Side Effects:

Common Nausea, Abdominal pain, Constipation, Flatulence, Diarrhoea.

Expert advice for Promisec Capsule
Inform your doctor if you do not feel better after taking it for 14 days as you may be suffering from some other problem that needs attention. Promisec can decrease magnesium levels in blood. Get your magnesium levels checked regularly. You may need a magnesium supplement or need to discontinue your medicine.  Inform your doctor if you are suffering from osteoporosis as Promisec can weaken your bones by decreasing calcium levels in blood. You may need a calcium supplement, preferably calcium citrate. Promisec is a well-tolerated medicine and provides relief for a long time. It may take a few days to show its effect. You can take an antacid for a quick relief during this time unless your doctor has asked you not to use them. Once you start feeling better, do not stop taking your medicine. Take it for the duration as advised by your doctor

Frequently Asked Questions

Q. Can I take Promisec with domperidone?
Promisec can be safely taken with domperidone as no harmful effects have been reported clinically. A fixed-dose combination of these two medicines is also available. Domperidone works by increasing the gut motility and Rabeprazole decreases the acid production in the stomach. So, this combination is very effective in the treatment of reflux esophagitis associated with acidity, heartburn, intestinal and stomach ulcers.

Q. What are the various conditions in which the use of Promisec is contraindicated?
Use of Promisec is contraindicated if you are allergic to this medicine or any other medicine belonging to the same class of drugs. Also, do not take Promisec if you are already taking a medicine containing nelfinavir (used for the treatment of HIV infection).

Q. What if I miss my dose of Promisec?
If you miss a dose of Promisec, take it as soon as you remember and the next dose as scheduled. However, if it is almost the time for your next dose, skip the missed dose and take your next dose and then follow the regular schedule. Do not take double the dose.

Q. Can I take Promisec along with oral contraceptive pills (birth control pills)?
Promisec can be safely taken with oral contraceptive pills (birth control). They do not affect each other's action and no harmful effects have been seen when they are used together.

Q. What is Promisec?
Promisec belongs to the group of medicines known as proton pump inhibitors (PPIs). This drug decreases the acid production in your stomach and is indicated for the treatment of conditions caused by excess acid secretion in the stomach.

Q. Can Promisec cause subacute cutaneous lupus erythematosus?
Promisec has been reported to cause subacute cutaneous lupus erythematosus in many studies. Common signs and symptoms of this disease include painful joints, tiredness, weakness, rash, fever, anemia, mouth ulcers, hair loss, and many others and these may get aggravated again and again. Talk to your doctor if you experience these side effects as you may need to discontinue this medicine.

Q. Can I take Promisec with ondansetron?
Ondansetron is an anti-emetic medicine which helps in relieving nausea (feeling sick) or vomiting. No harmful effects have been seen when Promisec is used with ondansetron. So, these two medicines can be taken together.

Q. Can Promisec cause lactose intolerance?
Lactose intolerance has been reported with the use of Promisec in some patients. Many Promisec preparations contain lactose as an ingredient. This is a digestive problem in which the patient cannot digest lactose, a type of sugar mainly found in milk and dairy products. The patient may complain of symptoms like flatulence (gas), diarrhea, bloating, stomach pain and feeling of being sick (nausea). Read the ingredients mentioned on the pack before taking the medicine.

Q. Can I take Promisec with Vitamin E?
Promisec can be taken with vitamin E. The combinations seems to have a beneficial effect in terms of better maintenance of moderate to severe esophagitis. However, there are not many studies or reports on this subject. Talk to your doctor for more information on this.

Q. Can I take Promisec with levosulpiride?
Promisec can be safely taken with levosulpiride as no harmful effects have been reported clinically. A fixed-dose combination of these two medicines is also available. Levosulpiride works by increasing the gut motility and Promisec decreases the acid production in the stomach. So, this combination is very effective in the treatment of reflux esophagitis associated with acidity, heartburn, intestinal and stomach ulcers.

Q. Does Promisec use increase the risk of clostridium difficile infection?
Use of proton pump inhibitors (PPIs) like Promisec may be associated with an increased risk of Clostridium difficile–associated diarrhea (CDAD) as reported in few studies and informed by the US FDA as well. A possibility of CDAD can be there in patients taking PPIs and developed diarrhea that does not improve.

Q. Can Promisec be used in cancer patients?
Promisec can be taken by cancer patients as prescribed by a doctor. Since cancer patients may also take many other medicines for the primary cancer treatment or for other symptoms and infections, there are chances of drug interactions with Promisec.

Q. For how long can Promisec be taken?
Take Promisec for as long as advised by your doctor. The duration of taking Promisec would vary depending on your condition. Do not stop taking this medicine without talking to your doctor.

Q. Can Promisec cause calcium deficiency and osteoporosis?
Promisec can cause osteoporosis (thinning of bones) as it decreases the calcium absorption leading to calcium deficiency. This leads to an increased risk of bone fractures on long-term use, like hip, wrist or spine fractures. Inform your doctor if you have osteoporosis or if you are taking corticosteroids (these can increase the risk of osteoporosis) before starting your therapy. Take enough calcium and vitamin D to reduce the risk.

