详解来法莫林(Xenleta)不良反应的预防与处理措施

Xenleta is an antibacterial drug that may also cause some side effects while treating diseases.

Side effects of Xenleta

1. Common side effects (incidence ≥2%)

These reactions are usually mild and can be tolerated by most patients:

The most common side effects of oral tablets are diarrhea (incidence up to 12%), nausea, vomiting, and elevated liver enzymes.

2. Serious side effects that require vigilance

Although the incidence is not high, you must seek medical attention immediately if the following conditions occur:

(1) QT interval prolongation: This drug may affect the electrical activity of the heart, leading to prolongation of the QT interval on the electrocardiogram, and increasing the risk of serious ventricular arrhythmias (such as torsade de pointes). Patients who have heart problems or are taking other drugs that prolong the QT interval are particularly at risk.

(2) Clostridium difficile-related diarrhea: It may be caused by the use of almost all antibacterial drugs. Symptoms can range from mild diarrhea to life-threatening colitis, with watery stools, abdominal pain, and fever. It may even occur up to 2 months after stopping the drug.

(3) Severe allergic reaction: People who are allergic to lefamoren or pleuromutilin drugs may develop rash, itching, difficulty breathing, swelling of the face or throat, etc., and need to stop taking the drug immediately and seek emergency medical help.

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.

Methods to manage and alleviate the side effects of Xenleta

1. Daily responses to common side effects

(1) Gastrointestinal reactions (nausea, vomiting, diarrhea):

When taking oral tablets, strictly adhere to the fasting requirements (1 hour before meals or 2 hours after meals) to reduce gastrointestinal irritation.

When diarrhea occurs, pay attention to replenishing water and electrolytes to prevent dehydration.

If diarrhea is severe, persistent, or bloody, you must consult a doctor immediately to rule out C. difficile infection.

(2) Injection site reaction: Inform medical staff that they can improve it by adjusting the infusion speed or changing the injection site.

(3). Headache/insomnia: Pay attention to rest and maintain a quiet environment. If it continues to affect your life, you should inform your doctor.

2. Principles for dealing with serious side effects

(1) Heart risks: Be sure to inform your doctor of your complete medical history and medication history before taking medication. If you are in a high-risk group and must use it, your doctor may recommend electrocardiogram monitoring. Never self-administer drugs that may prolong the QT interval.

(2) Signs of allergy: Stop taking medication immediately and seek emergency medical assistance.

Precautions for use of Xenleta in special populations

1. Patients with liver damage

Xenleta tablets are not recommended for patients with moderate or severe liver damage. It can be used in patients with mild liver impairment, but requires close monitoring.

2. Pregnant women and women of childbearing potential

(1) Fetal risk: Based on animal experiments, lefamoren may cause harm to the fetus and is contraindicated in pregnant women.

(2) Contraceptive requirements: Women of childbearing potential need to take a pregnancy test to confirm that they are not pregnant before taking the drug. And effective contraceptive measures must be taken during treatment and within 2 days after the last dose.

3. Breastfeeding women

Lefamorelin will enter into rat milk in large amounts, and it is speculated that it will also enter into human milk. However, it is recommended to suspend breastfeeding during treatment and within 2 days after the last dose, and pump out and discard the milk.

4. Elderly patients

The effectiveness and safety of lefamulin in elderly patients aged 65 and above are similar to those in younger patients, and there is no need to adjust the dose uniformly. However, because the elderly may be complicated by other diseases and medications, a comprehensive evaluation by a doctor is required.

5. Children and patients with renal impairment

Children: Safety and effectiveness have not been established in patients under 18 years of age and use is not recommended.