Entrectinib (Rozlytrek) is a targeted drug indicated for the treatment of tumors with specific gene mutations.
Common Adverse Reactions and Clinical Manifestations
1. Systemic Reactions
(1) Fatigue is one of the most common adverse reactions, affecting nearly half of patients.
(2) In addition, edema, fever and weight gain are also frequently reported.
2. Gastrointestinal Reactions
Many patients experience constipation, diarrhea, nausea, vomiting and abdominal pain. Taste alterations (dysgeusia) are also commonly reported.
3. Neurological Effects
Adverse reactions include dizziness, paresthesia (e.g., tingling or numbness), cognitive impairment (e.g., memory loss, inattention, confusion), mood disorders (e.g., anxiety, depression) and sleep disturbances (insomnia or somnolence).
4. Musculoskeletal Disorders
(1) Patients may experience myalgia, arthralgia, muscle weakness and limb pain.
(2) Special attention should be paid to the increased risk of fractures associated with this drug, which is particularly prominent in pediatric patients.
5. Effects on Other Systems
(1) Ocular: Blurred vision, photophobia, diplopia, floaters and other symptoms may occur.
(2) Cardiac: May lead to congestive heart failure and QT interval prolongation.
(3) Metabolic: May induce hyperuricemia.
(4) Hepatic: May cause elevated transaminase levels and hepatic injury.
Strategies for Alleviation and Management of Adverse Reactions
1. Routine Supportive Care
(1) For fatigue, rational scheduling of rest and activity is recommended.
(2) Nausea and vomiting can be relieved by dietary adjustments (small and frequent meals, avoidance of greasy foods) or the use of prescription antiemetics.
(3) For constipation, increase dietary fiber intake and water consumption; mild laxatives may be used if necessary.
(4) For diarrhea, attention should be paid to fluid and electrolyte replacement.
2. Medical Interventions for Specific Adverse Reactions
(1) Hepatic function monitoring: If signs of hepatic injury appear, physicians will adjust the dosage or temporarily discontinue the drug based on the severity.
(2) Cardiac function monitoring: Patients with cardiac risk factors need cardiac function assessment prior to medication administration. Any symptoms of heart failure (e.g., shortness of breath, edema) should be reported to physicians immediately.
(3) Fracture risk prevention: Patients should be alert to bone pain or abnormal movement and inform physicians promptly for evaluation.
(4) Hyperuricemia management: Monitor serum uric acid levels regularly; physicians may prescribe urate-lowering drugs if needed.
(5) QT interval prolongation: Conduct regular electrocardiograms and electrolyte tests; avoid concomitant use of other drugs that may prolong the QT interval.
(6) Ocular disorders: Any visual changes should be referred to an ophthalmologist promptly; physicians may recommend temporary discontinuation of the drug.
3. Dosage Adjustment and Medication Guidance
(1) For most adverse reactions, physicians may adopt strategies such as temporary drug discontinuation, dosage reduction or permanent discontinuation.
(2) Do not adjust the dosage on your own. If a dose is missed, take the missed dose as soon as you remember; however, if it is within 12 hours of the next scheduled dose, skip the missed dose.
(3) If vomiting occurs immediately after administration, a single supplementary dose may be taken.
Proper Storage and Environmental Requirements for the Drug
1. Storage Conditions
(1) Both capsules and oral granules should be stored in their original packaging at room temperature between 20°C and 25°C (68°F and 77°F).
(2) Short-term storage within a temperature range of 15°C to 30°C (59°F to 86°F) is permitted.
(3) The drug must be kept in a dry place and protected from moisture.
2. Safety Warning
Keep Entrectinib and all medications out of the reach of children to ensure safe medication use.
