Exclude gastric malignancy in presence of alarming symptom eg, significant unintentional wt loss, recurrent vomiting, dysphagia, haematemesis, anaemia or melaena. Increased risk of GI infections caused by bacteria; osteoporosis-related hip, wrist or spine fractures; Clostridium difficile
-associated diarrhea. Severe hypomagnesaemia; subacute cutaneous lupus erythematosus. Vit B12
malabsorption due to hypo- or achlorhydria. Ensure adequate intake of vit D & Ca. Long-term & high-dose use. Discontinue use at least 5 days prior to chromogranin A measurements. May cause allergic reaction due to colouring agent. Not recommended w/ HIV PIs eg, atazanavir. Concomitant use w/ digoxin or substances causing hypomagnesemia eg, diuretics. May affect ability to drive & use machines. Severe hepatic impairment. Avoid use during pregnancy. Lactation. Not recommended in childn <12 yr.