Idelalisib, as a PI3K δ inhibitor, may cause various adverse reactions during treatment, including liver toxicity, severe diarrhea, and other side effects that require immediate medical attention, as well as mild reactions that may self resolve. The following is a detailed classification of its adverse reactions.

1. Serious adverse reactions that require immediate medical attention

Hepatotoxicity manifests as a significant increase in ALT/AST levels, requiring full monitoring of liver function, and in severe cases, permanent discontinuation of medication is necessary.

Severe diarrhea or colitis may result in ineffective anti diarrheal medication and require interruption of treatment or use of corticosteroids.

Pneumonia includes interstitial pneumonia and organizing pneumonia. If coughing or difficulty breathing occurs, medication should be stopped immediately and the cause identified.

Intestinal perforation manifests as new abdominal pain and fever, and once it occurs, medication must be permanently discontinued.

Severe skin reactions such as SJS, TEN, etc. require interruption of treatment until diagnosis, and permanent discontinuation of medication after diagnosis.

2. Common adverse reactions that may self resolve

Symptoms such as facial or limb swelling, decreased appetite, and muscle pain usually gradually alleviate with treatment.

If night sweats, joint pain, drowsiness, etc. continue to affect daily life, it is necessary to inform the doctor, but most do not require special treatment.

3. Other adverse reactions that require attention

Neutropenia requires regular monitoring of blood cell counts, and treatment may be interrupted in severe cases.

The risk of infection increases, and PJP prevention and monitoring of CMV viremia are necessary during treatment.

Hypersensitivity reactions include anaphylactic shock, and severe reactions require permanent discontinuation of medication and emergency treatment.

4. Precautions for adverse reactions in special populations

Pregnant women using it may cause fetal malformations, and women of childbearing age should strictly use contraception until one month after stopping the medication.

Elderly patients are more prone to serious adverse reactions and require strengthened monitoring.