Exclude malignancy in the presence of any alarm symptom (eg, significant unintentional wt loss, recurrent vomiting, dysphagia, haematemesis, anaemia or melaena) & when gastric ulcer is suspected or present. Slightly increased risk of GI infections caused by bacteria (eg, Salmonella, Campylobacter &
Clostridium difficile). PPIs are associated w/ very infrequent cases of subacute cutaneous lupus erythematosus; consider stopping treatment if lesions occur especially in sun-exposed skin areas & if accompanied by arthralgia. Increased Chromogranin A (CgA) level may interfere w/ investigations for neuroendocrine tumours; stop treatment for at least 5 days before CgA measurements. Not recommended w/ atazanavir. Discontinue treatment in patients w/ severe liver impairment. Not to be used during pregnancy unless clearly necessary. Decide on whether to continue/discontinue breast-feeding or continue/discontinue therapy taking into account the benefit of breast-feeding to the child & the benefit of therapy to women.