Exclude possibility of tumours (gastric malignancy) prior to treatment. Keep patients on long-term treatment under regular surveillance. May reduce absorption of vit B12
. Monitor Mg levels prior to initiation & periodically in patients expected to be on prolonged treatment or when co-administered w/ medications that may cause hypomagnesaemia. Increased risk for osteoporosis-related fractures. Excessive unintentional wt loss, persistent vomiting, difficulty swallowing, vomiting blood or blood in faeces. Seriously reduced kidney function; severe liver problems. Glucose & sucrose intolerance. Increased risk for GI infections eg, Salmonella
& possibly Clostridium difficile
. Consider stopping treatment if lesions occur, especially in sun-exposed areas of the skin, & if accompanied by arthralgia. Fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency. Stop treatment at least 5 days before Chromogranin A measurements. Pregnancy & lactation.