| Management |
The use of idelalisib with other agents that can induce hepatotoxicity and/or diarrhea should be avoided whenever possible. Patients treated with idelalisib should be monitored for development of severe diarrhea or colitis and have serum ALT, AST, and bilirubin measured prior to initiation of treatment and regularly during treatment in accordance with the product labeling, and the dosing adjusted or interrupted as necessary. Permanent discontinuation of idelalisib is recommended in those who experience recurrent hepatotoxicity following dosage reduction and/or life-threatening diarrhea or intestinal perforation. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice. Patients should also contact their physician immediately if the number of bowel movements per day increases by six or more, or if they have new or worsening abdominal pain, chills, fever, nausea, or vomiting. |
