Use In Combination With Antibacterial Agents
Patients who are allergic to antibacterial agents (clarithromycin and amoxicillin) should take precaution when using with Pro-Rabeprazole.
Stomach Cancer (Gastric Malignancy)
Treatment with Pro-Rabeprazole does not prevent the presence of stomach ulcers
in these patients.
Patients on prolonged treatment (at least three months or years) or who are taking Pro-Rabeprazole with digoxin or may cause the deficiency of magnesium are at an increased risk. This may cause harmful effects like seizures
, muscle spasm, increase or decrease in heartbeat, dizziness
, disturbance in mental abilities and fatigue
. Treatment of low magnesium level in the blood can be improved by magnesium replacement or discontinuation of Pro-Rabeprazole.
Use With Methotrexate
When Pro-Rabeprazole is used with methotrexate, it may increase the level of methotrexate in the blood. In case of high dose intake of methotrexate, a temporary withdrawal of Pro-Rabeprazole should be considered.
Stomach And Intestinal Infection
Patients who are taking Pro-Rabeprazole are at an increased risk. Pro-Rabeprazole increases the count of bacteria in the stomach and intestine. It may increase the risk of infection caused by Salmonella
and Clostridium difficile.
Interference With Laboratory Tests
Increased Chromogranin A (protein) level may interfere with the test for both neural and endocrine cancer
). To avoid this interference, Pro-Rabeprazole should be discontinued for at least 5 days before chromogranin A measurements.
Subacute Cutaneous Lupus Erythematosus
Pro-Rabeprazole may cause subacute cutaneous lupus
erythematosus, lesion and pain
in a joints (arthralgia). Immediate medical help and discontinuation of proton pump inhibitors should be considered on the occurrence of lesions and pain in joints (arthralgia).
Use With Warfarin
Use of Pro-Rabeprazole with warfarin increases the levels of blood parameters such as blood clotting time which may lead to abnormal bleeding
and may cause a fatality. Blood parameters should be monitored in patients taking Pro-Rabeprazole with warfarin.
Inflammation Within The Kidneys
Patients who are taking Pro-Rabeprazole are at an increased risk. Pro-Rabeprazole may cause inflammation in the kidneys which lead to unknown harmful allergic reactions in the body. If a patient develops inflammation in the kidneys, discontinue the use of Pro-Rabeprazole.
Vitamin B-12 Deficiency
Patients who are taking Pro-Rabeprazole are at an increased risk. Long-term (more than 3 years) use of acid-suppressing agents may lead to vitamin
B-12 deficiency due to the absence of hydrochloric acid in the stomach. Diagnosis should be considered if these clinical symptoms persist.
Bacteria (Clostridium difficile) Associated Diarrhea
Patients who are taking Pro-Rabeprazole are at an increased risk. The use of Pro-Rabeprazole with clarithromycin or amoxicillin may cause bacteria associated diarrhea
. Patients with bacteria associated diarrhea should take the lowest dose of Pro-Rabeprazole for short period of time.
Patients with bone weakness related fractures
are at an increased risk when using Pro-Rabeprazole for the longer period of time or taking its high doses. Long-term use or high doses of Pro-Rabeprazole may increase the risk of fractures of the wrist, hip, or spine. Patients with bone weakness related fractures should take the lowest dose of Pro-Rabeprazole for the shorter duration of time. Also, patients should have an adequate intake of calcium