阿西替尼(阿昔替尼)Axitinib会出现副作用吗
病情描述:阿西替尼(阿昔替尼)Axitinib会出现副作用吗
展开2024-01-20 13:23:06
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病情描述:阿西替尼(阿昔替尼)Axitinib会出现副作用吗
展开2024-01-20 13:23:06
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陈志明
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阿西替尼(阿昔替尼)Axitinib会出现副作用吗,阿西替尼(Axitinib)常见副作用包括高血压、疲劳、腹泻、食欲减少、恶心、声音嘶哑、手足综合症(HFS)、体重减轻、呕吐和便秘。监测血压和完整的血象是在治疗期间推荐的。阿西替尼(Axitinib)是一种小分子酪氨酸激酶抑制剂。它对多种肿瘤类型显示出部分反应,用于治疗肾细胞癌(RCC)。疗效如下:1.抑制肿瘤生长。2.延长肾细胞癌患者的进展生存期。3.阿昔替尼(Axitinib)也被用于治疗术后复发的肾细胞癌患者。该药品在治疗相关疾病方面表现出色,疗效显著、安全性高。
Title: Does Axitinib (Axitinib) Come with Side Effects?
Introduction:
Axitinib, also referred to as Axitinib, is a tyrosine kinase inhibitor primarily used for the treatment of advanced renal cell carcinoma (Kidney cancer) after the failure of one prior systemic therapy. This medication functions by slowing the growth of cancer cells in the body. Despite its effectiveness, patients undergoing Axitinib treatment might experience various side effects. Understanding these potential effects is crucial for patients, caregivers, and healthcare professionals. In this article, we will explore the possible side effects associated with Axitinib treatment.
1. Common Side Effects
Like all medications, Axitinib can lead to several common side effects such as hypertension (high blood pressure), fatigue, loss of appetite, nausea, hoarseness, voice changes, hand-foot syndrome (palmar-plantar erythrodysesthesia), weight loss, and gastrointestinal disturbances. These side effects are generally manageable and often decrease in severity over time as the body adjusts to the medication. However, it is important for patients to communicate any notable symptoms to their healthcare provider.
2. Serious Adverse Reactions
In addition to the common side effects, Axitinib can also cause more severe adverse reactions such as hemorrhage (bleeding), thrombotic events (blood clots), gastrointestinal perforation (a hole that develops through the wall of the stomach, small intestine, large bowel, or gallbladder), reversible posterior leukoencephalopathy syndrome (a rare neurological disorder), and proteinuria (excess protein in the urine). These serious side effects require immediate medical attention and may necessitate adjustment of the treatment plan.
3. Cardiovascular and Hematologic Effects
Axitinib has been associated with cardiovascular events such as heart failure, left ventricular dysfunction, and myocardial infarction (heart attack). Patients may also experience hematologic abnormalities including decreased levels of thyroid stimulating hormone (TSH), anemia, and increased risk of bleeding. Careful monitoring for these complications is essential during Axitinib therapy.
4. Hepatic and Dermatologic Side Effects
Another category of side effects linked to Axitinib involves the liver and skin. Elevated liver enzymes, liver failure, and hepatic impairment have been reported in some patients. Dermatologic reactions can include rash, dry skin, hand-foot skin reaction, and alopecia (hair loss). Patients receiving Axitinib should be vigilant for any signs or symptoms of hepatic dysfunction or significant skin changes.
5. Risk of Hypertension and Thyroid Abnormalities
Patients taking Axitinib often experience elevated blood pressure, necessitating close monitoring and management. Furthermore, thyroid abnormalities such as hypothyroidism and hyperthyroidism may occur, requiring regular thyroid function tests and appropriate intervention as needed.
In conclusion, while Axitinib is a valuable treatment for advanced renal cell carcinoma, it is imperative for patients and healthcare providers to be vigilant about potential side effects. Through open communication and regular monitoring, many of these adverse reactions can be effectively managed, allowing patients to continue benefiting from this important therapy. As with any medication, the decision to use Axitinib should be based on a thorough evaluation of its benefits and potential risks.
