Lurbinectedin precautions and drug interactions

When using Lurbinectedin, you need to focus on hematological toxicity, hepatotoxicity and drug interaction risks. It has clear interactions with CYP3A4 inhibitors/inducers and grapefruit, and medication monitoring and contraindications must be strictly followed.

Precautions during the medication period of Lurbinectedin

1. Hematological toxicity

Severe neutropenia, thrombocytopenia and anemia may occur. Regular blood routine monitoring is required, and supportive treatment or dosage adjustment is required if necessary.

2. Hepatotoxicity

Liver function needs to be evaluated before treatment, and ALT/AST/bilirubin should be monitored every cycle during treatment. If liver damage of grade 2 or above occurs, administration must be suspended and the dosage reduced after recovery.

3. Reproductive toxicity

has potential embryo-fetal toxicity. Patients of childbearing age need to take effective contraceptive measures during the medication and within 6 months after the last dose.

4. Handling special situations

(1). Missed dose: Contact the medical team immediately. Do not take a double dose. The subsequent dosing plan needs to be adjusted according to the medication cycle.

(2) Drug overdose: There is no specific antidote. In the event of overdose, the drug should be stopped immediately, symptomatic and supportive treatment should be given, and vital signs should be closely monitored.

The pictures are from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Lurbinectedin Precautions

1. Myelosuppression

Lurbinectedin may cause bone marrow suppression. Blood routine needs to be monitored before treatment and before each medication. The drug can only be used when baseline neutrophils ≥ 1500 cells/mm³ and platelets ≥ 100000/mm³. If severe suppression occurs, the drug needs to be suspended, reduced or discontinued according to the situation. When neutrophils are <500 cells/mm³, it is recommended to use G-CSF for prevention.

2. Hepatotoxicity

Medication may cause liver damage. Liver function needs to be monitored regularly before and during treatment. If abnormalities occur, suspend, reduce the dose, or discontinue the drug according to the severity.

3. Extravasation causes tissue necrosis

Drug extravasation can cause skin and soft tissue necrosis (needing debridement). It is recommended to use a central venous catheter to reduce the risk. Close observation is required during infusion. If extravasation occurs, the drug should be discontinued immediately and the tube removed. Signs of necrosis should be monitored. Subsequent infusion sites need to be changed and supportive treatment given.

4. Rhabdomyolysis

Rhabdomyolysis may occur during treatment. Creatine phosphokinase (CPK) needs to be monitored regularly before and during treatment. In severe cases, the dose should be suspended or reduced.

5. Embryo-fetal toxicity

Based on animal research and mechanism of action, drugs can cause fetal harm. Pregnant women need to be aware of the risks, and men and women of childbearing potential need to take effective contraceptive measures.

Lurbinectedin drug interactions

1. Strong CYP3A inhibitors

Combined use with strong CYP3A inhibitors will increase the systemic exposure of lurbinectedin, and the dose of lurbinectedin needs to be reduced.

2. Moderate CYP3A inhibitors

When used together with moderate CYP3A inhibitors, it is necessary to consider whether to adjust the dose based on the clinical situation.

3. Strong CYP3A inducers

Combined use with strong CYP3A inducers will reduce the systemic exposure of rupitidine and may reduce the efficacy, so combined use should be avoided.