Medical Information

Daprodustat, as an inhibitor of hypoxia inducible factor prolyl hydroxylase, is mainly used to treat renal anemia. Its side effects involve multiple aspects such as the blood system, cardiovascular system, and gastrointestinal tract, and require regular monitoring and targeted measures for risk prevention and control.

1. Common side effects and coping strategies

(1) Abnormal blood system: may cause rapid increase in hemoglobin levels, requiring monitoring of hemoglobin levels every 2 weeks and adjusting the dosage to maintain the target range of 10-11g/dL.

(2) Hypertension risk: The incidence of elevated blood pressure during treatment is about 15%. It is recommended to strengthen blood pressure monitoring and, if necessary, use antihypertensive drugs to control it.

(3) Gastrointestinal reactions: The incidence of nausea and diarrhea is about 10%. It is recommended to take it after meals. If symptoms persist, consider reducing dosage or symptomatic treatment.

2. Special risk prevention and control

(1) Prevention of thrombotic events: Avoid hemoglobin levels above 11g/dL. For high-risk patients, consider anticoagulant therapy. Seek medical attention immediately if chest pain or limb swelling occurs.

(2) Iron metabolism management: Regularly monitor ferritin and transferrin saturation, and iron deficient individuals need to supplement intravenous iron to maintain TSAT ≥ 20%.

(3) Liver function monitoring: The incidence of ALT/AST elevation is about 5%. Regular check ups are required before and during treatment, and medication should be stopped immediately if jaundice occurs.

3. Attention to drug interactions

(1) CYP2C8 inhibitors, such as gefilzil, may increase the blood concentration of Dapuxostat. When used in combination, it should be reduced by 50% and closely monitored.

(2) P-gp inducer: Rifampicin may reduce drug exposure, dosage adjustment should be considered, and hemoglobin monitoring frequency should be strengthened.

(3) Antacid drugs: Aluminum/magnesium antacids should be taken every 2 hours to avoid affecting drug absorption efficiency.

4. Management of special populations

(1) Dialysis patients: Medication should be administered after dialysis, and peritoneal dialysis patients should avoid dialysis fluid exchange within 4 hours after administration.

(2) Liver damage patients: Children Pugh B/C grade patients have their starting dose halved and their monitoring interval extended to every 4 weeks.

(3) Surgical patients: Prior to elective surgery, the risk of thrombosis needs to be evaluated, and medication should be suspended and hemoglobin changes monitored for one week before surgery.