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Symptoms include seizures, arrhythmias, low blood pressure, severe muscle contraction (tetany), and death.[230] In a recent review of 10 cases, the elderly patients had been taking PPIs for an average of 8.3 yrs.[226] They suffered from severe symptoms of low magnesium and there was significant morbidity related to fatigue, unsteadiness, severe muscle contraction, seizures, cardiac arrhythmias, and multiple hospitalizations

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Potency loss accelerates rapidly, and contamination risk increases

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