Sorafenib, as a multi-target kinase inhibitor, has side effects that involve multiple systems and require targeted mitigation measures. This article will systematically sort out common adverse reactions and scientific response plans to help patients take medication safely.

1. Common side effects and mitigation methods

(1) Skin reactions: The incidence of hand and foot skin reactions (redness, swelling, and flaking) is about 30%. It is recommended to use urea ointment to moisturize and avoid friction; Skin rash can be treated with topical corticosteroids, and in severe cases, dosage should be reduced.

(2) Digestive symptoms: Diarrhea (40% -60%) requires electrolyte supplementation and a low fiber diet; Nausea and vomiting can be treated with medication after meals, and antiemetic drugs may be used if necessary.

(3) Hypertension: incidence rate of 15% -35%, baseline assessment is required before medication, and ACEI/ARB antihypertensive drugs are preferred after occurrence. If the duration is ≥ 160/100mmHg, medication should be suspended.

2. Serious side effects requiring immediate medical attention

(1) Cardiac toxicity: QT interval prolongation is manifested as fainting and palpitations, requiring immediate electrocardiogram monitoring and discontinuation of medication.

(2) Bleeding risk: Gastrointestinal bleeding (vomiting blood, black stool) or intracranial bleeding should be treated urgently, and medication should be discontinued if platelet count is less than 50 × 10 ⁹/L.

(3) Liver injury: permanent discontinuation of AST/ALT>5 times upper limit or bilirubin>3 times upper limit, accompanied by ascites, indicates liver failure.

3. Special protective measures

(1) Infection prevention: Avoid crowd gathering during the period of neutropenia, and blood culture tests are required for fever>38 ℃.

(2) Trauma protection: Use an electric shaver to avoid intense exercise and prevent bleeding.

(3) Light sensitivity: SPF50+sunscreen is required when going out, and UV lamps are prohibited.

(4) Drug interactions: Avoid using strong inducers of CYP3A4 (such as rifampicin) in combination, as it may reduce efficacy.