Contraindications and people who should use ibrutinib with caution

Ibrutinib is a new targeted anti-cancer drug that has been widely used in the treatment of various B-cell malignancies such as chronic lymphocytic leukemia(CLL)/small lymphocytic lymphoma (SLL). However, like other drugs, ibrutinib has certain contraindications and should be used with caution.

1. Contraindications

1. It is contraindicated in patients who are allergic to any component of ibrutinib. Anaphylaxis may manifest as rash, difficulty breathing, etc., and may be life-threatening in severe cases.

2. Patients with severe hepatic insufficiency (Child-Pugh C) should avoid using ibrutinib. Hepatic insufficiency may lead to abnormal drug metabolism and increase the risk of adverse reactions.

2. Use with caution

1. Patients with renal insufficiency: The use of ibrutinib in patients with mild to moderate renal insufficiency (CrCl greater than 25 mL/min) is not expected to affect the exposure, but patients with severe renal insufficiency and dialysis patients should use it with caution and close monitoring.

2. Patients with hepatic impairment: Patients with mild or moderate hepatic impairment (Child-Pugh A and B) should reduce the recommended dose of ibrutinib and monitor for adverse reactions more frequently.

3. Patients with chronic graft-versus-host disease: Patients with total bilirubin levels greater than 3 times the upper limit of normal should avoid ibrutinib unless it is of non-hepatic origin or due to Gilbert syndrome. Patients with total bilirubin levels greater than 1.5 to 3 times should have the recommended dose reduced.

4. Patients with heart disease: Ibrutinib may cause arrhythmia and heart failure. For patients with cardiac complications, such as hypertension, diabetes, arrhythmia history, etc., they should be used with caution and their heart rhythm and cardiac function should be closely monitored.

In short, before using ibrutinib, patients should fully understand its contraindications and caution groups, and use it rationally under the guidance of a doctor to ensure the therapeutic effect and patient safety. It is understood that ibrutinib/ibrutinib is available in domestic and foreign markets, but prices vary depending on region and version. It is recommended that patients choose a suitable version of the drug to purchase and use based on their own needs and actual conditions.