Hyperacidity, GERD, and ulcers:
Indications for: KONVOMEP
Short-term treatment (4–8 weeks) of active benign gastric ulcer. To reduce risk of upper GI bleed in critically ill adult patients.
Gastric ulcer: 40mg once daily for 4–8 weeks. GI bleed risk reduction: initially 40mg, followed by 40mg 6–8hrs later, then 40mg once daily thereafter for 14 days.
Concomitant rilpivirine-containing products.
Symptomatic response does not preclude gastric malignancy. Discontinue and evaluate if acute tubulointerstitial nephritis, severe cutaneous adverse reactions, or cutaneous/systemic lupus erythematosus occurs. Sodium-restricted diets. CHF. Avoid use in Bartter's syndrome, hypokalemia, hypocalcemia, acid-base imbalance abnormalities. Long-term therapy (eg, >3yrs) may lead to malabsorption/deficiency of Vit. B12. Monitor magnesium levels prior to and during prolonged therapy. Consider monitoring magnesium, calcium levels in those with preexisting risk of hypocalcemia (eg, hypoparathyroidism). Increased risk of fundic gland polyps with long-term use (esp. >1yr) or osteoporosis-related fractures (hip, wrist or spine) with long-term (≥1yr) and multiple daily dose PPI therapy. Use lowest dose for shortest duration appropriate to condition. Pregnancy. Nursing mothers.
Proton pump inhibitor + antacid.
Avoid concomitant clopidogrel, St. John's Wort, rifampin, atazanavir, nelfinavir. May potentiate citalopram, cilostazol, diazepam, digoxin, phenytoin, warfarin (monitor INR/PT), tacrolimus, saquinavir, methotrexate (esp. high-dose); monitor. Potentiated by voriconazole. May alter absorption of pH-dependent drugs (eg, erlotinib, dasatinib, nilotinib, ketoconazole, itraconazole, mycophenolate mofetil, iron salts). Monitor drugs metabolized by CYP450 (eg, cyclosporine, disulfiram). Long-term use of bicarbonate with calcium or milk may cause milk-alkali syndrome. Concomitant digoxin, diuretics may predispose patients to hypomagnesemia. May interfere with neuroendocrine tumor diagnostic investigations, secretin stimulation tests; interrupt therapy for ≥14 days. May result in false (+) urine tests for tetrahydrocannabinol.
Headache, abdominal pain, nausea, diarrhea, vomiting, flatulence; bone fracture; possible C. difficile associated diarrhea; rare: hypomagnesemia and mineral metabolism.
Renal (~77%). Half-life: ~1 hour (range: 0.4–4.2 hours).
Generic Drug Availability:
Kit (pwd + diluent)—90mL, 150mL, 180mL