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Several published observational studies suggest that proton pump inhibitorPPItherapy may be associated with an increased risk for osteoporosis-related fractures of the hipwristor spineThe risk of fracture was increased in patients who received high-dosedefined as multiple daily dosesand long-term PPI therapya year or longerPatients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treatedPatients at risk for osteoporosis-related fractures should be managed according to established treatment guidelinessee DOSAGE AND ADMINISTRATION and ADVERSE REACTIONS

No overall differences in safety and efficacy were observed between the elderly and younger individualsand other reported clinical experience has not identified differences in responses between the elderly and younger patientsbut greater sensitivity of some older individuals cannot be ruled out.

Esomeprazole may cause new or worsening symptoms of lupusTell your doctor if you have joint pain and a skin rash on your cheeks or arms that worsens in sunlight.

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