Risdiplam is used to treat spinal muscular atrophy, but it is not suitable for all patients. Understanding contraindications and dietary restrictions helps ensure medication safety and avoid serious adverse reactions.
I. Absolute Contraindications
1. Patients allergic to any ingredient of this product
(1) Patients with known allergy to risdiplam or any excipients are prohibited from using it.
(2) Allergic reactions may manifest as rash, urticaria, dyspnea, or angioedema.
(3) If you have a history of allergies, inform your doctor before use.
2. Pregnant women
(1) Animal studies have shown that this drug can cause embryonic and fetal developmental abnormalities and teratogenic effects.
(2) Avoid use during pregnancy.
(3) Women of childbearing potential must confirm they are not pregnant before treatment and should take effective contraceptive measures during treatment and for at least 1 month after discontinuation.
II. Populations requiring cautious use
1. Women planning pregnancy
(1) Women planning pregnancy should stop using risdiplam at least 1 month before conception.
(2) If accidental pregnancy occurs during treatment, inform your doctor immediately, and a professional physician will assess whether to continue treatment.
2. Breastfeeding women
(1) Animal studies suggest that this drug may be excreted into milk.
(2) Currently, there are no safety data on use during human lactation.
(3) The potential risk to breastfeeding infants cannot be ruled out.
(4) Breastfeeding women should weigh the benefits and risks under medical guidance to decide whether to stop breastfeeding or discontinue the drug.
3. Newborns younger than 20 days of age
(1) Because liver and kidney functions in newborns are not yet mature, drug metabolism and clearance may be affected.
(2) If infants younger than 20 days require this medication, it should be used under close medical supervision.
4. Patients taking specific concomitant medications
(1) Risdiplam may increase the plasma concentrations of drugs excreted via MATE1 or MATE2-K pathways (e.g., metformin, fexofenadine).
(2) When co-administered with such drugs that have a narrow therapeutic window, monitor efficacy and adverse reactions.
III. Dietary restrictions and precautions
1. Grapefruit and related products
(1) Grapefruit and its juice may affect the metabolism of risdiplam, leading to abnormal fluctuations in plasma concentrations.
(2) Avoid eating grapefruit, drinking grapefruit juice, or consuming beverages containing grapefruit ingredients during treatment.
2. Seville oranges
(1) Seville oranges (sour oranges often used to make marmalade) may also modulate CYP3A enzyme activity and affect drug metabolism.
(2) Avoid eating foods or drinks containing Seville oranges during treatment.
3. Other foods that may affect CYP3A
(1) Although only grapefruit and Seville oranges are explicitly to be avoided, to ensure medication safety, it is advisable to avoid consuming large amounts of other specific foods that may affect drug-metabolizing enzymes.
(2) If unsure whether a particular food is safe, consult a doctor or pharmacist.
4. General dietary advice
(1) Apart from the specific forbidden foods mentioned above, no special dietary restrictions are needed.
(2) Maintain a balanced diet; taking the drug with or after meals helps absorption.
(3) If you need to use nutritional supplements or special dietary products, inform your doctor in advance.
