The contraindications of pyrotinib mainly involve hypersensitivity to drug components, severe hepatic or renal insufficiency, pregnant and lactating women, and concomitant use with specific drugs. Prior to administration, a comprehensive assessment of the patient's condition is required, and the treatment plan should be adjusted under the guidance of a physician.
Contraindications of Pyrotinib
Hypersensitivity Reactions
Patients with known hypersensitivity to pyrotinib or any of its excipients are contraindicated. Hypersensitivity symptoms may include skin rash, dyspnea, angioedema, etc. If such symptoms occur, the drug must be discontinued immediately and medical attention should be sought.
Severe Hepatic or Renal Insufficiency
The drug is contraindicated in patients with moderate to severe hepatic insufficiency (e.g., Child-Pugh Class C) or severe renal insufficiency (e.g., creatinine clearance rate < 30 mL/min). Pyrotinib is primarily metabolized in the liver; hepatic or renal dysfunction may significantly increase the risk of drug toxicity.
Pregnancy and Lactation
Pyrotinib may cause fetal harm, and is therefore contraindicated in pregnant women. Lactating women should suspend breastfeeding during the treatment period and for a certain period after drug discontinuation; the specific duration should be determined by the physician.
Contraindications Related to Drug Interactions
Concomitant use with potent CYP3A4 inhibitors or inducers (e.g., clarithromycin, rifampicin, etc.) should be avoided, as such use may significantly alter the plasma concentration of pyrotinib.
Cautious consideration is required when co-administering with drugs that prolong the QT interval (e.g., certain antiarrhythmic drugs), as this may increase the risk of cardiotoxicity.
Underlying Cardiac Diseases
Patients with uncontrolled arrhythmias, symptomatic heart failure, or a significant decrease in Left Ventricular Ejection Fraction (LVEF) should be carefully evaluated, and the drug may be contraindicated if necessary.
Additional Precautions
During the treatment period, regular monitoring of liver function, blood routine, electrocardiogram, and cardiac function is required.
In case of severe diarrhea, hand-foot syndrome, or cardiac adverse reactions, dose reduction or drug discontinuation should be performed promptly, along with symptomatic treatment.
Note: Pyrotinib is a prescription-only medicine. The specific dosage regimen must be formulated by the physician based on the patient's individual condition; the dosage should not be adjusted or the drug discontinued without medical guidance. Patients must strictly follow the physician's instructions and attend regular follow-up visits during the treatment period.
