Precautions while taking Bosutinib

Bosutinib is a targeted therapy drug mainly used to treat chronic myeloid leukemia (CML) and other specific types of blood diseases. Although bosutinib has achieved certain clinical efficacy, patients may experience some side effects and adverse reactions during the treatment process. Therefore, it is necessary to pay close attention to a series of possible safety issues when using bosutinib and take appropriate measures according to the specific situation.

1. Gastrointestinal toxicity

Gastrointestinal adverse reactions are common side effects during bosutinib treatment, manifesting as diarrhea, nausea, vomiting, and abdominal pain. Research shows that diarrhea is one of the most common symptoms that can affect patients' daily lives. To manage these discomforts, symptomatic measures such as antidiarrheal drugs, antiemetics, and fluid therapy are often used. In addition, patients need to receive appropriate care and monitoring based on their doctor's recommendations to ensure that gastrointestinal reactions are controlled in a timely manner. Gastrointestinal discomfort can be effectively reduced through dietary modifications and lifestyle interventions.

2. Myelosuppression

Another important side effect of bosutinib is myelosuppression, which may lead to hematological abnormalities such as thrombocytopenia, anemia, and neutropenia. Because these changes may affect the patient's immune system and coagulation function, it is recommended to perform a complete blood count weekly during the initial period of treatment, especially in the first month, and to perform routine blood tests monthly as clinically necessary. If a patient has abnormal blood indicators, the doctor may adjust the dose according to the specific situation, or temporarily stop the medication as needed until the blood indicators return to normal.

3. Hepatotoxicity

The use of bosutinib may also cause impairment of liver function, manifested by increased serum aminotransferases (such asALT and AST). Liver damage is usually more noticeable in the early stages of treatment, so monthly liver enzyme tests are recommended during the first three months of treatment. For patients who have already experienced elevated transaminases, liver function should be monitored more frequently, and treatment plans should be adjusted in a timely manner based on test results. If liver function abnormalities are severe, the drug may need to be discontinued or the dose adjusted to avoid further liver damage.

4. Cardiovascular toxicity

Cardiovascular toxicity is an aspect of bosutinib treatment that requires special attention. Bosutinib may cause heart failure, left ventricular dysfunction, and cardiac ischemia. Such adverse reactions are particularly common in patients with risk factors for coronary artery disease, such as diabetes, hypertension, obesity, and vascular disease, which may increase the risk of cardiovascular problems. Therefore, patients need to closely monitor cardiac function during treatment and regularly check for symptoms related to heart failure and cardiac ischemia. If abnormalities are found, the doctor will make treatment adjustments based on the patient's specific condition.

5. Liquid Retention

Fluid retention is another potential side effect of bosutinib treatment and manifests itself as pericardial effusion, pleural effusion, pulmonary edema, and peripheral edema. These fluid retentions may cause difficulty breathing or other signs in the patient and require appropriate monitoring and care. With regular check-ups and symptomatic treatment, most symptoms of fluid retention can be effectively relieved. During treatment, patients should also pay attention to avoid overtaxing the heart and lung functions to reduce the occurrence of fluid retention.

6. Nephrotoxicity

Bosutinib may cause impairment of renal function during treatment, especially in patients with existing renal dysfunction. Studies have shown that patients may experience a decrease in their estimated glomerular filtration rate (eGFR) during treatment with bosutinib. Therefore, renal function should be monitored regularly during treatment, especially in patients with risk factors for renal impairment. If there is abnormal kidney function, the doctor may adjust the drug dosage or take other treatment measures based on the patient's specific situation to avoid further kidney damage.

7. Embryo-fetal toxicity

Bosutinib has been shown to have embryonic-fetal toxicity in animal experiments. Bosutinib may cause harm to the fetus when used by pregnant women. Although there are insufficient data in pregnant women to accurately assess the specific effects of the drug on the fetus, animal studies suggest that taking bosutinib during pregnancy may cause fetal structural abnormalities, increased embryo-fetal mortality, and growth changes. Therefore, pregnant women should use caution when using bosutinib and the drug should not be taken during pregnancy.

For females of childbearing potential, it is recommended that effective contraception be used during treatment with bosutinib and for at least2 weeks after the last dose. This reduces the potential risk of the drug to the fetus. If a woman becomes pregnant during treatment, she should inform her doctor immediately to evaluate whether treatment needs to be stopped or the treatment plan needs to be adjusted.

Reference materials:https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adc84ad5-a04d-4fee-9ba8-91f7abd928e3