Serplulimab (a PD-1 inhibitor) is an antineoplastic agent that demands special caution regarding drug-drug interactions. There is no absolute definition of "three most contraindicated drugs", yet clinical administration should be alert to the risks of its combined use with immunosuppressants, other immunotherapeutic agents and live vaccines, which may aggravate side effects or compromise therapeutic efficacy.
1. Immunosuppressants (e.g., glucocorticoids, TNF-α inhibitors)
Serplulimab exerts antitumor effects by activating the immune system to attack tumor cells. Concomitant use of immunosuppressants (e.g., high-dose glucocorticoids, antirheumatic drugs) may weaken its antitumor efficacy. However, short-term glucocorticoid therapy is necessary for the management of immune-related adverse reactions (e.g., pneumonia, enteritis), which should be prescribed only after physicians weigh the risks and benefits.
2. Other immunotherapeutic agents (e.g., CTLA-4 inhibitors, PD-L1 inhibitors)
Combined use of multiple immune checkpoint inhibitors (e.g., ipilimumab) may enhance immune activation, but also significantly increase the incidence and severity of immune-related adverse reactions (e.g., hepatitis, myocarditis). Such combination regimens must be implemented strictly in accordance with clinical protocols, with close monitoring required.
3. Live vaccines
Administration of live vaccines (e.g., measles vaccine, varicella vaccine) during serplulimab treatment may raise the risk of vaccine-related infections due to excessive immune system activation. Live vaccines should be avoided during treatment and for at least 3 months after drug discontinuation.
Other Precautions
Chemotherapy or targeted drugs: Concomitant use with some chemotherapy regimens (e.g., paclitaxel, platinum-based drugs) may increase the risk of myelosuppression or hepatic and renal dysfunction, requiring regular monitoring of blood routine and hepatic/renal function.
Chinese herbal medicines or health supplements: Some ingredients (e.g., immune-enhancing herbal medicines) may interfere with therapeutic efficacy or increase the risk of adverse reactions. Consult a doctor before use.
Important Notes
Strictly follow the doctor’s instructions during medication and do not adjust the dosage without authorization. Seek immediate medical attention if symptoms such as fever, dyspnea or severe rash occur. It is recommended to inform the doctor of your complete current medication history (including over-the-counter drugs and supplements) before treatment, and attend regular follow-ups for safety assessment.
