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