Use In Combination With Antibacterial Agents
Patients who are allergic to antibacterial agents (clarithromycin and amoxicillin) should take precaution when using with Rolay.
Stomach Cancer (Gastric Malignancy)
Treatment with Rolay 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 Rolay 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 Rolay.
Use With Methotrexate
When Rolay 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 Rolay should be considered.
Stomach And Intestinal Infection
Patients who are taking Rolay are at an increased risk. Rolay 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, Rolay should be discontinued for at least 5 days before chromogranin A measurements.
Subacute Cutaneous Lupus Erythematosus
Rolay 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 Rolay 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 Rolay with warfarin.
Inflammation Within The Kidneys
Patients who are taking Rolay are at an increased risk. Rolay 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 Rolay.
Vitamin B-12 Deficiency
Patients who are taking Rolay 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 Rolay are at an increased risk. The use of Rolay with clarithromycin or amoxicillin may cause bacteria associated diarrhea
. Patients with bacteria associated diarrhea should take the lowest dose of Rolay for short period of time.
Patients with bone weakness related fractures
are at an increased risk when using Rolay for the longer period of time or taking its high doses. Long-term use or high doses of Rolay may increase the risk of fractures of the wrist, hip, or spine. Patients with bone weakness related fractures should take the lowest dose of Rolay for the shorter duration of time. Also, patients should have an adequate intake of calcium