Indications

Gastro-oesophageal reflux disease, Irritable bowel syndrome, Dyspepsia

Contraindication

Phaeochromocytoma, epilepsy, manic states, hyperprolactinaemia, mammary dysplasia, malignant mastopathies, cardiac impairment. GI bleeding, mechanical obstruction or perforation. Concomitant use w/ rilpivirine, atazanavir and nelfinavir. Lactation.

Special Precautions

May impair ability to drive or operate machinery. Pregnancy and lactation. Gastric malignancy should be ruled out. Consider Zn++ supplementation during IV therapy in patients who are prone to Zn++ deficiency. Pregnancy. Monitoring Parameters Monitor Mg levels prior to initiation and periodically during prolonged use.

Side Effects

Amenorrhoea, gynaecomastia, galactorrhoea, changes in libido. Increased risk of Clostridium difficile-associated diarrhoea (CDAD). Headache, dizziness, nausea, vomiting, abdominal pain, flatulence, diarrhoea, constipation, dyspepsia, arthralgia, insomnia, rhinitis, inj site reaction (e.g. thrombophlebitis and abscess). Long-term treatment may lead to atrophic gastritis, symptomatic and asymptomatic hypomagnesaemia, cyanocobalamin malabsorption, and increased risk of osteoporosis-related fracture.

Drug Interactions

Reduced bioavailability with sucralfate, aluminium- and magnesium-containing antacids. Effect on GI motility may be antagonised by anticholinergic agents, narcotics and analgesics. Avoid alcohol. Increased risk of digoxin-induced cardiotoxic effects. Increased risk of hypomagnesaemia w/ diuretics. May increase INR and prothrombin time of warfarin. May increase serum concentration of methotrexate and saquinavir. Delayed absorption and decreased bioavailability w/ sucralfate. Decreased absorption of ketoconazole, itraconazole.

Route of Administration

Oral

Dosage

As directed by the physician