功能主治:进展期肾细胞癌(RCC)的成人患者
用法用量: 用法用量 有肿瘤治疗经验的医生才可使用阿昔替尼治疗。 推荐剂量 1、阿昔替尼推荐的起始口服剂量为5mg(每日两次)。 阿昔替尼可与食物同服或在空腹条件下给药,每日两次给药的时间间隔约为12小时(见【药代动力学】)。 应用一杯水送服阿昔替尼。 2、只要观察到了临床获益,就应继续治疗,或直至发生不能接受的毒性,该毒性不能通过合并用药或剂量调整进行控制。 3、如果患者呕吐或漏服一次剂量,不应另外服用一次剂量。 应按常规服用下一次处方剂量。 剂量调整指南 建议根据患者安全性和耐受性的个体差异增加或降低剂量。 一、在治疗过程中,满足下述标准的患者可增加剂量: 1、能耐受阿昔替尼至少两周连续治疗、未出现2级以上不良反应(根据美国国立癌症研究所(NCI)不良事件常见术语标准[CTCAE])、血压正常、未接受降压药物治疗。 当推荐从5mgBID开始增加剂量时,可将阿昔替尼剂量增加至7mgBID,然后采用相同标准,进一步将剂量增加至10mgBID。 2、在治疗过程中,一些药物不良反应的治疗可能需要暂停或永久中止阿昔替尼给药,或降低阿昔替尼剂量(见【注意事项】)。 如果需要从5mgBID开始减量,则推荐剂量为3mgBID。 如果需要再次减量,则推荐剂量为2mgBID。 二、合用CYP3A4/5强效抑制剂: 1、应避免合用CYP3A4/5强效抑制剂(比如:酮康唑、伊曲康唑、克拉霉素、阿扎那韦、茚地那韦、奈法唑酮、奈非那韦、利托那韦、沙奎那韦、泰利霉素、伏立康唑)。 建议选择无CYP3A4/5抑制潜能或有CYP3A4/5微弱抑制潜能的药物作为替代的合用药物。 2、尽管尚未在接受CYP3A4/5强效抑制剂的患者中进行阿昔替尼剂量调整的研究,但如果必须与CYP3A4/5强效抑制剂合用,建议将阿昔替尼的剂量减半,因为预计降低剂量后,阿昔替尼血浆浓度-时间曲线下面积(AUC)将调整至不与抑制剂合用的AUC范围内。 3、可根据患者安全性和耐受性的个体差异增加或降低随后剂量。 如果停止与强效抑制剂合用,应将阿昔替尼剂量恢复至(当经过3-5个抑制剂半衰期后)开始CYP3A4/5强效抑制剂给药前使用的剂量(见【药物相互作用】和【药代动力学】)。 4、合用强效CYP3A4/5诱导剂阿昔替尼与强效CYP3A4/5诱导剂合用可能降低阿昔替尼的血浆浓度(见【药物相互作用】)。 建议选择无或仅有最低程度CYP3A4/5诱导可能性的药物作为替代的合用药物。 5、尽管尚未在接受强效CYP3A4/5诱导剂的患者中研究阿昔替尼剂量调整,但如果必须与强效CYP3A4/5诱导剂合用,建议逐渐增加阿昔替尼的剂量。 据报道,大剂量强效CYP3A4/5诱导剂的最大诱导作用在合用该诱导剂治疗一周内出现。 如果阿昔替尼的剂量增加,应仔细监测患者的毒性。 6、一些不良药物反应的治疗可能需要暂停或永久中止阿昔替尼治疗,和/或降低阿昔替尼的剂量(见【注意事项】)。 如果停止与强效诱导剂合用,应立即将阿昔替尼的剂量恢复至开始强效CYP3A4/5诱导剂给药前使用的剂量(见【药物相互作用】)。