The contraindications for dalafenib mesylate capsules involve specific allergic reactions and drug interactions, and medication for special populations should be adjusted based on pregnancy, liver and kidney function, and other factors. The following is a detailed explanation of contraindications and medication for special populations.

1. Contraindications

(1) Allergic reactions: It is contraindicated for patients with a history of hypersensitivity reactions to dalafenib or its excipients, manifested as severe rash or anaphylactic shock.

(2) Combination therapy contraindications: Do not use in combination with potent CYP3A4 or CYP2C8 inhibitors, as it may lead to abnormally high blood concentrations of dalafenib.

2. Medication for special populations

(1) Pregnancy period: Animal studies have shown embryotoxicity, and pregnant women should avoid using it. Before treatment, it is necessary to confirm the pregnancy status, and effective contraception should be used during the medication period and 4 weeks after the last dose.

(2) Breastfeeding period: Medication may be secreted with breast milk. Breastfeeding should be stopped during treatment and within 2 weeks after discontinuation of medication.

(3) Children: Safety and efficacy have not been established for patients under 18 years old, and its use is not recommended.

(4) Elderly: Patients aged 65 or older do not need to adjust their dosage, but need to strengthen monitoring of adverse reactions.

(5) Liver dysfunction: mild to moderate damage does not require dose adjustment; Patients with severe damage (Child Pugh C) should use with caution.

(6) Renal insufficiency: mild to moderate damage does not require dose adjustment; There is insufficient data on patients with severe damage (eGFR<30mL/min), and it is recommended to reduce usage.