In the presence of any alarm symptoms (eg, such as a large spontaneous weight loss, frequent vomiting, dysphagia, vomiting of blood or melena), and in the presence of gastric ulcers (or suspected it) to exclude malignancy development, as trenbolone acetate powder treatment with esomeprazole can lead to a smoothing of symptoms and, thus, delay the correct diagnosis.
You should always consult a specialist in the following cases:
• if there is a history of stomach ulcers or operations on the digestive tract;
• during continuous symptomatic treatment of indigestion or heartburn for 4 or more weeks;
• the development of jaundice or severe liver disease;
• patients older than 55 years with the appearance of new symptoms of the gastrointestinal tract or a change in recent years is already available;
• if necessary, endoscopic procedures or urea breath test (determination of Helicobacter pylori).
patients with recurrent symptoms of dyspepsia / heartburn or taking the drug for a long period (more than 1 year in particular) should be regularly monitored by the physician. Do not use the drug Neo-zekst ®for a long time to prevent. Hypomagnesemia. Severe hypomagnesemia observed in patients treated with PPIs, such as esomeprazole, for at least three months, and in most cases the treatment for a year.There have been serious hypomagnesemia symptoms, such as chronic fatigue, convulsions, delirium, convulsions, dizziness trenbolone acetate powder and ventricular arrhythmia, but they can begin gradually and go unnoticed. In most patients, hypomagnesemia disappeared after supplementation of magnesium and discontinuation of PPIs. For patients who may require long-term treatment, or who are already taking PPIs together with digoxin or drugs that may cause hypomagnesemia (eg, diuretics), physicians should consider measuring magnesium levels before starting reception PPI and periodically during treatment. fractures. Use of PPI, especially in large doses and for long periods (> 1 year) may result in a modest increased risk of hip fracture, carpal bones and the vertebral bodies, particularly in the elderly in the presence of people or other known risk factors. Research suggests that taking these drugs may increase the overall risk of fractures by 10-40%. To some extent this risk increase may be the result of other factors. Patients at risk for osteoporosis should be treated according to current clinical guidelines and take in the required amount of vitamin D and calcium. During treatment with PPIs gastrin plasma concentration increases as a result of reduced intragastric acid secretion. Patients taking PPIs in for a long time, often marked formation of cysts in the glandular stomach. These phenomena are caused by physiological changes as a result of inhibition of gastric acid secretion. Cysts are benign and regress. Patients on therapy “on demand” mode should be instructed to contact their physician if symptoms change in character. Taking into account the concentration fluctuations of esomeprazole in the blood plasma in the appointment of the drug in the treatment of “on demand” mode, it is necessary to take into account the interaction of the drug with other drugs (see. “Interaction with other medicinal products” section). In the appointment of esomeprazole for Helicobacter pylori eradication should be considered the possibility of drug interactions for all components of the therapy. Clarithromycin is a potent inhibitor of the isoenzyme of CYP3A4, therefore the appointment of eradication therapy in patients receiving other drugs metabolized with the participation of isoenzyme CYP3A4 (eg cisapride), it is necessary to take into account possible contraindications and interactions of clarithromycin with these drugs. Treatment PPI may slightly increase the risk of gastrointestinal infections , agents which are Salmonella, Campylobacter and Clostridium difficile in hospitalized patients. esomeprazole may reduce the absorption of vitamin B12 due to hypo- or achlorhydria. This should be considered when using the drug in patients with a deficiency or with a risk of deficiency of vitamin B 12 during prolonged therapy. The tablets contain sucrose, therefore should not be administered esomeprazole for patients with hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-izomaltaznoy failure . In the period of treatment with trenbolone acetate powdermay increase the concentration of chromogranin a, used for the diagnosis of neuroendocrine tumors, so it is recommended the abolition of esomeprazole at least 5 days prior to the study. Subacute cutaneous lupus erythematosus (PKKV). The use of PPIs is associated with very rare cases PKKV development. If there is a lesion of the skin, especially in open areas to sunlight, together with arthralgia, then the patient should promptly seek medical care, and the physician should consider the decision to cancel esomeprazole. PKKV the treatment of IDUs in history can increase the risk of PKKV the use of other PPIs.
Special precautions for the destruction of unused medicinal product
No need for special precautions during the destruction of the unused drug Neo-zekst ® .
Effects on ability to drive vehicles, machinery
During treatment with esomeprazole should be careful when driving, mechanisms and refrain from doing so in the case of side effects such as dizziness (rarely) and blurred vision (rare). bulking steroids for sale oraltec pharmaceuticals where to buy topical steroid creams
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