What are the precautions for using Upadacitinib?
Upadacitinib, as a JAK1 inhibitor, should be used with a focus on infection risk, thrombotic events, laboratory indicator monitoring, and special population management. The following precautions are summarized based on clinical trials and drug instructions.
1. Serious risk of infection
(1) May increase the risk of bacterial, viral (including shingles), fungal, and other infections, and should be avoided during active infections.
(2) Before treatment, tuberculosis screening is necessary, and patients with latent tuberculosis should receive preventive anti tuberculosis treatment.
(3) Assess immediately when new symptoms of infection appear, and suspend medication for severe infections.
2 Thrombosis formation
(1) The risk of deep vein thrombosis and pulmonary embolism increases, especially in individuals with cardiovascular risk factors.
(2) During medication, respiratory distress, chest pain, or lower limb edema require urgent evaluation.
(3) Patients undergoing combined anticoagulant therapy need to be closely monitored for bleeding tendency.
3 Laboratory monitoring
(1) Detect lymphocytes, neutrophils, and hemoglobin every 3 months before and after treatment.
(2) Regularly monitor liver enzymes, and adjust the dosage when ALT/AST is greater than 3 times the upper limit.
(3) Patients with abnormal blood lipids need to have their blood lipid levels rechecked within 4-8 weeks.
4. Medication for special populations
(1) Prohibited during pregnancy, effective contraception is required for women of childbearing age during the medication period until 4 weeks after discontinuation.
(2) It is not recommended to use during lactation, and elderly patients need to assess the risk of thrombosis.
(3) Patients with severe liver and kidney dysfunction need to adjust their dosage.
5 Drug Interactions
(1) Avoid combining with potent CYP3A inhibitors and reduce to 15mg/day if necessary.
(2) Combined use with immunosuppressants or biologics may increase the risk of infection.
6. Infection related contraindications
(1) Patients with severe active infections are prohibited from using it, including local and systemic infections.
(2) Active tuberculosis patients are forbidden and need to complete appropriate anti tuberculosis treatment first.
(3) Patients with chronic or recurrent infections should use caution and assess the risk of infection.
Disclaimer：《What are the precautions for using Upadacitinib?》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！