AGAMREE requires vigilant monitoring for infections, endocrine dysfunction, and systemic complications.

Clinical Monitoring and Risk Mitigation

Key precautions include immunosuppression-related infections (e.g., reactivation of TB, hepatitis B, fungal/parasitic infections), necessitating pre-treatment screening. Chronic use risks hypothalamic-pituitary-adrenal (HPA) axis suppression, hyperglycemia, hypertension, and osteoporosis; regular monitoring of cortisol, blood glucose, blood pressure, and bone density is advised. Live vaccines must be administered ≥4–6 weeks pre-treatment. Gastrointestinal perforation risk is elevated in patients with peptic ulcers or diverticulitis. Behavioral/mood disturbances (e.g., psychosis, insomnia) warrant close psychiatric monitoring. Ophthalmic exams are recommended for cataracts/glaucoma with prolonged use. Avoid in cerebral malaria or untreated Strongyloides infection.