伊曲莫德的用药指南

Itramod is a selective sphingosine-1-phosphate receptor modulator indicated for the treatment of moderately to severely active ulcerative colitis in adults. The drug exerts an immunomodulatory effect by regulating lymphocyte migration. The standard dose is 2 mg orally once daily. The use of itridimod requires strict compliance with pre-medication assessment, treatment period monitoring and management of special populations to balance efficacy and safety.

Medication Guidelines for Itrimod

Standardized use requires the establishment of a complete pre-medication assessment system and treatment period monitoring plan, and medication must be used strictly under the guidance of a doctor.

Pre-medication assessment requirements

A complete blood count (including lymphocyte count), electrocardiogram, liver function and fundus examination must be completed before treatment. People with no history of chickenpox infection or who have not completed chickenpox vaccination need to be tested for VZV antibodies. Those who are negative should complete the vaccination and postpone treatment for 4 weeks. Those who plan to receive live attenuated vaccines should complete the vaccination at least 4 weeks before treatment.

Standard dosage regimen

The recommended dose is 2 mg once a day, swallow the whole tablet, with food or on an empty stomach. If you miss a dose, you should take it at the next time you take the medicine as originally planned. Do not take a double dose. The drug is a round green film-coated tablet, engraved with "ETR" and "2" logos, and needs to be stored at 20-25°C.

Key points of monitoring during the treatment period

After the first dose, heart rate changes need to be closely monitored, and liver function and fundus should be reviewed regularly. Symptoms of vision changes, persistent headache, or abnormal liver function tests should be evaluated immediately. Avoid the use of live attenuated vaccines during treatment and for 5 weeks after stopping treatment, and limit UV exposure.

Side effects of Itrimod

Adverse reactions of Itrimod involve multiple systems, and their occurrence is directly related to the immunomodulatory properties of the drug.

Common adverse reactions

Headache, elevated liver enzymes and dizziness are mostly mild to moderate. Asymptomatic bradycardia and slight increase in blood pressure may occur after the first dose.

Management of serious adverse reactions

Signs of posterior reversible encephalopathy syndrome (PRES) (sudden headache, disturbance of consciousness, etc.) require immediate neurological evaluation. The drug should be discontinued if liver damage, severe infection, or macular edema is confirmed. Patients with high-risk skin require regular professional examinations.

Timely identification and management of adverse reactions of itrimod is crucial to maintaining treatment continuity.

Special population use of itramod

Different populations have different metabolism and tolerance of itramod, and the medication regimen needs to be adjusted individually.

Cardiovascular risk groups

It is contraindicated for those with a history of serious cardiovascular events in the past 6 months. Those with uncontrolled cardiovascular disease, resting heart rate <50 bpm, or those using Class Ia/III antiarrhythmic drugs require cardiology consultation and evaluation. Use with caution in patients with prolonged QT interval.

Patients with abnormal liver and kidney function

No dose adjustment is required for mild to moderate liver impairment (Child-Pugh Class A/B), and it is contraindicated for severe (Child-Pugh Class C) liver function impairment. No dose adjustment is required in patients with any stage of renal impairment, but data are limited in patients with end-stage renal disease.

Pregnant and lactating women

Contraindicated during pregnancy (animal experiments show teratogenicity). Women of childbearing potential need effective contraception during treatment and for 1 week after stopping the drug. The pros and cons of taking medication during lactation need to be weighed, and breastfeeding should be suspended if necessary.

Elderly patients

The pharmacokinetics of patients aged ≥65 years are similar to those of young people, but due to more comorbidities, more monitoring is required. There are limited data on patients aged ≥75 years in clinical studies (only 3 cases), and the benefit-risk ratio needs to be carefully evaluated.

Special groups need to strictly control the indications when using itridimod, and seek guidance from specialists when necessary.