Kremezin Special Precautions

This product should be administered with care in the following patients: Patients with peptic ulcer or esophageal varix. Since this product is passed in solid state in the digestive tract, this product may irritate the affected area]. Patients with a predisposition to constipation.
This product may exacerbate constipation and increase ammonia in the blood in patients with hepatic disorder as an underlying disease.
Important precautions: Patients diagnosed as progressive chronic renal failure who are in the conservative therapy. The administration of this product should be considered after the chronic renal failure is confirmed to be the progressive stage by the increase of serum creatinine. As for prolonging the time to initiation of dialysis, the administration of this product should be considered after the increase in rate of serum creatinine (S-Cr) is confirmed to be moderate or more (changes in 1/S-Cr/month are 0.01 dL/mg or more). Clinical changes in serum creatinine and uremic symptom are observed appropriately in patients under the treatment with this product and the continuation of the administration is investigated around 6 months after the start of the administration.
When improvement is not observed, appropriate measures such as discontinuation of the treatment or replacement with other therapies should be taken.
When the improvement cannot be expected during the treatment with this product, appropriate measures such as the initiation of dialysis therapy should be taken.
When other drugs are used in combination, these drugs should not be used concurrently, considering that this product is an adsorbent.
There have been no reports for noticeable abnormalities in homeostasis of vitamins and hormones in vivo, but caution concerning physical status should be exercised especially on long-term treatment with this product, considering that this product is an adsorbent.
Use in Children: The safety of this product in a premature baby, a newborn baby, an infant, a baby or a little child has not been established (insufficient clinical data).
Use in the Elderly: This product should be administered under careful supervision. Since the elderly often have reduced physiological function, adverse drug reactions are likely to occur.