The medication precautions for 10mg * 56 tablets/box of dalfampridine sustained-release tablets involve dosage control, contraindications, monitoring requirements, and management of special populations, which must be strictly followed to reduce the risk of adverse reactions.

1. Applicable population

(1) Multiple sclerosis: Clinically diagnosed recurrent remitting or secondary progressive multiple sclerosis patients, used to improve walking ability (can increase walking speed by 25% -40%).

(2) Age range: Patients aged 18-65 years old have clear therapeutic effects, and elderly patients should be cautious when using it after evaluating renal function.

2 Dosage and administration method

(1) Dose control: The recommended dose is 10mg orally every 12 hours, exceeding this dose may increase the risk of epileptic seizures.

(2) Administration method: The sustained-release tablet must be swallowed in its entirety and should not be crushed, broken or chewed to avoid damaging its sustained-release properties and causing a sudden increase in blood drug concentration.

3 Forbidden Groups

(1) Epilepsy patients: It is contraindicated for those with a history of epileptic seizures, as this medication may lower the seizure threshold.

(2) Renal insufficiency: If the creatinine clearance rate is less than 50ml/min, it is contraindicated because the drug is mainly excreted through the kidneys and is prone to accumulation and poisoning.

4 Monitoring requirements

(1) Renal function monitoring: Baseline examination is required before medication, and creatinine clearance rate should be rechecked at 3 and 6 months after medication. If proteinuria occurs, evaluation is needed.

(2) Neurological symptoms: If dizziness, ataxia, etc. occur, it is necessary to evaluate whether to reduce dosage. In severe cases, medication should be discontinued.

5 Special Population Management

(1) Elderly patients are more prone to balance disorders and need to strengthen fall prevention measures and adjust dosage according to kidney function.

(2) Pregnancy and lactation period: There is insufficient safety data for pregnancy. During lactation, the pros and cons should be weighed to decide whether to suspend medication or stop breastfeeding.

6 Drug Interactions

(1) Avoid combination therapy: Be cautious when using other drugs that lower the threshold for epilepsy (such as quinolone antibiotics), as it may increase the risk of epilepsy.

(2) Metabolic effects: CYP enzyme inhibitors may increase blood drug concentrations and require close monitoring of adverse reactions.