During the treatment of Capivasertib, special attention should be paid to adverse reactions such as high blood sugar, diarrhea, and skin toxicity, which need to be managed through regular monitoring and dosage adjustment. The following is a detailed explanation of specific precautions.

1. High blood sugar management

Kapasetinib may induce hyperglycemia, with an incidence rate of approximately 13%. The history of diabetes needs to be screened before medication, and fasting blood glucose level should be monitored weekly during treatment.

(1) Blood glucose monitoring

If fasting blood glucose remains above 250mg/dL, medication should be suspended and insulin therapy should be initiated. After blood sugar is controlled to a safe range, it may be considered to reduce the dosage and resume medication.

(2) Risk population

Patients with diabetes or those with abnormal glucose tolerance need to strengthen monitoring, and adjust the hypoglycemic program in advance if necessary.

2 Diarrhea treatment

The incidence of diarrhea is 44%, of which 9% are grade 3 severe reactions. The medication should be suspended immediately upon the first occurrence of grade 2 diarrhea until the symptoms subside to below grade 1.

(1) Symptomatic treatment

Preventive use of antidiarrheal drugs such as loperamide should be used when resuming medication. If recurrence occurs, the dosage should be reduced in a gradient: the first dose should be reduced to 320mg twice a day.

(2) Fluid replacement support

Severe diarrhea requires assessment of dehydration risk and, if necessary, intravenous fluid replacement to correct electrolyte imbalances.

3. Skin toxicity response

About 38% of patients develop rashes, including acne like dermatitis and erythema palmaris. It is recommended to use non-alcoholic moisturizers for daily care.

(1) Graded processing

Grade 1-2 reactions can continue with medication and local use of glucocorticoids. Level 3 reactions require interruption of treatment until remission, followed by reduced use.

(2) Preventive measures

Avoid direct sunlight and use mild cleaning agents. When skin cracks appear, Vaseline can be applied for protection.