Ponatinib, as an important drug for the treatment of specific leukemia, has contraindications mainly related to cardiovascular risk, special populations, and drug interactions. The following are specific contraindications and recommended medication times.

1. Absolute contraindications

(1) Severe cardiovascular disease: It is contraindicated for patients with recent myocardial infarction, unstable angina, stroke, or severe peripheral arterial disease, as it may increase the risk of arterial thrombotic events.

(2) Severe liver dysfunction: Child Pugh Class C patients are contraindicated due to lack of safety and efficacy data.

2 Relative Contraindications

(1) Poor control of hypertension: Medication can only be considered after stabilizing blood pressure to<140/90mmHg.

(2) History of pancreatitis: Careful evaluation of the risk benefit ratio is necessary, and close monitoring of amylase and lipase is necessary during treatment.

3 taboos for special populations

(1) Pregnancy: Animal studies have shown embryotoxicity, and pregnant women should avoid using it and take effective contraceptive measures during treatment.

(2) Breastfeeding period: Medications may be secreted through breast milk, and breastfeeding women should pause breastfeeding during the medication period and within 2 weeks after discontinuation.

4 contraindications for drug interactions

(1) Strong CYP3A inhibitors, such as clarithromycin and itraconazole, may significantly increase the exposure to sunitinib.

(2) Anticoagulant/antiplatelet drugs: Combination with warfarin and aspirin may increase the risk of bleeding and should be carefully evaluated.

5 Suggestions for Regular Medication Timing

(1) Standard protocol: once daily, recommended to be taken at the same time in the morning or evening, with a 24-hour interval between doses.

(2) Relationship with eating: It can be taken with food or on an empty stomach, but the daily medication conditions must be consistent (such as choosing to take after meals).

Adjustment of medication time for 6 special circumstances

(1) When combining CYP3A inhibitors: If the dosage needs to be adjusted to 200mg per day, it is recommended to take it in two doses (100mg in the morning and 100mg in the evening) to balance the blood drug concentration.

(2) When gastrointestinal reactions occur: If taking it in the morning causes discomfort, it can be changed to taking it after dinner to alleviate symptoms.