As a targeted therapy drug, the use of Brigatinib has clear contraindications, dietary restrictions, and special condition constraints. The following provides a detailed explanation from four aspects: absolute contraindications, relative contraindications, food interactions, and special restriction conditions, with a focus on the risks associated with pregnancy contraindications and CYP3A metabolism.

1. Absolute taboo group

(1) Pregnant women: Based on animal studies showing embryotoxicity, contraceptive measures should be taken during treatment and at least 4 months after discontinuation of medication. Unexpected pregnancies should be immediately discontinued and evaluated with medical attention.

(2) Severe liver function impairment: Child Pugh Class C patients are contraindicated as significant inhibition of drug metabolism may lead to toxic accumulation.

(3) Acute phase of interstitial lung disease: Previous use of ALK inhibitors with severe lung injury is prohibited from reuse.

2. Relatively taboo population

(1) Breastfeeding women: Medications may be secreted through breast milk, and breastfeeding should be suspended during treatment and for one week after discontinuation of medication.

(2) Severe bradycardia: Patients with a basal heart rate of less than 50 beats per minute or atrioventricular block of grade II or above should use it with caution and require electrocardiographic monitoring.

(3) Active infected individuals: When neutrophils are less than 1.5 × 10 ⁹/L, infection control should be prioritized before considering medication.

3. Taboo foods and drugs

(1) Grapefruit products: containing strong CYP3A4 inhibitors, can increase the blood concentration of brigatinib by more than three times.

(2) St. John's wort: As a strong inducer of CYP3A4, it significantly reduces drug efficacy and requires an interval of at least 14 days.

(3) High fat diet: When taken with a high-fat meal, AUC increases by 40%. It is recommended to take on an empty stomach or under a uniform low-fat diet.

4. Special Restrictions

(1) Ophthalmic monitoring: Retinal examination is required every 3 months before and during the treatment, especially for diabetes patients.

(2) Dose adjustment: The recommended starting dose for Asian populations is 90mg instead of 180mg, as the incidence of interstitial lung disease is higher.

(3) Surgical restrictions: Medication must be discontinued for at least 7 days before major surgery, and can only be resumed after the wound has healed.