Medical Information

Axitinib, as a targeted anti-tumor drug, is mainly contraindicated for patients with special physiological conditions and underlying diseases. At the same time, attention should be paid to drug interactions and dietary restrictions. The following provides a systematic explanation from three aspects: the classification of taboo populations, food taboos, and medication restrictions, with a focus on key taboos such as liver dysfunction, pregnancy, and breastfeeding.

1. Absolute taboo group

(1) Pregnant women

Animal studies have shown that it can cause fetal malformations, and pregnant women need to terminate their pregnancy if using it. Pregnancy testing is required before treatment to confirm, and strict contraception should be implemented during the medication period until 2 weeks after discontinuation.

(2) Severe liver dysfunction

Child Pugh Class C patients are contraindicated as significant inhibition of drug metabolism may lead to toxicity accumulation. Moderate damages require a 50% reduction starting from.

(3) Active bleeding patients

Including gastrointestinal bleeding, intracranial bleeding, etc., as drugs may inhibit platelet function and increase the risk of bleeding.

2. Relatively taboo population

(1) Uncontrolled hypertension

If the systolic blood pressure is greater than 140mmHg, antihypertensive treatment should be carried out first. During the medication period, blood pressure should be monitored daily, and if a hypertensive crisis occurs, medication should be stopped immediately.

(2) Recent surgical patients

Discontinue medication at least 24 hours before scheduled surgery, and avoid use until wound healing after surgery as it may affect angiogenesis.

(3) QT interval prolongation patients

Electrocardiogram monitoring is required to avoid the use of other QT prolonging drugs in combination, and blood potassium levels should be maintained at 4.0 mmol/L.

3. Taboo foods and drinks

(1) Grapefruit products

Furancoumarin can inhibit CYP3A4 enzyme and increase blood drug concentration by more than three times, including grapefruit juice, honey pomelo, etc.

(2) St. John's Grass

This herb induces CYP3A4 to cause drug failure, and all health products or tea drinks containing this ingredient should be avoided.

(3) High-fat diet

During medication, avoid fried foods and it is recommended to take them on an empty stomach or 2 hours after a low-fat meal. This can increase bioavailability by 20%.

4. Special Restrictions

(1) Combination therapy restrictions

Strong CYP3A4 inhibitors (such as ketoconazole) need to be reduced by 50%, while inducers (such as rifampicin) need to be increased by 2 times.

(2) Imaging examination

Stop taking iodinated contrast agents for 48 hours before use as it may increase the risk of hypothyroidism.

(3) Vaccination

Avoid receiving live vaccines (such as measles vaccine), as the response rate to inactivated vaccines may decrease by 30% -50%.