Axitinib, as a targeted therapy drug, must strictly follow specific restrictions on its use, including contraindications, dosage adjustment requirements, and medication control under special circumstances. The key limiting conditions are described below in terms of clinical contraindications, special population restrictions, and treatment monitoring.

1 Absolute taboo group

Prohibited for individuals allergic to axitinib or excipients; Pregnant women are prohibited from using it (animal studies have shown embryotoxicity). Patients with severe liver function impairment (Child Pugh C grade) are contraindicated, and mild to moderate impairment requires reduced monitoring.

2 Special Population Restrictions

(1) Pregnancy and lactation period

Prohibited during pregnancy, women of childbearing age need to confirm their pregnancy status before taking medication, and contraception is required during treatment and one week after discontinuation. Breastfeeding is prohibited as the medication may be secreted into breast milk. Breastfeeding should be stopped during the treatment period and within one week after the last administration.

(2) Children and the elderly

The safety of children under 18 years old has not been established; Elderly patients (≥ 65 years old) do not need to adjust the dosage, but need to strengthen adverse reaction monitoring.

Three organ dysfunction restrictions

Moderate to severe liver function impairment requires a reduction of 25% -50%; Patients with end-stage renal disease should avoid using it. Regular monitoring of liver and kidney function is required during the treatment period (every 2 weeks to every month).

4. Combination therapy restrictions

Avoid combination with potent CYP3A4/5 inhibitors (such as ketoconazole) or inducers (such as rifampicin). When it is necessary to use it in combination, the dose of axitinib needs to be adjusted (inhibitor combination is halved, inducer combination is doubled).

5. Control of treatment process

Discontinue medication if grade 3 hypertension occurs; Grade 4 hypertension or hypertensive crisis requires permanent discontinuation of medication. Medication should be suspended at least 24 hours before surgery.