司帕生坦(Sparsentan)用法用量:推荐剂量,剂量调整、肾脏剂量调整

Sparsentan is the first dual-pathway blocker. Its use method and dosage must be determined according to the specific conditions of each patient. It is recommended to take 200mg per day at the beginning, and then slowly adjust it according to the patient's tolerance to the drug and the therapeutic effect.

Usage and dosage of Sparsentan

1. Recommended dosage

(1) Initial dose: Take 200 mg of Sparsentan orally once a day for 14 consecutive days.

(2) Maintenance dose: After the initial course of treatment, if the patient does not develop intolerance, increase the dose to 400 mg of spaxentan orally once a day.

(3) Note: If sparsentan treatment is stopped midway and then restarted, consider slowly increasing the dose: first start with a starting dose of 200 mg per day for 14 days, and then increase to the recommended maintenance dose of 400 mg per day.

2. Administration method

Instruct the patient to swallow the tablet whole with water in the morning or evening before eating. Moreover, the time relationship between medication and meals should be kept fixed, such as always eating before meals.

3. Dealing with missed doses

If you accidentally forget to take the medicine once, just take it at the regularly planned time next time. Never take a double dose or take extra supplements at one time.

Dose adjustment of sparsentan

1. Renal function adjustment

For those patients whose renal function may partially depend on the activity of the renin-angiotensin system, such as those with renal artery stenosis, chronic kidney disease, severe congestive heart failure or hypovolemia, special caution should be taken when using sparsentan. There is currently no specific dose adjustment method recommended. If the patient's renal function experiences a clinically significant decline during treatment, suspension or discontinuation of treatment should be considered.

2. Liver function adjustment and dose adjustment

Sparsentan is best not to be used as initial treatment in patients whose baseline aminotransferase exceeds 3 times the upper limit of normal, or who have any degree of liver function impairment (Child-Pugh A/B/C grade), because the risk of hepatotoxicity will be significantly increased and monitoring will be more difficult.

3. An increase in aminotransferase occurs during treatment

If ALT/AST is between 3 times the upper limit of normal value and 8 times the upper limit of normal value:

(1) Another aminotransferase test can be done to confirm; if it is confirmed to be elevated, suspend sparsentan treatment.

(2) Monitor aminotransferase and bilirubin levels at least once a week, and if necessary, monitor INR until the patient has no symptoms and the indicators return to the baseline level before treatment.

(3) If the aminotransferase level returns to the pre-treatment level, you can consider restarting sparsentan, with a starting dose of 200 mg per day.

(4) Within 3 days after restarting taking sparsentan, the aminotransferase and bilirubin levels should be rechecked, and then closely monitored.

(5) If ALT/AST exceeds 8 times the upper limit of normal values: If no other reason is found, sparsentan treatment should be permanently discontinued.

4. Situations in which sparsentan treatment cannot be resumed

(1) ALT or AST increase exceeds 3 times the upper limit of normal value, total bilirubin exceeds 2 times the upper limit of normal value, or INR exceeds 1.5.

(2) ALT or AST elevation exceeds 3 times the upper limit of normal and is accompanied by symptoms of hepatotoxicity, such as nausea, vomiting, right upper quadrant pain, fatigue, anorexia, jaundice, dark urine, fever or itching, and/or eosinophilia.

(3) ALT or AST exceeds 5 times the upper limit of normal values ​​and lasts for more than two weeks.

(4) Patients who have experienced clinical symptoms of hepatotoxicity.

(5) Patients whose liver enzymes and bilirubin have not returned to pre-treatment levels.