Not to be used for control of hyperparathyroidism. Discontinue use if serious inflammatory disorders of different parts of GIT including serious complications eg, haemorrhage, perforation, ulceration, necrosis, colitis & colonic/caecal mass occurs. Not recommended in adults w/ CKD not on dialysis w/ serum P <1.78 mmol/L. Patients w/ dysphagia; swallowing disorders or oesophageal abnormalities; severe GI motility disorders including untreated or severe gastroparesis, retention of gastric contents & abnormal or irregular bowel motion; active inflammatory bowel disease, major GIT surgery; hypothyroidism. Patients w/ CKD who develop low levels of fat-soluble vit A, D, E & K; hypo- or hypercalcemia; metabolic acidosis. Possible folate deficiency during long term use. Carefully monitor & re-evaluate patients who develop severe constipation or other severe GIT symptoms; peritoneal dialysis. Assess regularly serum vit A, D, E & K & folate level in patients not taking supplemental vit & folic acid during treatment. Additional monitoring of fat-soluble vit & folic acid in patients undergoing peritoneal dialysis. Monitor serum Ca & bicarbonate level at regular intervals. Hepatic impairment. Pregnancy & lactation. Childn <6 yr or w/ BSA <0.75 m
2.
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