What are the possible adverse reactions of Besudil/Yilaike and how to deal with them?

Belumosudil mesylate tablets (Belumosudil) is an innovative oral drug for chronic graft-versus-host disease (cGVHD). Its safety issues are a common focus for patients and clinicians. Judging from overseas medication experience and real-world reports, the overall tolerability of besudil is relatively controllable, but a certain degree of adverse reactions may still occur during long-term medication, which requires standardized monitoring and individualized treatment.

In clinical application, the most common adverse reactions of besudil are mild to moderate, mainly involving the gastrointestinal system, changes in liver function indicators, and systemic symptoms such as fatigue. Some patients may experience loss of appetite, nausea, diarrhea or abdominal discomfort in the early stages of taking the drug. Such conditions are usually related to the drug's regulation of the intestinal mucosa and inflammatory pathways. In actual treatment, most patients can gradually relieve their symptoms by taking it with meals, adjusting their diet or short-term symptomatic support, and generally do not need to interrupt treatment.

Fluctuations in liver function indicators are also one of the issues that need to be paid attention to during the use of Besudil. Overseas data show that some patients may experience mild increases in transaminases or bilirubin during treatment, but most of them are reversible changes. Clinically, it is usually recommended to regularly monitor liver function before medication and during treatment. Once abnormalities are found, medication can be suspended, dosage adjusted, or follow-up strengthened according to the specific situation. Patients with severe liver function abnormalities need to re-evaluate the treatment plan under the guidance of a specialist.

In addition, systemic reactions such as fatigue, muscle discomfort, and headache have also been reported in some patients. Such symptoms are mostly related to chronicGVHD itself or the immune regulatory state, and it is difficult to completely distinguish drug factors. In actual management, more emphasis is placed on comprehensively assessing the patient's overall condition and avoiding simple discontinuation of medication, but instead reducing symptoms through improving sleep, nutritional support and basic disease control.

Reference: https://www.drugs.com/pro/rezurock.html