Q. What are the rare side effects of Promisec?
Rare side effects seen with the use of Promisec includes a decrease in white cells or platelets, allergic reactions, problems like blurred vision, wheezing, shortness of breath (bronchospasm), dry mouth, thrush, liver problems like jaundice, hair loss (alopecia), skin rash on exposure to sunshine, joint pains (arthralgia) or muscle pains (myalgia), severe kidney problems (interstitial nephritis), increased sweating and inflammation of the gut causing diarrhoea.

Q. How does Promisec work?
Proton (acid) pumps are found on the stomach mucosa and they are responsible for secreting acid in the stomach. Promisec works by blocking this gastric acid pump and this unique mechanism of action helps in decreasing the acid secretion in the stomach.

Q. Does Promisec cause hepatitis B and can a patient of hepatitis take Promisec?
Promisec can rarely cause hepatitis with or without jaundice and very rarely it can lead to hepatic failure and encephalopathy in patients with the underlying liver disease. Promisec does not cause hepatitis B or any other viral hepatitis. However, there are studies showing an increased occurrence of hepatic encephalopathy in hepatitis B patients using PPIs. These medicines should be used with caution in patients with the underlying liver disease.

Q. Does Promisec increase chromogranin levels?
Use of proton pump inhibitors like Promisec has been seen to be associated with an increase in chromogranin levels. This increase in chromogranin levels can be due to the effect of these drugs on enterochromaffin cells and this could also falsely increase the levels in patients with neuroendocrine tumours.

Q. Does Promisec cause dementia?
Use of proton pump inhibitors like Promisec has been recently linked with the development of dementia in elderly patients. As this risk of developing dementia is not confirmed, talk to your doctor for more information on this effect.

Q. Does Promisec cause vitamin deficiencies?
Promisec may cause vitamin B12 and vitamin C deficiency. When taken orally, vitamin B12 requires an acidic environment for its absorption from the stomach while Promisec causes a decrease the gastric acid secretion. You may need to take vitamin B12 supplements from outside. The clinical significance of the decrease in vitamin C levels is not known, so vitamin C supplementation is not recommended.

Q. Does Promisec have an expiry date?
Yes, Promisec does expire. Please check the expiry date written on the pack and it refers to the last day of that month. Do not use Promisec after the expiry date.

Q. What is the role of Promisec before endoscopy in patients with gastrointestinal bleeding?
Promisec before endoscopy in patients with gastrointestinal bleeding reduces the need for endoscopic therapy, the rate of post-endoscopy bleeding, and shortens hospital stays. Hence Promisec is given before endoscopy in patients with gastrointestinal bleeding.

Q. Are there any withdrawal symptoms associated with the use of Promisec?
There are no withdrawal symptoms seen when patients stop using Promisec as it has no habit forming tendencies.

Q. Can Promisec cause magnesium deficiency?
Promisec can cause magnesium deficiency in the blood. Low magnesium levels is a rare side effect seen in patients treated with Promisec for at least three months and in most cases after a year of therapy. The patient may have symptoms like tetany, arrhythmias, and seizures and may need to stop this medicine and take magnesium from outside. Magnesium levels should be tested at regular intervals in the patients taking Promisec for a long duration.

Q. Is Promisec a controlled substance?
Promisec is not a controlled substance. It is available when prescribed by a doctor.

Q. Can Promisec be used in cardiac patients?
Patients with cardiac disease can take Promisec. However, Promisec can interact with certain drugs (e.g clopidogrel, digoxin) which might be used by a patient with an underlying cardiac disease. Patients taking Promisec and digoxin may need to be monitored for digoxin toxicity. Promisec decreases the activation of clopidogrel, thus reducing its effects. Patients taking these medicines together needs to be monitored closely by a doctor.

Q. Can the use of Promisec cause iron deficiency?
Use of Promisec can cause iron deficiency and a decrease in hemoglobin levels as it decreases the acidic environment of the stomach needed for the absorption of iron. However, there are no recommendations on the regular monitoring of iron levels or taking iron supplements when the patient is taking Promisec.

Q. Is Promisec a narcotic substance?
Promisec is a not a narcotic substance and has not been reported to have any abuse potential. Promisec does not get you high and does not cause any addiction as no withdrawal symptoms have been reported when you stop taking this drug.

Q. Is Promisec available without a prescription as an over the counter product?
Promisec is a prescription medicine and you can buy this drug by providing a doctor's prescription. Promisec is not available as an over the counter (OTC) product.

Q. How is Promisec metabolised in the body?
Promisec is metabolized in the liver by the cytochrome P450 enzymes mainly CYP2C19. There could be an increase in the level of Promisec in patients with underlying liver disease because of a decrease in its metabolism. However, the amount of drug does not increase if given once a day.

Q. Can Promisec be used in stroke patients?
Promisec can be used in stroke patients. There are studies suggesting that proton-pump inhibitors (PPIs) as a class are not associated with an increased short-term risk of recurrent stroke or death among older adults treated with clopidogrel after stroke.