Before taking Rukobia(Fostemsavir)

Immune Reconstitution Syndrome

Combination antiretroviral therapy (including fostemsavir) may trigger immune reconstitution syndrome, which manifests as an inflammatory response to latent or residual opportunistic infections (such as Mycobacterium avium infection, cytomegalovirus, Pneumocystis jirovecii pneumonia, and tuberculosis). Close monitoring and timely treatment are required.

QTc Interval Prolongation

Doses higher than the recommended dose (2400 mg twice daily) can significantly prolong the QTc interval. It should be used with caution in patients with a history of QTc prolongation, those taking drugs known to cause Torsades de Pointes, or patients with heart diseases. Elderly patients are more prone to drug-induced QTc interval prolongation.

Liver Enzyme Elevation in Patients Coinfected with Hepatitis B or Hepatitis C

The proportion of liver transaminase elevation is higher in patients coinfected with hepatitis B (HBV) or hepatitis C (HCV). Some cases are associated with hepatitis B reactivation, especially when anti-hepatitis B treatment is discontinued. It is recommended to initiate or maintain effective hepatitis B treatment.

Adverse Reactions or Loss of Virological Response Caused by Drug Interactions

Concomitant use of certain drugs may lead to a decrease in fostemsavir exposure (resulting in reduced efficacy or drug resistance) or an increase in fostemsavir exposure (increasing the risk of QTc prolongation). Before and during medication use, drug interactions should be evaluated, and adverse reactions should be monitored.