Your Health, We Care
Release date: 2025-03-04 14:43:42 Recommended: 74
Osimertinib is a third-generation EGFR-TKI-targeted drug, and its clinical application needs to strictly follow the dosage specifications and medication precautions to ensure the therapeutic effect and reduce the risk of adverse reactions.
Standardized medication is the basis for the efficacy of osimertinib.
The recommended dose of osimertinib is 80 mg per day, swallowed whole, without distinguishing between pre- and post-meal. For patients with dysphagia, the tablets can be dissolved in 50ml of non-carbonated water and taken separately, and 15ml of gastric tube administration should be dissolved and rinsed. The treatment cycle is continued until disease progression or intolerable toxicity, and postoperative adjuvant therapy should not exceed 3 years.
In the event of grade 3 or above adverse reactions, the drug should be suspended, which can be interrupted for up to 3 weeks. The dose can be reduced to 40 mg/day after recovery, and in certain cases if the QTc interval is prolonged by more than 500 ms, the drug needs to be permanently discontinued. Dose adjustment is not required for patients with abnormal liver and kidney function, but caution is required in patients with end-stage renal disease or severe liver impairment.
It is necessary to make up the dose within 12 hours after the missed dose, and skip this dose if it exceeds 12 hours. It is strictly forbidden to make up for the omission by doubling the dose to prevent the accumulation of toxicity.
What are the key points to pay attention to throughout the medication process?
Safe drug use requires multi-dimensional risk prevention and control.
The type of EGFR mutation, including T790M mutation status, must be confirmed by an FDA/NMPA-approved test method prior to use. Blind administration without mutational validation may accelerate drug resistance and increase the cost of treatment.
Regular monitoring is required during treatment:
• Cardiac function: LVEF was measured at baseline and every 3 months, and QT interval changes were tracked by ECG
• Pulmonary toxicity: Immediately discontinue the drug for evaluation when symptoms of ILD such as dyspnea occur
• Liver function: Monitor aminotransferases every 2 weeks for the first 3 months and monthly thereafter
The drug is contraindicated during pregnancy, and animal experiments have shown that 1.5 times the clinical dose can cause embryotoxicity. Breastfeeding should be stopped while breastfeeding, as the drug may be secreted through breast milk. Patients with congenital long QT syndrome are contraindicated, and those who are taking CYP3A4 inducers such as St. John's wort need to adjust their treatment regimens.
The efficacy of osimertinib depends on precise dose control and whole-process risk management. From genetic detection to adverse reaction intervention, each link requires doctor-patient coordination to maximize the benefits of treatment in standardized medication.
