Idelalisib(Zydelig) is a drug that targets PI3Kδ kinase and needs to be strictly followed to balance efficacy and safety. Proper administration and management of adverse reactions are very important for the effectiveness of treatment.
How to take Idelalisib(Zydelig)?
The use of Idelalisib should be based on the patient's individual condition and the doctor's guidance, and the following are the specific medication specifications.
Recommended dosage and dosage and dosage
The recommended dose of Idelalisib is 150 mg orally twice daily and can be taken with or without food. Tablets should be swallowed whole, not broken or chewed. The original Gilead drug in the United States is 150mg×60 tablets. Treatment should be continued until disease progression or intolerable toxicity occurs, and long-term regimens should be evaluated regularly.
Dose adjustment and medication for special populations
In case of serious adverse reactions, the dose can be reduced to 100mg twice daily. Older patients (≥ 65 years old) are at high risk of adverse reactions and need to strengthen liver function and routine blood monitoring. Patients with abnormal liver function (eg, ALT/AST > 2.5 times the upper limit of normal) should be cautious and avoid combining other hepatotoxic drugs. There are no safety data for children, pregnant women, and lactating women, and it is not recommended.
Prior to treatment, no active infection should be confirmed and Pneumocystis jirovecii pneumonia (PJP) prophylaxis should be completed. During the treatment period, liver enzymes and blood counts were monitored every 2 weeks, and the treatment regimen was adjusted in time.
Measures for the treatment of missed doses of Idelalisib
The management of missed drugs should be flexibly responded to according to the time window to avoid dosage confusion affecting efficacy.
Principles of top-up after missed doses
If the missed dose is within 6 hours, the dose should be retaken immediately and the medication should be continued as originally planned. If it is more than 6 hours, skip this dose and take the next dose directly. It is not advisable to double the dose to make up for missed doses, as this increases the risk of toxicity.
Patient self-management recommendations
It is recommended to use mobile phone reminders or dispensing pill boxes to reduce the probability of missing doses. If the dose is frequently missed, it is necessary to communicate with the doctor to assess compliance issues and adjust the medication regimen if necessary. The timing of medication and adverse reactions are recorded to provide complete information at the follow-up visit.
Missed doses may cause fluctuations in blood levels and affect the effectiveness of treatment. Patients should follow their doctor's instructions strictly to ensure continuity of medication.
Adverse effect mitigation methods of Idelalisib
Common adverse effects of Idelalisib require early recognition and intervention to reduce the risk of complications.
Hepatotoxicity and infection management
Severe hepatotoxicity occurred in 16% of patients, with ALT/AST elevated more than 5 times normal. Liver enzymes should be monitored every 2 weeks, and if abnormally elevated, the drug should be suspended until the dose is reduced and restarted. Forty-eight percent of patients develop severe infections (eg, pneumonia, sepsis) that require infection control prior to treatment and seek medical attention as soon as fever or cough worsens.
Diarrhea is treated with skin reactions
Twenty percent of patients have grade 3 or higher diarrhea that does not respond to antimotility and require discontinuation of Idelalisib and corticosteroids. Severe skin reactions (e.g., Stevens-Johnson syndrome) require permanent discontinuation and dermatologic consultation. Patients with neutropenia (58%) require weekly routine monitoring of blood count, and whitening drugs if necessary.
Intestinal perforation is rare but fatal, and new abdominal pain or vomiting requires immediate evaluation. Hypersensitivity reactions (e.g., anaphylactic shock) require permanent discontinuation and emergency treatment. Avoid live vaccines during treatment to reduce exposure to infection.
Idelalisib should be stored at 15-30°C, away from moisture and light. Patients should have regular re-examination of imaging and laboratory indicators, and cooperate with doctors to adjust treatment strategies. If you have any new symptoms, contact your health care team to find out if they are related to medication and do not interrupt treatment on your own.
