Symptomatic response to therapy does not preclude the presence of gastric malignancy. Rare reports of symptomatic & asymptomatic hypomagnesemia in patients treated w/ PPIs for at least 3 mth, in most cases after a yr of therapy. Monitor Mg levels prior to treatment initiation & periodically in patients expected to be on prolonged treatment or those w/ concomitant digoxin or drugs that may cause hypomagnesemia (eg, diuretics). Increased risk for osteoporosis-related fractures of the hip, wrist or spine w/ long-term therapy (≥1 yr) & multiple daily doses. Slightly increased risk of GI infections eg, Salmonella, Campylobacter, & possibly
Clostridium difficile. Associated w/ very infrequent cases of subacute cutaneous lupus erythematosus; consider stopping therapy if lesions occur, especially in sun-exposed areas of the skin & if accompanied by arthralgia. Should not be given during pregnancy & lactation unless considered essential. No experience in childn.
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