Precautions for the use of Entrectinib
Entrectinib, as a TRK/ROS1 inhibitor, should be used with a focus on neurological toxicity, cardiac risk, and special population management. The following precautions are based on drug characteristics and clinical data summary.
1. Adverse reactions in the nervous system
(1) Common dizziness, ataxia, and cognitive impairment can occur at a rate of 40% -60%. Avoid driving or operating machinery during medication.
(2) Severe cases may experience seizures or consciousness disorders, requiring immediate discontinuation of medication and symptomatic supportive treatment.
2. Cardiac toxicity monitoring
(1) May cause QT interval prolongation, baseline electrocardiogram abnormalities, or use of other QT prolonging drugs. Caution should be exercised.
(2) During the treatment period, regular monitoring of electrocardiogram and electrolytes is required. If palpitations or fainting occur, urgent evaluation is needed.
Risk of interstitial lung disease
(1) About 3% of patients develop ILD/pneumonia, characterized by new onset cough, difficulty breathing, or fever.
(2) If symptoms appear, the medication should be stopped immediately and confirmed by imaging. After diagnosis, the medication should be permanently stopped.
4. Liver and kidney function monitoring
(1) Monitor transaminase levels every 2 weeks before treatment and during medication. If ALT/AST is greater than 3 times the upper limit, medication should be suspended.
(2) Patients with moderate to severe liver dysfunction should reduce their dosage, while patients with end-stage renal disease should avoid using it.
Medication for 5 special populations
(1) Prohibited during pregnancy, women of childbearing age should use effective contraception during medication and 6 weeks after discontinuation.
(2) Breastfeeding women should pause breastfeeding during treatment, and elderly patients need to strengthen fall prevention.
6 Drug Interactions
(1) Avoid using potent CYP3A4 inducers/inhibitors in combination, as it may significantly affect blood drug concentrations.
(2) The combination of QT prolonging drugs requires an increase in the frequency of electrocardiogram monitoring.
Disclaimer：《Precautions for the use of Entrectinib》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！