What are the precautions for Adagrasib?

In clinical studies of Adagrasib (Adagrasib), warnings and precautions such as gastrointestinal adverse reactions , QTc interval prolongation, hepatotoxicity, interstitial lung disease/pneumonitis etc. have emerged. Discontinue and resume at reduced dose upon recovery, or permanently discontinue based on severity.

1. Gastrointestinal adverse reactions:Serious gastrointestinal adverse reactions include gastrointestinal bleeding, Gastrointestinal obstruction , colitis, intestinal obstruction and stenosis, and patients may also experience nausea, diarrhea, or vomiting. Monitor and manage patients using supportive care, including antidiarrheal medications, antiemetics, or fluid replacement, as indicated.

2. QTc interval prolongation:Adagrasib can cause QTc interval prolongation, thereby increasing the risk of ventricular tachyarrhythmia (such as torsade de pointes) or sudden death. Avoid coadministration of adagrasiib with other drugs known to prolong the QTc interval. Patients with congenital long QT syndrome and concurrent QTc prolongation should avoid the use of adagrasib. Monitor electrocardiograms and electrolytes prior to initiation of use, during concurrent use, and as clinically indicated in patients with congestive heart failure, bradycardia, electrolyte abnormalities, and in patients who cannot avoid concomitant medications known to prolong the QT interval.

3. Hepatotoxicity:May lead to drug-induced liver injury and hepatitis. Patients receiving adagrasiib developed alanine aminotransferase (ALT)/aspartate aminotransferase (AST) elevation, and the median time to the first ALT/AST elevation was 3 weeks. Monitor liver laboratory tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total bilirubin) before initiating treatment and monthly for 3 months or as clinically indicated, with more frequent testing in patients with elevated transaminases.

4. Interstitial lung disease (ILD)/Pneumonia:This can be fatal. Monitor patients for new or worsening symptoms of ILD/pneumonitis (e.g., dyspnea, cough, fever) during treatment with adagrasib. Discontinue adagrasib in patients with suspected ILD/pneumonitis or permanently if no other potential cause of ILD/pneumonitis is identified.

5. Special Populations: Based on animal studies, adagrasib may impair fertility in women and men of reproductive potential; due to the potential for serious adverse reactions in breastfed children, it is recommended that women not breastfeed during treatment with the drug and for 1 week after the last dose.

Sinceadagrasibthe original drug has not yet been launched in China, patients can only purchase adagrasib through overseas channels, and the U.S. original version of 200mg*180 tablets is priced at hundreds of thousands of yuan per box (the price may fluctuate due to exchange rates), which is very expensive. Currently, there are no generic drugs of adagrasib produced overseas. For more drug information and specific prices, please consult Yaode’s medical consultant.