Not recommended in patients w/ CKD not on dialysis w/ serum P <1.78 mmol/L. Dysphagia, swallowing disorders, severe GI motility disorder including untreated or severe gastroparesis, retention of gastric contents & abnormal or irregular bowel motion; active inflammatory bowel disease; major GIT surgery. Re-evaluate patients who develop severe constipation or other severe GI symptoms. Patients w/ CKD may develop low levels of fat-soluble vit A, D, E & K; hypocalcemia or hypercalcemia. Possibility of folate deficiency during long term treatment. Metabolic acidosis. Peritonitis. Patients taking anti-arrhythmias & anti-seizure medicinal products. Hypothyroidism. Hyperparathyroidism. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Monitor fat-soluble vit & folic acid in patients undergoing peritoneal dialysis. Monitor serum bicarbonate level. Pregnancy & lactation. Childn <18 yr.
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