In general,<unk>  is fairly well tolerated, even up to five years after clinical trial follow-up. The side effect profile is similar to that of omeprazole. The most common side effects include headache, nausea, and diarrhea. Rare side effects include rashes, flu-like symptoms, and infections (including by the gastrointestinal pathogen Clostridium difficile). Rare instances of<unk> -induced liver injury (also known as hepatotoxicity) have been reported. Characteristic proton-pump inhibitor hepatoxicity usually occurs within the first four weeks of starting the medication.<unk>  is associated with elevated serum gastrin levels, which are thought to be dependent upon the degree of CYP2C19 metabolism the drug undergoes. In comparison,<unk>  is not as significantly metabolized by this enzyme compared to other medications in the same class, like omeprazole. Elevated serum gastrin may be associated with gastric cancer. Acid suppression via<unk>  can decrease the absorption of vitamin B12 and magnesium, leading to deficiency. Very serious side effects have been reported in people taking<unk> , but these effects have not been "correlated directly" with the use of<unk> . These include Stevens–Johnson syndrome, serious hematological abnormalities, coma, and death. Other possible side effects, common to other PPIs medications in the same class, include bone fractures due to osteoporosis and serious infections with Clostridium difficile.
Rabeprazole
Esomeprazole
Lansoprazole
Omeprazole
Dexlansoprazole
Tenatoprazole
Pantoprazole
Cimetidine