Taboo populations, foods, and restrictions for Sorafenib in Natco, India
Sorafenib, as a multi kinase inhibitor, has clear contraindications, dietary restrictions, and special condition requirements for its use. The following provides a detailed explanation from three aspects: contraindications, dietary restrictions, and usage limitations to help patients safely take medication.
1. Absolute taboo group
(1) Pregnant women
Animal experiments have shown a significant increase in embryo mortality and malformation rates. Women of childbearing age need to confirm a negative pregnancy test before taking medication, and effective contraceptive measures should be taken during treatment and 6 months after discontinuing medication.
(2) Severe liver dysfunction
Not recommended for patients with Child Pugh C cirrhosis, as it may worsen hepatic encephalopathy and coagulation dysfunction. ALT>5 times the normal value or bilirubin>3 times the normal value should be evaluated before medication.
2. Relatively taboo population
(1) Cardiovascular disease patients
Use with caution in patients with recent myocardial infarction (within 6 months) and unstable angina pectoris. During the medication period, blood pressure should be monitored weekly, and if there is ≥ grade 3 hypertension (>160/100mmHg), the medication should be permanently discontinued.
(2) Bleeding prone individuals
Patients with a history of active gastrointestinal ulcers and hemoptysis should use with caution. Avoid using antiplatelet/anticoagulant drugs in combination, and discontinue medication for at least 2 weeks before surgery.
3. Dietary taboos
(1) Grapefruit/Yangtao
Containing strong CYP3A4 inhibitors can increase blood drug concentration by three times. It is necessary to completely avoid consuming related products, including fruit juice and jam.
(2) High-fat diet
A high-fat diet (fat>30%) during medication can reduce bioavailability by 29%. It is recommended to take it on an empty stomach or one hour after a low-fat meal.
4. Special Restrictions
(1) Drug interactions
Prohibiting the use of CYP3A4 strong inducers (rifampicin/phenytoin sodium) in combination can lead to loss of efficacy. Combined use with docetaxel requires a 50% reduction in the latter's dosage.
(2) Treatment monitoring requirements
Before treatment, it is necessary to complete: electrocardiogram (QT interval), thyroid function, and urine protein testing. Monitor blood pressure every 2 weeks and liver function every month during treatment.
5. Special population restrictions
(1) Child patients
The safety and efficacy of patients under 18 years old have not been established and are limited to clinical trials.
(2) Elderly patients
Patients aged 65 and above are more prone to grade 3 or higher adverse reactions. It is recommended to reduce the starting dose to 400mg/day.
Disclaimer：《Taboo populations, foods, and restrictions for Sorafenib in Natco, India》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！