The side effects and mitigation methods of Regorafenib in Laos' Lucius version
Regorafenib, as a multi kinase inhibitor, commonly has side effects such as skin reactions, hypertension, fatigue, etc. Most of them can be relieved through dose adjustment and symptomatic treatment, but serious reactions such as liver toxicity should be noted. The following provides a systematic explanation of symptom classification, coping measures, and special precautions.
1. Skin related side effects
(1) Hand and foot skin reaction: manifested as redness, swelling, and peeling, requiring the use of urea ointment for moisturizing. Avoid friction and pressure, and reduce or suspend medication in severe cases.
(2) Rash: Mild rash can be treated with hydrocortisone cream, while widespread rash requires treatment with antihistamines. If accompanied by fever or mucosal involvement, seek medical attention immediately.
2. Cardiovascular system response
(1) Hypertension: During treatment, blood pressure should be monitored weekly, and if it is ≥ 160/100mmHg, antihypertensive treatment should be initiated. Avoid co use with NSAIDs.
(2) Myocardial ischemia: Stop medication immediately when chest pain occurs, and transfer to the cardiology department for treatment after confirmation by electrocardiogram.
3. Digestive system side effects
(1) Diarrhea: Loperamide should be used more than 4 times a day, and electrolytes should be monitored to prevent dehydration. Hematuria requires colonoscopy evaluation.
(2) Hepatotoxicity: If ALT/AST>5 times the normal value, medication should be suspended. After liver protection treatment is restored, dosage should be reduced and continued.
4. Systemic response
(1) Fatigue: Stage by stage activity combined with nutritional support to rule out anemia or thyroid dysfunction.
(2) Fever: Neutropenia accompanied by fever requires emergency treatment, and G-CSF may be used if necessary.
5. Serious reactions that require urgent handling
(1) Bleeding: In case of vomiting blood or intracranial hemorrhage, permanently discontinue medication and administer platelets or fresh frozen plasma.
(2) Perforated fistula: Abdominal pain accompanied by peritoneal irritation requires emergency CT, fasting, and surgical consultation.
6. Special precautions
(1) Dose adjustment: The first occurrence of grade 3 toxicity should be reduced to 120mg, and if it occurs again, it should be reduced to 80mg.
(2) Drug interactions: Avoid using strong CYP3A4 inducers in combination, and discontinue use of St. John's wort.
(3) Wound healing: Stop medication at least 2 weeks before surgery, and restart only after complete wound healing after surgery.
Disclaimer：《The side effects and mitigation methods of Regorafenib in Laos' Lucius version》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！