Medical Information

Delamanid is an important drug for the treatment of multidrug-resistant tuberculosis, but it carries specific risks in terms of cardiovascular effects, liver effects, and drug interactions. Patients need strict monitoring and precautions during medication.

I. Monitoring and Prevention of QT Interval Prolongation

1. Baseline and regular electrocardiogram examinations

Delamanid may cause QTc interval prolongation. Patients must undergo an electrocardiogram before medication to assess the baseline QTc level. During treatment, regular electrocardiogram rechecks are required to closely monitor QTc changes.

2. Avoid concomitant use of related drugs

Delamanid is strictly prohibited from being used in combination with other drugs known to prolong the QTc interval (such as certain antiarrhythmic drugs, macrolide antibiotics, fluoroquinolones) to avoid additive risks.

3. Correct electrolyte disturbances

Hypokalemia and hypomagnesemia can increase the risk of QTc prolongation. During medication, electrolyte balance should be monitored and maintained, and corrected promptly if necessary.

II. Prevention and Monitoring of Hepatotoxicity

1. Regular liver function rechecks

Delamanid is mainly metabolized in the liver and may cause liver injury. During treatment, liver function indicators, especially transaminase levels, need to be monitored regularly.

2. Be alert to symptoms of liver injury

Patients should closely observe whether signs such as fatigue, decreased appetite, nausea, jaundice (yellowing of the skin or sclera), or dark urine appear. If any occur, seek medical attention immediately.

3. Contraindicated in severe hepatic impairment

For patients with severe hepatic impairment, drug metabolism capacity is significantly reduced, and Delamanid should be prohibited.

III. Management of Drug Interactions

1. Avoid concomitant use with strong CYP3A4 inducers

Delamanid is mainly metabolized through CYP3A4. Strong CYP3A4 inducers such as rifampin, carbamazepine, and phenytoin can significantly reduce the blood concentration of Delamanid, leading to decreased efficacy, and concomitant use should be avoided.

2. Use other anti-tuberculosis drugs with caution

When used in combination with other anti-tuberculosis drugs, potential interactions between drugs need to be assessed, especially drugs that may affect the QTc interval or liver function.

3. Inform the physician of all medications

Patients should proactively report to the physician all prescription drugs, over-the-counter drugs, and health supplements they are taking, so that the physician can assess the risk of drug interactions and formulate a safe combination medication plan.