present in the gastrointestinal tract. Treatment with proton pump inhibitors may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter and possibly Clostridium difficile.
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 NORMON. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.
Driving and using machines: Esomeprazole NORMON is not likely to affect ability to drive or use any tools or machines.