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Proton pump inhibitors may increase the risk of gastrointestinal infections because of their acid suppressive effects.
Early toxicological studies identified carcinoid-like tumours of the gastric mucosa in rats given very high doses of omeprazole over long periods.
Before giving omeprazole or other proton pump inhibitors to patients with gastric ulcers the possibility of malignancy should be excluded since these drugs may mask symptoms and delay diagnosis. Omeprazole and other proton pump inhibitors should be used with caution in hepatic impairment and dose adjustment may be required.
