伐度司他的用药指南

Valdostat (Vafseo) is an oral HIF-PH inhibitor that provides an innovative treatment option for anemia patients with dialysis-dependent chronic kidney disease (CKD). This article will introduce in detail the medication guidelines, side effects and medication for special groups of vadostat, to help medical practitioners and patients correctly understand and use this drug.

Dosage Guidelines for Valadostat

As a new drug for the treatment of anemia in chronic kidney disease, its medication regimen needs to strictly follow individualized principles and monitoring specifications.

Pre-treatment assessment

Before starting treatment, it is necessary to comprehensively assess the patient's anemia status and rule out other causes of anemia (such as vitamin deficiency, chronic inflammation, etc.). Iron reserve status must be detected. If serum ferritin is <100mcg/L or transferrin saturation is <20%, iron supplementation is required first. At the same time, baseline liver function tests (ALT, AST, bilirubin) should be performed.

Dosage schedule

The recommended starting dose is 300 mg once a day. Swallow the whole tablet and do not chew it. Patients who were naïve to or converted from ESAs were given the same starting dose. The target hemoglobin value should be controlled at ≤11g/dL to avoid being too high and increasing the risk of thrombosis.

Dose adjustment and monitoring

Monitor the hemoglobin level every 2 weeks at the beginning of treatment, and monthly after stabilization. The dose adjustment principle is to increase by 150 mg every 4 weeks (to a maximum of 600 mg) or reduce the dose more frequently as needed. If hemoglobin rises too quickly (>1g/dL/2 weeks) or exceeds 11g/dL, medication needs to be suspended.

Strictly following the medication guidelines for vadostat can effectively control anemia symptoms while minimizing treatment risks.

Side Effects of Valostat

Understanding the potential adverse reactions of Valostat is of great significance to the safe clinical use of the drug.

Common adverse reactions

High blood pressure and diarrhea are the most common side effects, and some patients may experience symptoms such as headache and nausea.

Serious adverse reactions

Thrombotic events (such as myocardial infarction, stroke) are the most serious risks that require vigilance. Others include hepatotoxicity (elevation of ALT/AST), hypertensive crisis, epileptic seizures, and gastrointestinal bleeding.

Risks of long-term use

Long-term use may increase the risk of malignant tumors. Although the causal relationship is not yet clear, patients with abnormal liver function need to pay special attention to the manifestations of hepatotoxicity.

The side effects of Valostat should be discovered and dealt with promptly during medication.

Usage of Valostat in Special Populations

Individual differences and special risks need to be considered when using Valostat in different groups of people.

Pregnant and lactating women

Use by pregnant women only when clearly needed. Animal studies have shown that high doses may affect fetal development. Breastfeeding women should suspend breastfeeding while taking the drug.

Children and the Elderly

Safety and effectiveness in pediatric patients have not been established. Elderly patients over 65 years old do not need to adjust the dosage, and the medication characteristics are similar to those of younger patients.

Patients with abnormal liver and kidney function

Contraindicated in patients with cirrhosis or acute liver disease. No dose adjustment is required in Child-Pugh Class B patients. For use in dialysis patients only, no dose adjustment is required based on renal function.

Developing individualized medication plans for special groups can maximize the therapeutic effect of vadostat.