As a targeted drug, the monitoring and management of adverse reactions such as liver toxicity, interstitial lung disease, and diarrhea should be given special attention to when using sotaloxib. Baseline assessment of liver function is required before treatment, and regular follow-up examinations should be conducted during medication; Immediate screening for interstitial lung disease is required when pulmonary symptoms appear; Diarrhea and other gastrointestinal reactions require timely symptomatic support and adjustment of dosage. The following items detail specific precautions.

1. Monitoring and Management of Hepatotoxicity

(1) Baseline examination: Serum ALT, AST, alkaline phosphatase, and total bilirubin levels must be tested before treatment to establish baseline liver function data.

(2) Regular monitoring: Liver function will be rechecked every 3 weeks for the first 3 months, and the frequency will be increased monthly or according to clinical needs thereafter. Encrypt monitoring is required when abnormalities occur.

(3) Dose adjustment: Suspend medication when AST/ALT reaches grade 2 with symptoms or grade 3-4. After recovery, reduce the dose (first to 480mg/day, second to 240mg/day). If AST>3 × ULN and bilirubin>2 × ULN, permanent discontinuation of medication is required.

Identification and management of interstitial lung disease/pneumonia

(1) Symptom monitoring: Pay close attention to newly developed or worsening pulmonary symptoms such as dyspnea, cough, fever, etc., and conduct timely imaging evaluation.

(2) Medication principle: Suspected cases should be immediately suspended from medication, and medication should be permanently discontinued after diagnosis. Other causes such as infection need to be ruled out.

3 Measures to deal with diarrhea

(1) Graded treatment: If the treatment for grade 3-4 diarrhea is ineffective, the medication should be temporarily stopped until the symptoms are ≤ grade 1. After recovery, the dosage should be reduced in steps from 480mg to 240mg.

(2) Supportive treatment: Mild diarrhea can be treated with symptomatic treatments such as montmorillonite powder, while moderate to severe cases require fluid replacement and electrolyte balance support.

4 Strategies for Relieving Fatigue

(1) Life regulation: Maintain a regular schedule, engage in activities at different times, prioritize important tasks, and supplement nutrition appropriately.

(2) Exclude triggers: Evaluate potential factors such as anemia, thyroid function, or depression, and provide targeted interventions.

(3) Medical intervention: Severe fatigue accompanied by weight loss requires medication suspension to rule out tumor progression or other complications.