Alpelisib-Piqray causes high blood sugar issues

The warnings and precautions in the Alpelisib (Alpelisib)-Piqray instructions indicate that patients using this drug may cause hyperglycemia problems, including ketosis, and in some cases are related to hyperglycemic hyperosmolar nonketotic acidosis syndrome (HHNKS) or ketoacidemia. In the clinical studies of Apelix, patients with type 1 or uncontrolled type 2 diabetes (hemoglobin A1c>6.5%) were excluded from the clinical trials.

Providers should measure fasting plasma glucose (FPG), hemoglobin A1c, and optimize blood glucose before initiating treatment with Apelvis. Signs and symptoms of high blood sugar may include excessive thirst, urinating more often or peeing more than usual, or increased appetite with weight loss. In grade ≥2 (FPG 160-250 mg/dL) hyperglycemia, the median time to first onset of hyperglycemia was 15 days. After starting treatment, blood glucose should be monitored regularly. Antihyperglycemic agents may be initiated as clinically indicated to improve blood glucose levels. When monitoring blood glucose, do not reduce the dose of Apelvis until Level 2 is achieved. The first-line recommendations for antidiabetic treatment are metformin or an insulin sensitizer; short-acting insulin may also be used in the short term until hyperglycemia subsides.

The original drug of Apellis is not marketed in the country and therefore cannot be included in medical insurance. There are European and Indian versions of the original Apelvis drug sold overseas. The ingredients are basically the same. The price of the European version of 150mg*56 tablets per box may be more than 4 RMB 40,000 ( (The price may fluctuate due to the exchange rate), The price of the Indian version150mg*28 tablets per box may be more than 5,000 yuan (the price may fluctuate due to the exchange rate). There are currently no generic versions of Apelvis produced and marketed.