General: Symptomatic response to therapy with Rabeprazole does not preclude the presence of gastric malignancy.
Renal impairment: Peptard-D should be used with caution in patients with renal impairment or in those at risk of fluid retention. In patients with severe renal insufficiency (serum creatinine more than 6 mg/100 ml, ie. more than 0.6 mmol/L) the elimination half-life of domperidone was increased. The dosing frequency should be altered depending on the severity of impairment, and the dose may need to be reduced. Patients on prolonged therapy should be reviewed regularly.
Hepatic impairment: Since domperidone is highly metabolized in the liver, Peptard-D should be used with caution in patients with hepatic impairment.
Use in Pregnancy: There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Use in Lactation: Since many drugs are excreted in milk, caution should be exercised when this drug is administered to a nursing mother.
Pediatric use: The safety and effectiveness of Rabeprazole and domperidone in pediatric patients have not been established.