Consider the possibility of malignancy since it may mask symptoms & delay diagnosis in patients w/ gastric ulcer. Pseudomembranous colitis w/ antibiotic combination therapy. Increased risk of GI infections; consider diagnosis of
Clostridium difficile infection &
Clostridium difficile-associated diarrhea for diarrhea that does not improve. Increased risk for osteoporosis-related fractures of the hip, wrist, or spine (w/ high doses & long-term therapy). Hypergastrinemia, possible enterochromaffin-like cell hyperplasia & carcinoid formation in the stomach, adenomas & carcinomas in the liver & neoplastic changes in the thyroid w/ long term treatment. Concomitant use w/ MTX. Hepatic impairment. Pregnancy & lactation.