The contraindications for Vamorolone mainly involve specific infection states and allergic reactions, and the dosage should be adjusted according to physiological conditions for special populations. The following will explain from three aspects: contraindications, prohibited foods, and medication for special populations, and provide specific precautions.

1. Contraindications

(1) Absolute taboo

It is contraindicated for individuals allergic to famolon or excipients, as it may cause immediate hypersensitivity reactions such as angioedema. Patients with systemic fungal infections should avoid using it as it may increase the risk of infection spread.

(2) Relative taboos

Active tuberculosis patients need to complete anti tuberculosis treatment first. Uncontrolled diabetes may aggravate the fluctuation of blood sugar. Individuals who have recently received live vaccination should delay administration for at least 4 weeks.

2. Forbidden foods

(1) Grapefruit products

Furancoumarin can inhibit CYP3A4 metabolic enzymes, leading to an abnormal increase in blood drug concentration. During treatment, it is advisable to completely avoid consuming fruit juice or pulp.

(2) High salt food

If the daily sodium intake exceeds 3g, water and sodium retention may be added. It is recommended to limit the intake of pickled food and processed meat.

3. Medication for special populations

(1) Children

Strict monitoring of growth rate and bone age is required, and the percentile of height should be evaluated every 3 months. When growth retardation occurs, it is necessary to consider reducing or suspending treatment.

(2) Elderly people

Patients aged 65 and above have an increased risk of osteoporosis. It is recommended to undergo baseline bone density testing and supplement with calcium supplements. Patients with renal dysfunction need to adjust the dosing interval.

(3) Pregnancy period

Animal studies have shown teratogenic risks, but human data is limited. Only when the benefits to the mother are significantly greater than the risks to the fetus, an informed consent form must be signed.

(4) Lactation period

Corticosteroids can be secreted into breast milk, and it is recommended to suspend breastfeeding during treatment. If medication is needed, breastfeeding should be done at least 6 hours after taking the medication.

(5) Liver dysfunction

The clearance rate of Child Pugh B/C grade patients is reduced by 30% -50%. It is recommended to halve the dose and monitor transaminases. If jaundice occurs, the medication should be stopped immediately.