Erivedge, as an inhibitor of the Hedgehog signaling pathway, has clear contraindications, dietary restrictions, and medication constraints when used. The following system explains high-risk populations, prohibited food combinations, and special restrictions that need to be avoided to ensure medication safety.

1. Taboo population

(1) Pregnant women and those planning to conceive: Based on animal teratogenic data, use during pregnancy can lead to severe fetal malformations. Women of childbearing age should take effective contraceptive measures during treatment and within 24 months after the last dose.

(2) Breastfeeding women: Medications may be secreted through breast milk. Breastfeeding should be stopped during treatment and 24 months after the last dose to avoid infant exposure risks.

(3) Severe liver and kidney dysfunction: Patients with Child Pugh C-grade cirrhosis or eGFR<30ml/min are contraindicated as metabolic and excretion disorders may lead to drug accumulation and toxicity.

2. Forbidden foods

(1) Grapefruit and its products: The furan coumarin contained in it significantly inhibits CYP3A4 enzyme, causing a more than two-fold increase in the blood concentration of Vimodge and increasing the risk of toxicity.

(2) High fat diet: Compared with fasting administration, a high-fat meal can increase the AUC of the drug by 31%. It is recommended to take it 1 hour before or 2 hours after meals.

3. Restrictive conditions

(1) Pre medication evaluation

Baseline liver function must be confirmed: dose adjustment is required for ALT/AST>2.5 times ULN or bilirubin>1.5 times ULN, and is contraindicated for severe abnormalities.

Pregnancy testing: Women of childbearing age must complete serum HCG testing 48 hours before medication, and only those with negative results can initiate treatment.

(2) Monitoring during treatment

Monthly creatine kinase testing: Especially for patients receiving statin therapy, if CK continues to increase by more than 3 times ULN, medication should be suspended.

Quarterly electrocardiogram examination: Patients at risk of QT interval prolongation (such as hypokalemia) need to be monitored regularly, and medication should be discontinued if QTc>500ms occurs.