Precautions for Macitentan in the Lusius version of Laos
As an endothelin receptor antagonist, Macitentan's precautions mainly involve embryotoxicity, liver function monitoring and blood system effects. It is necessary to strictly control contraception and regularly assess liver function and hemoglobin levels, while being alert to the risk of fluid retention and deterioration of pulmonary hypertension.
1. Embryo fetal toxicity
(1) Pregnant women are prohibited from using it. Women of childbearing age need to confirm their pregnancy status before taking medication, and effective contraceptive measures should be taken during treatment and one month after stopping medication.
(2) Animal experiments have shown teratogenicity, and human data is limited but there is a clear risk. If missed, supplementation is necessary but not at double the dose.
2. Liver function monitoring
(1) Regular testing of ALT/AST before and during treatment, and interruption of treatment if symptoms of liver injury (such as jaundice) occur.
(2) Avoid using it for patients with moderate to severe liver function impairment (Child Pugh B/C grade), and adjust the dosage carefully for patients with mild impairment.
3. Decreased hemoglobin
(1) In the early stages of medication, hemoglobin levels are commonly reduced, and regular testing is required at baseline and during treatment. Anemic patients should use caution.
(2) Severe anemia requires blood transfusion or medication suspension, and medication evaluation should be stopped when hemoglobin is less than 8g/dL.
4. Risk of fluid retention
(1) Peripheral edema or worsening of heart failure may occur, and weight and symptoms need to be monitored. Diuretic treatment may be necessary.
(2) When used in combination with potent CYP3A4 inhibitors, dosage should be reduced to avoid excessive blood drug concentration exacerbating adverse reactions.
5. Deterioration of pulmonary arterial hypertension
(1) Sudden discontinuation of medication may lead to a relapse of the condition, and should be gradually reduced under the guidance of a doctor.
(2) If breathing difficulties worsen or exercise tolerance decreases, immediate medical evaluation is required.
6. Medication for special populations
(1) Prohibited during lactation, medication may affect infants with milk secretion.
(2) The safety of children has not been established, and elderly patients need individualized assessment of liver and kidney function.
Disclaimer：《Precautions for Macitentan in the Lusius version of Laos》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！