During the use of sorafenib, special attention should be paid to adverse reactions such as hepatotoxicity, hypertension, hand foot skin reactions, and diarrhea. Scientific monitoring and proactive management are key to ensuring treatment safety.

1、 Monitoring and Management of Hepatotoxicity

Recheck liver function (ALT, AST, bilirubin) monthly before medication and during treatment.

If the transaminase level significantly increases (more than three times the normal upper limit), medication should be suspended and the cause investigated.

Avoid combining the use of other liver damaging drugs (such as excessive use of acetaminophen) and limit alcohol consumption.

2、 Blood pressure control and monitoring

Monitor blood pressure at least once a week during the initial stage of treatment, and recheck monthly after stabilization.

If the systolic blood pressure is ≥ 140mmHg or the diastolic blood pressure is ≥ 90mmHg, antihypertensive therapy (such as ACEI or ARB drugs) should be initiated.

When experiencing headaches, dizziness, or blurred vision, it is necessary to immediately measure blood pressure and seek medical attention.

3、 Care for Hand and Foot Skin Reactions

Apply moisturizing cream (containing urea or ceramide) daily to avoid hot water washing and excessive friction.

Wear soft cotton shoes and socks to reduce prolonged walking or standing.

When painful erythema or desquamation occurs, topical corticosteroid ointment can be applied locally, and medication should be suspended if necessary.

4、 Diarrhea management strategy

Timely replenish water and electrolytes (such as oral rehydration salts) when diarrhea occurs to avoid dehydration.

Adjust diet: avoid greasy, spicy and dairy products, and choose light and digestible foods (such as rice porridge and bananas).

If diarrhea occurs more than 3 times a day or is accompanied by fatigue, antidiarrheal drugs such as loperamide can be used and the doctor should be informed.