Domperidone should not be taken with oral erythromycin, ketoconazole or any other CYP3A4 inhibitors that prolong the heartbeat.
Patients with birth problems are at an increased risk while using this medicine. This medicine contains lactose and may be inadequate for patients with galactosemia
, lactose intolerance or abnormal absorption of glucose/galactose.
Stomach and Intestinal Infections
Patients taking pantoprazole may see an increased risk of stomach and intestine infections produced by bacteria (for example campylobacter
). Pantoprazole may increase the number of bacteria usually present in the upper tract of the stomach and intestine.
Regularly monitor the patients who are on long term therapy, especially more than one year.
Ability to Produce or Develop Cancer
Patients using pantoprazole for a long-term may have the potential to develop cancer
, which is due to the severe type of digestive disorder (GERD
Decreased Blood Magnesium Levels
Patients taking long-term treatment of proton pump inhibitors for three months to 1 year are at an increased risk. These patients may suffer from involuntary contraction
of muscles, irregular heartbeat and seizures
. Low level of magnesium in the blood should be treated by discontinuation of the proton pump inhibitor and magnesium replacement. Regular monitoring of the magnesium levels before starting treatment with proton pump inhibitor should be done in patients expected with long term therapy or who have to take proton pump inhibitors with digoxin or diuretics
Patients taking high doses, multiple daily doses or long term therapy (more than a year) of proton pump inhibitor (PPI) are at increased risk of fracture
. There is an increased risk for bone diseases related fractures of wrist, spine or hip in patients receiving proton pump inhibitor therapy. Such patients should use the lowest dose and shortest term of therapy as suitable to the disease. Patients having bone diseases related fractures should manage as per the guidelines of the treatment.
Vitamin B12 Deficiency
Patients taking long-term treatment of acid-suppressing medicines are at an increased risk. These patients may suffer from abnormal absorption of vitamin
B12 due to decreased or absence of stomach acid. Monitoring of vitamin B12 deficiency should be considered in such patients.
Patients taking pantoprazole may see an increased risk of stomach inflammation. Stomach inflammation may occur in patients using pantoprazole for long-term, especially in patients with Helicobacter pylori infection.
Existing Stomach Cancer
Treatment given according to the symptoms with pantoprazole does not prevent existing stomach cancer
Effects on the Heart
Patients aged more than 60 years and taking daily 30 mg of domperidone are at an increased risk. These patients may suffer from serious irregular heartbeat or sudden loss of heart function. Use the lowest effective dose of domperidone in adults and children. Take necessary precautions in patients using domperidone and other medicines which prolong heartbeat, and patients with electrolyte disturbances or having heart diseases such as heart failure.
Kidney problems are observed in patients taking proton pump inhibitor like pantoprazole. During any time of proton pump inhibitor therapy, kidney problems and an unknown allergic reaction may occur. If kidney problem occurs then stop taking pantoprazole.
Patients taking proton pump inhibitor therapy such as pantoprazole and hospitalized patients are at an increased risk. Patients taking pantoprazole may experience an increased risk of bacteria (Clostridium difficile) associated diarrhea
. Diagnosis should be carried out if diarrhea persists. Patients taking proton pump inhibitor therapy should use the lowest dose and shortest term of the treatment according to the condition.
Patients taking domperidone continuously and experienced symptoms after taking the meal that persists for more than two weeks should talk with their doctor. Patients should consult their doctor if their nausea
and vomiting persist for more than 48 hours. Domperidone should not be used for the treatment of motion sickness and in patients with existing heart diseases.