The side effects and mitigation methods of the Laotian version of Neratinib
As an anti-tumor drug, the side effects of Neratinib involve digestive system, skin reactions, and systemic symptoms, which require targeted management. The following is an explanation from three aspects: common side effects, serious adverse reactions, and mitigation strategies, including clinical monitoring points and intervention measures.
1. Common self relieving side effects
(1) Digestive system: Diarrhea (95% incidence), nausea (43%), and vomiting (26%) usually occur in the early stages of treatment and gradually decrease after 3-5 days.
(2) Skin reactions: Skin rash (45%) and paronychia (29%) are characterized by erythema and desquamation, mostly with grade 1-2 toxicity.
(3) Systemic symptoms: fatigue (28%), decreased appetite (25%) are related to drug metabolic load, usually temporary.
2. Serious side effects requiring medical intervention
(1) Hepatotoxicity: When ALT/AST levels increase by more than 5 times ULN, permanent discontinuation of medication is required, with an incidence rate of approximately 9%.
(2) Severe diarrhea: When dehydration or electrolyte imbalance occurs, intravenous fluid replacement should be immediately administered and medication should be suspended.
(3) Interstitial lung disease: manifested as newly developed cough/dyspnea, requiring permanent discontinuation of medication and administration of corticosteroids.
3. Targeted mitigation measures
(1) Diarrhea management: The initial treatment is combined with loperamide, with prophylactic use in the first two cycles (4mg first dose, followed by 2mg each time).
(2) Skin care: Use alcohol free moisturizer and apply 1% hydrocortisone topically when a grade 2 rash appears.
(3) Liver function monitoring: ALT/AST should be tested before treatment and every 4 weeks. If there are abnormalities, the dosage should be adjusted according to CTCAE grading.
4. Special precautions
(1) Drug interactions: Avoid using PPI in combination (which can reduce AUC by 65%), and take H2 receptor antagonists every 3 hours.
(2) Maternity protection: Effective contraception is required from the treatment period to one month after discontinuation of medication, as male patients may experience oligospermia.
(3) Cardiovascular risk: Discontinue medication when QTc>480ms, and weekly monitoring of electrocardiogram is required for patients with underlying heart disease.
Disclaimer：《The side effects and mitigation methods of the Laotian version of Neratinib》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！