Symptomatic response to therapy with Rabeprazole sodium does not preclude the presence of gastric or oesophageal malignancy, therefore the possibility of malignancy should be excluded prior to commencing treatment. Although no evidence of significant drug related safety problems was seen in a study of patients with mild to moderate hepatic impairment versus normal age and sex matched controls, it is advised to be cautious when is first initiating Rabeprazole sodium (Reloxa) in patients with severe hepatic dysfunction.