What are the possible consequences of long-term use of selumetinib/coceyu?

Long-term selumetinib treatment in patients with neurofibromatosis requires comprehensive cardiac, ocular, hepatic, skin and gastrointestinal management, as well as regular laboratory and imaging studies. Patients should maintain close communication with their doctors and report any abnormal symptoms in a timely manner to reduce potential risks and ensure medication safety and therapeutic effects.

1. Effects on the cardiovascular system: Patients who use selumetinib for a long time may experience changes in cardiac function, especially a decrease in left ventricular ejection fraction. Although the changes are mild and reversible in most patients, the risk of heart failure remains a concern. It is recommended that a cardiac evaluation be performed before starting treatment and that cardiac function be monitored periodically during treatment, including electrocardiography and cardiac ultrasound.

2. Eye adverse reactions: Selumetinib may affect the health of the retina and cornea, leading to blurred vision, light sensitivity, visual distortion or dry eyes. Some patients may develop retinal edema or pigmentary changes. These side effects can be improved by suspending or adjusting the dose in most cases, but long-term unmonitoring may cause ongoing vision problems. Regular ophthalmic follow-up is essential for patients on long-term medication.

3. Skin and hair reactions: Long-term oral administration of selumetinib may cause rash, dryness, desquamation, and changes in hair color. Skin symptoms are generally mild to moderate, but some patients may develop a severe inflammatory rash requiring topical or systemic treatment. Symptoms can be reduced by keeping the skin moisturized and avoiding UV exposure.

4. Gastrointestinal effects: Long-term medication may cause loss of appetite, nausea, vomiting or diarrhea. Although these reactions are usually manageable, persistent gastrointestinal discomfort may affect the patient's nutritional status and overall quality of life. It is recommended that patients make appropriate dietary adjustments under the guidance of a doctor and report serious symptoms in a timely manner.

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References：https://www.drugs.com/selumetinib.html