Side effects and mitigation methods of Pomalidomide in Laos
Pomalidomide, as an immunomodulatory agent, requires special attention to its side effects management, including blood toxicity, infection risk, and teratogenicity. The following is an explanation from three aspects: common side effects, serious side effects, and targeted relief measures. The cited data are all from clinical trials and drug instructions.
1. Common side effects and alleviation
(1) Hematological toxicity
The incidence of neutropenia is as high as 48%, and weekly monitoring of blood routine is required. When there is a decrease of grade 3 or above, medication should be suspended and G-CSF supportive therapy should be considered.
(2) Fatigue and fatigue
About 36% of patients experience symptoms, and it is recommended to take medication in divided doses (taking at night can alleviate daytime drowsiness), combined with mild aerobic exercise to improve symptoms.
(3) Gastrointestinal reactions
Nausea (22%) can be relieved by taking medication after meals, while diarrhea (18%) requires supplementation with electrolyte solution and use of loperamide if necessary.
2. Dealing with serious side effects
(1) Venous thromboembolism
The incidence rate is 4% -8%, and all patients require prophylactic anticoagulation (such as aspirin). Immediately perform vascular ultrasound examination when limb swelling/chest pain occurs.
(2) Secondary malignant tumor
Skin cancer screening should be conducted every 3 months during the treatment period, and new skin lesions need to be confirmed by biopsy. Avoid exposure to ultraviolet rays such as sunbathing.
(3) Hepatotoxicity
The incidence of ALT elevation is 12%, and liver function needs to be monitored monthly. When jaundice or transaminase levels exceed 5 times the upper limit, the medication should be permanently discontinued.
3. Management of special populations
(1) Patients of childbearing age
Having teratogenicity (grade X), it is necessary to confirm a negative pregnancy test before treatment, and use dual contraception measures during the medication period until 4 weeks after discontinuation.
(2) Elderly patients
People over 75 years old are more likely to develop deep vein thrombosis, and it is recommended to prioritize the use of low molecular weight heparin for prevention rather than aspirin.
4. Drug interaction prevention
(1) CYP1A2 inhibitors
The combination of potent inhibitors (such as fluvoxamine) can increase blood drug concentration by 67%, and the dosage of pomalidomide needs to be adjusted.
(2) Hematopoietic growth factor
Combined use with EPO may increase the risk of thrombosis, and it is recommended to administer the medication at intervals of at least 12 hours.
Disclaimer：《Side effects and mitigation methods of Pomalidomide in 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！