The use of Risumic tablets requires special attention to cardiovascular risk, differentiation syndrome, and drug interactions. The following provides detailed guidelines on precautions and interactions, covering the management of special populations and contraindications for combination use.

1. Core precautions

Before treatment, complete electrocardiogram and electrolyte tests are required, and QTc>450msec is prohibited. Be alert for differentiation syndrome during the initial 3-41 days of medication, and use dexamethasone as an emergency backup. Patients of childbearing age need to use dual contraception until 4 months after discontinuing the medication.

2. Key points of cardiovascular monitoring

Monitor QT interval weekly to avoid hypokalemia/hypomagnesemia. Prohibition of the combination use of fluoroquinolones, tricyclic antidepressants, and other QT prolonging drugs. Stop medication immediately if fainting or arrhythmia occurs.

3. Treatment of differentiation syndrome

The typical manifestation is fever accompanied by lung infiltration or deterioration of renal function. After diagnosis, dexamethasone 10mg q12h should be administered intravenously immediately until symptoms improve, and if necessary, transferred to ICU monitoring.

4. Management of special populations

Monthly assessment of bone age for pediatric patients; Patients with liver dysfunction need to reduce their dosage by 25%; Strengthen monitoring of edema in elderly people. Feeding should be suspended during lactation, and strict risk assessment is required for use during pregnancy.

5. Absolute contraindication to the combination of drugs

Strong CYP3A4 inhibitors, such as itraconazole, can increase blood drug concentrations by three times. Do not consume with grapefruit products and avoid using in combination with P-glycoprotein substrates.

6. Principle of dose adjustment

If grade 3 blood toxicity occurs, the medication should be suspended and reduced by 20% after recovery. Patients with pancreatitis permanently discontinue medication. Child Pugh C grade liver function is contraindicated.