Medical Information

Sotorasib is a targeted therapy drug, and special attention should be paid to adverse reactions such as liver toxicity and interstitial lung disease when using it, and the dosage should be adjusted according to the patient's condition. The following provides a detailed explanation of precautions from six aspects: medication monitoring, special populations, and dosage adjustment.

Monitoring before medication and during treatment

(1) Liver function monitoring: Check transaminase, bilirubin and other indicators every 3 weeks for the first 3 months of treatment, and monitor monthly or as needed in the later stages. If abnormalities occur, the frequency should be increased, and medication should be suspended or the dosage adjusted if necessary.

(2) Pulmonary symptom monitoring: If there are symptoms of interstitial lung disease such as difficulty breathing and coughing, the medication should be stopped immediately and the cause should be investigated. After diagnosis, it should be permanently discontinued.

2. Handling of missed doses and vomiting

(1) Missed dose: It can be taken within 6 hours, and if it exceeds 6 hours, the dose will be skipped. The next day, the medication will be taken normally, and double supplementation is prohibited.

(2) Vomiting: No need for supplementation, take the next dose according to the original plan.

3. Medication for special populations

(1) Pregnant women: Animal experiments have shown embryonic toxicity. Pregnant women are advised to discontinue feeding during lactation.

(2) Children: Lack of safety data, not recommended for use.

(3) Elderly people: No need to adjust dosage, but need to strengthen liver and kidney function monitoring.

4 Principles of Dose Adjustment

(1) The first dose was reduced to 480mg/day, and the second dose was reduced to 240mg/day.

(2) Hepatotoxicity grade 3-4 or accompanied by elevated bilirubin requires permanent discontinuation of medication.

(3) When the symptoms of grade 3-4 diarrhea/nausea do not improve with supportive treatment, the medication should be suspended until the symptoms are relieved and then reduced and continued.

5 Drug Interactions

(1) Avoid using CYP3A4 strong inducers, P-glycoprotein substrates, and acid suppressants in combination.

(2) When it is necessary to use sensitive CYP3A4 substrates in combination, the dosage should be adjusted according to the instructions.

6 Prevention of Side Effects

Severe reactions such as jaundice, chest pain, and persistent vomiting require immediate medical attention, with particular attention to liver function and respiratory symptoms.