Tivozanib: Rare but Serious Complications and Patient Safety Strategies

Tivozanib: Rare but Serious Complications and Patient Safety Strategies

Reversible posterior leukoencephalopathy syndrome (PRES) is a rare but serious neurological complication, occurring in approximately one in a thousand patients. Its main symptoms include severe headache, epileptic seizures, severe lack of energy, confusion, decreased vision or even blindness, and other visual and neurological disturbances, such as unilateral arm or leg weakness. If any of these symptoms occur, patients or their family members must inform the doctor immediately. Once PRES is confirmed by imaging, the doctor will immediately and permanently discontinue Tivozanib treatment. In most cases, after prompt discontinuation of the causative drug and symptomatic treatment (e.g., blood pressure control, antiepileptic therapy), the symptoms of PRES are reversible. Delayed diagnosis may lead to permanent brain damage. Therefore, patients and families should be aware of these warning signs, especially those with a history of hypertension, who are at higher risk.

Tivozanib: Risk of Aneurysm and Arterial Dissection

During post-marketing use of Tivozanib, a serious vascular side effect of unknown frequency has been identified: aneurysm (abnormal widening and weakening of the blood vessel wall) and arterial dissection (tearing of the blood vessel wall). These conditions can occur in arteries anywhere in the body, and if ruptured, may lead to fatal massive bleeding or stroke. Although the exact incidence is unknown, this is a risk that requires vigilance. If you have a history of aneurysm or vascular dissection, inform your doctor before taking the medication. If during treatment you suddenly experience severe headache (like a "thunderclap"), chest pain, back pain, a pulsatile mass in the abdomen, or unexplained unilateral limb weakness or sensory abnormalities, seek immediate medical attention. Controlling blood pressure and avoiding strenuous exercise and emotional agitation may help reduce the risk.

Bleeding, Perforation, and Wound Healing Precautions

Tivozanib may increase the risk of bleeding from multiple sites in the body. Common bleeding sites include the brain, mouth, gums, lungs, gastrointestinal tract, female reproductive organs, rectum, and adrenal glands. Symptoms include hemoptysis, hematemesis, melena, hematuria, unexplained bruising or petechiae on the skin. Severe active bleeding requires immediate drug discontinuation and emergency management. Additionally, although uncommon, gastrointestinal perforation or fistula formation is a life-threatening complication; be alert for severe abdominal pain, peritoneal signs, etc. Finally, because Tivozanib may affect wound healing, if you plan to undergo any surgery (including dental procedures), inform your doctor in advance. Doctors typically recommend temporarily discontinuing Tivozanib treatment for a period before surgery and resuming it after the wound has basically healed. Please be sure to follow your doctor's perioperative medication guidance.