Before starting treatment with dexlansoprazole, the possibility of malignant neoplasm should be excluded, since the preparation can mask symptoms and delay the correct diagnosis.
If symptoms persist despite adequate treatment, further evaluation should be undertaken.
When taking proton pump inhibitors, which include dexlansoprazole, the risk of gastrointestinal infections, accompanied by diarrhea, caused by Clostridium difficile bacteria, increases, especially in hospitalized patients. This must be taken into account if the patient's condition does not improve with the treatment of diarrhea.
Patients in this case are advised to take the minimum effective dose of dexlansoprazole with the shortest duration of treatment.
In patients receiving high doses of the preparation or with prolonged therapy with proton pump inhibitors (PPIs) for a year or more, the risk of osteoporotic fractures of the hips, hands and spine increases. Patients at risk of osteoporotic fractures should adhere to the recommended dosages (see section "Dosage and Administration").
In rare cases, patients experienced symptomatic and asymptomatic hypomagnesemia when taking PPI preparations for at least three months, and in most cases, when taking it for a year. Symptoms of hypomagnesemia are tetany, arrhythmia, and seizures. Treatment - magnesium replacement and withdrawal of PPI preparations. In patients who need long-term treatment or who are concurrently taking PPI preparations with digoxin or other preparations that can cause hypomagnesemia (for example, diuretics), it is necessary to monitor the concentration of magnesium in the serum before and during treatment.
In case of impaired renal function: dose adjustment in patients with impaired renal function is not required.
In case of impaired liver function: in patients with moderate hepatic impairment (class B but Child-Pugh), the daily dose should not exceed 30 mg of dexlansoprazole.
There are no clinical data on the use of the preparation in patients with severe disorders (class C according to Child-Pugh).
No dose adjustment is required in patients with mild liver dysfunction (Child-Pugh class A).
Use in the elderly: dose adjustment in elderly patients is not required.
Influence on the ability to drive vehicles / mechanisms.
Due to the likelihood of dizziness and visual impairment, you should refrain from driving vehicles and other mechanisms that require increased attention.
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