来法莫林(Xenleta)的用药指南

Lefamoren (Xenleta) is a pleuromutilin antibiotic. The tablets should be taken at least 1 hour before or 2 hours after meals. The tablets should be swallowed whole and should not be crushed or divided.

Indications for Xenleta

It is mainly used to treat community-acquired bacterial pneumonia (CABP) in adults. Common pathogenic bacteria it targets include Streptococcus pneumoniae, Staphylococcus aureus (methicillin-sensitive strains), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae.

Lefamoren (Xenleta) Medication Guide

1. Recommended dose

The recommended dose is 600mg, once every 12 hours.

2. Treatment course

The standard treatment course is 5 days.

3. Taking time

It must be taken on an empty stomach at least 1 hour before a meal or at least 2 hours after a meal. The whole tablet needs to be taken with enough water (about 180-240mL) and cannot be crushed or broken.

4. Treatment of missed doses

If you miss a dose, you should take it as soon as possible 8 hours before the next dose; if it is less than 8 hours, skip the missed dose and take the next dose as originally planned.

The pictures come 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.

Dose adjustment of Xenleta for special groups

1. Patients with hepatic insufficiency

It is not recommended for patients with moderate (Child-Pugh B) or severe (Child-Pugh C) liver damage. Patients with mild liver damage do not need to adjust the dose.

2. Patients with renal insufficiency

For patients with renal insufficiency, including patients undergoing hemodialysis, there is no need to adjust the dose of lefamolin.

3. Elderly patients

In clinical studies, the efficacy and incidence of adverse reactions in elderly patients (≥65 years old) were similar to those in younger patients, so no additional dose adjustment is required.

4. Pregnant women

Based on animal studies, lefamoren may cause harm to the fetus. Women of childbearing age should confirm that they are not pregnant before taking the drug, and take effective contraceptive measures during treatment and within 2 days after the last dose.

5. Breastfeeding women

It is recommended to suspend breastfeeding during the entire treatment period and within 2 days after the last dose, and to pump out and discard breast milk.

Adverse reactions of Xenleta

Common reactions of tablets (incidence ≥2%): mainly include diarrhea, nausea, vomiting and elevated liver enzymes.

It is worth noting that diarrhea may be a manifestation of Clostridium difficile-associated diarrhea (CDAD), and timely medical attention is required once it occurs. In addition, this drug has the potential risk of prolonging the QT interval on the electrocardiogram and should be avoided in patients who already have QT interval prolongation or are taking other drugs that can prolong the QT interval.

Lefamoren (Xenleta) drug interactions

1. Enzyme inducers

Combined use with strong or moderate CYP3A4 or P-gp inducers (such as rifampin) will significantly reduce the blood concentration of lefamorelin, which may affect the efficacy, and combined use should be avoided.

2. Enzyme inhibitors

Combined use with strong CYP3A or P-gp inhibitors (such as ketoconazole) will significantly increase the blood concentration of lefamoren tablets and increase the risk of adverse reactions, so combined use should be avoided.

3. QT interval prolonging drugs

Should avoid combined use with Class IA (such as quinidine) or Class III (such as amiodarone) antiarrhythmic drugs and other drugs that can prolong the QT interval (such as certain antipsychotics, fluoroquinolones).