Venetoclax is contraindicated for patients with severe liver dysfunction (Child Pugh C), severe kidney dysfunction (CrCl<15mL/min), and pregnancy. Before medication, a comprehensive assessment of liver and kidney function as well as pregnancy status must be conducted to ensure patient safety.

1、 Severe liver dysfunction patients

1.1 Definition

Child Pugh C grade (decompensated cirrhosis) or ALT/AST>5 × ULN with jaundice.

1.2 Prohibition Basis

Drug metabolism mainly relies on the liver, and severe liver damage can lead to drug accumulation, exacerbating liver toxicity.

1.3 Clinical recommendations

Prohibited: Venetoclax is not recommended for this type of patient.

Moderate liver damage (Child Pugh B): Reduced dosage and close monitoring are required, and the specific plan should follow the doctor's advice.

2、 Severe renal insufficiency patients

2.1 Definition

Patients with creatinine clearance rate (CrCl)<15mL/min or end-stage renal disease (ESRD) who have not received dialysis.

2.2 Prohibition Basis

When renal function is severely impaired, drug clearance slows down, increasing blood drug concentration and toxicity risk (especially electrolyte imbalance).

2.3 Clinical recommendations

Prohibited: Patients in this category should not use Venetoclax.

CrCl15-30mL/min: It is necessary to reduce the dosage under specialized guidance and strengthen electrolyte monitoring.

3、 Pregnant women and those preparing for pregnancy

3.1 Risk Warning

Animal experiments have shown that Venetoclax has embryotoxicity and teratogenicity, and is contraindicated during pregnancy.

3.2 Contraceptive Requirements

Women of childbearing age must undergo pregnancy testing (negative) before treatment, and effective contraceptive measures must be used for at least 30 days during treatment and after discontinuation of medication.

Male patients (with partners of childbearing age) should use condoms for at least 30 days during treatment and after discontinuing medication.

3.3 Management of Unexpected Pregnancy

If pregnancy is diagnosed during treatment, stop medication immediately and consult obstetrics and genetic counseling specialists.