The contraindicated population for Belumosudil involves patients with special physiological states and underlying diseases. The contraindicated foods mainly include specific ingredients that affect drug efficacy, and the restrictions cover medication monitoring and behavioral taboos. The following three categories provide detailed explanations of clinical contraindication standards and precautions.

1. Taboo population

(1) Pregnant women: Animal studies have shown teratogenic risks, and medication should be avoided during pregnancy. Women of childbearing age need to confirm their pregnancy status before taking medication.

(2) Breastfeeding period: Medications may be secreted through breast milk. Breastfeeding is prohibited during treatment and for one week after discontinuation of medication.

(3) Liver dysfunction: Child Pugh grade C patients are contraindicated, and moderate to severe liver damage requires dose adjustment and close monitoring of transaminases.

2. Forbidden foods

(1) Grapefruit products: contain strong CYP3A4 inhibitors, which can increase blood drug concentration and increase the risk of toxicity.

(2) High fat diet: take with meals to reduce bioavailability by 30%, and should be taken on an empty stomach or with a uniform low-fat standard meal.

(3) Alcohol: It increases the metabolic burden on the liver and may induce or exacerbate drug-induced liver injury.

3. Restrictive conditions

(1) Birth control: Patients of childbearing age should use two contraceptive methods until one month after the last dose.

(2) Drug combination therapy: It is prohibited to use potent CYP3A4 inducers (such as rifampicin) in combination, and an interval of at least 14 days is required.

(3) Monitoring requirements: Blood routine tests should be conducted every 2 weeks during baseline and treatment periods, and liver and kidney function should be evaluated monthly.

4. Special restrictions

(1) Surgical contraindications: Stop medication for one week before scheduled surgery, and inform the anesthesiologist of medication history for emergency surgery.

(2) Vaccination: Live vaccines are prohibited, and inactivated vaccines must be administered during the interval between treatment cycles.

(3) Driving restrictions: Do not operate machinery or drive when experiencing dizziness or blurred vision of at least level 2.