When taking Inavolisib, special attention should be paid to liver toxicity, metabolic abnormalities, and infection risks. Strict adherence to dosage adjustment and monitoring requirements and timely management of adverse reactions can reduce treatment risks. The following sub items explain key precautions.

1. Liver function monitoring and management

(1) Regular monitoring of ALT/AST is required before and during treatment, with weekly monitoring in the initial stage. The interval can be extended after stabilization.

(2) If symptoms of liver damage such as fatigue and jaundice occur, seek medical attention immediately. If the liver enzyme level is above grade 3, medication should be suspended.

2 Measures for preventing and controlling high blood sugar

(1) Fasting blood glucose and HbA1c should be screened before treatment, and high-risk patients (such as diabetes patients) need to strengthen monitoring.

(2) When symptoms such as excessive drinking and urination occur, blood sugar should be tested immediately. Severe hyperglycemia may require interruption of treatment.

3 Infection Prevention and Treatment

(1) Control existing infections before treatment and prevent Pneumocystis jirovecii pneumonia (PJP) throughout the entire process.

(2) If symptoms of infection such as fever and cough occur, seek medical attention immediately. For severe infections, medication should be temporarily suspended.

4. Adverse reactions to the digestive system

(1) Loperamide can be used in the early stages of diarrhea, while medical intervention and consideration of dose reduction are necessary for persistent or bloody diarrhea.

(2) Nausea and vomiting can be treated by adjusting the medication time (such as after meals), and in severe cases, intravenous fluid replacement is needed for support.

Medication for 5 special populations

(1) Pregnant women are prohibited from using it, and women of childbearing age should use effective contraception during treatment and one month after discontinuing the medication.

(2) Patients with moderate to severe liver damage need to adjust their dosage, and those with renal dysfunction should be monitored carefully.

6 Drug Interactions

(1) Avoid using strong CYP3A4 inhibitors/inducers in combination, as it may affect the blood concentration of enalapril.

(2) Co administration with anticoagulants increases the risk of bleeding and requires close monitoring of coagulation function.