As an anti tuberculosis drug, the side effects of pretomanid mainly involve the nervous system, liver, and blood system, and different treatment measures need to be taken according to the severity of symptoms. The following categories explain their common and cautionary side effects.

1 Common but potentially self relieving side effects

(1) Nervous system: headache, dizziness, peripheral neuropathy (manifested as numbness or tingling in hands and feet).

(2) Digestive system: Nausea, vomiting, decreased appetite, usually relieved with prolonged medication.

(3) Systemic symptoms: fatigue, weakness. It is recommended to avoid driving or operating machinery during medication.

Serious side effects that require immediate medical attention

(1) Hepatotoxicity: Jaundice, darkened urine color, and pain in the upper right abdomen suggest possible liver injury.

(2) Abnormal blood system: abnormal bleeding, bruising, persistent fever, which may be related to bone marrow suppression.

(3) QT interval prolongation: palpitations and fainting require immediate electrocardiogram monitoring.

3 Forbidden Groups

(1) Pregnancy period: Animal studies have shown embryotoxicity, and pregnant women should avoid using contraception. Women of childbearing age should take contraceptive measures during treatment and after discontinuing medication.

(2) Breastfeeding period: Medications may be secreted through breast milk. Breastfeeding is prohibited during treatment and after the last administration.

(3) Liver function impairment: Patients with severe liver dysfunction should use caution and closely monitor liver function indicators.

4 Special precautions

(1) When using combination therapy, it is necessary to monitor bone marrow suppression and neuropathy related to linezolid.

(2) HIV infected individuals may experience drug interactions and need to adjust their antiretroviral regimen.

(3) During the treatment period, liver function, blood routine, and electrolyte levels should be monitored monthly.

(1) Liver function monitoring: Regular monitoring of liver function is required during treatment, and any abnormalities should be promptly adjusted in dosage or discontinued.

(2) Drug interactions: Caution should be exercised when combined with strong CYP3A4 inducers or inhibitors as it may affect drug concentration.

(3) Adverse reaction management: Common adverse reactions include peripheral neuropathy, liver dysfunction, etc., which need to be treated in a timely manner.