Should not be taken for >4 wk or as preventive measure. Risk of reduced vit B
12 absorption, & vit B
12 deficiency if body stores of vit B
12 are already low. Consider monitoring of Mg levels prior to treatment initiation & periodically during treatment. Treatment may lead to slightly increased risk of GI infections eg, Salmonella, Campylobacter, & possibly
Clostridium difficile. Long-term therapy (≥1 yr) & multiple daily doses may be associated w/ increased risk for osteoporosis-related fractures of the hip, wrist or spine. Subacute cutaneous lupus erythematosus (SCLE) after previous PPI treatment may increase risk of SCLE w/ other PPIs. Reports of serious skin reactions including SJS, TEN, DRESS & erythema multiforme. Caution in patients treated for heartburn or indigestion continuously for ≥4 wk; patients >55 yr taking non-prescription indigestion treatment daily or w/ any new or recently changed reflux symptoms; patients w/ previous gastric ulcer or stomach surgery; patients w/ liver problems or jaundice; patients w/ regular serious complaints or conditions; patients due to have endoscopy, C-urea breath test, or chromogranin A blood test; patients w/ history of skin reaction after treatment w/ medicine that reduces stomach acid. Concomitant use w/ MTX. Patients who experience dizziness or disturbed vision should not drive or use machines. Should not be taken while pregnant or breast-feeding. Should not be used by childn & adolescents <18 yr.