If side effects such as fever, diarrhea, or vomiting occur during the use of Evrysdi tablets, graded management measures should be taken according to the severity of the symptoms.

1. Heat treatment

Fever may indicate infection or drug reactions. When the body temperature is below 38.5 ℃, it can be physically cooled and observed for 24 hours. If the fever persists or exceeds 38.5 ℃, seek medical attention immediately to investigate the source of infection. When combined with chills and coughing, it may indicate infection related to leukopenia, and urgent blood routine examination should be performed.

(1) Home care

Maintain daily temperature records and supplement electrolyte solutions to prevent dehydration. Avoid using NSAIDs such as ibuprofen as they may increase the risk of gastrointestinal irritation. It is recommended to choose acetaminophen, but the daily dose should be controlled to be ≤ 3g.

(2) Medical indications

Fever accompanied by blurred consciousness, rash, or neck stiffness should rule out meningitis. If the neutrophil count is less than 0.5 × 10 ⁹/L, intravenous antibiotic treatment is necessary even for low-grade fever. Blood culture should be collected before antibiotic use.

2 Diarrhea management

Mild diarrhea (<4 times a day) can be treated with oral rehydration therapy, under temporary observation. Moderate to severe diarrhea or diarrhea lasting for more than 48 hours should be treated with medical attention to avoid self medication to mask symptoms. If there is bloody stool, mucous stool or abdominal pain, it suggests possible colitis and requires colonoscopy evaluation.

(1) Dietary adjustments

Adopt a BRAT diet (bananas, rice, apple sauce, toast) and avoid dairy products and high fiber foods. Drink potassium containing beverages (such as coconut water) in small amounts multiple times to maintain water electrolyte balance. Record the frequency and changes in bowel movements.

(2) Drug intervention

Doctors may prescribe loperamide, but it is contraindicated for patients with fever or bloody stools. Severe cases require intravenous fluid replacement, and octreotide may be used if necessary. Probiotic preparations can assist in restoring the balance of gut microbiota.

3 Vomit control

For brief vomiting (<3 times/day), try rinsing your mouth with a small amount of ice water, and after 30 minutes, drink diluted salt water in portions. Vomit with blood or coffee grounds should be treated urgently, and attention should be paid to upper gastrointestinal bleeding. When continuous vomiting leads to dehydration, intravenous fluid replacement is needed for support.

(1) Antiemetic strategy

Use 5-HT3 receptor antagonists (such as ondansetron) according to medical advice, and be aware that they may cause constipation. Ginger preparations can alleviate mild nausea. Avoid lying flat and maintain a sitting position for at least 30 minutes after eating.

(2) Nutritional maintenance

After vomiting subsides, try clearing fluids first and gradually transition to low-fat soft foods. Eat in small amounts 6-8 times and avoid taking Risperidone on an empty stomach. If unable to eat for 24 hours, a nutritional consultation is required to evaluate the necessity of tube feeding.