Dose modifications of PAC in specific situations
| Symptoms/signs . | Dose modification . |
|---|---|
| Diarrhea | |
| New onset | Initiate antidiarrheal medications |
| Increase of at least 7 stools per day over baseline | Hold PAC until diarrhea resolves |
| Recurrence | Hold PAC until diarrhea resolves and restart at 50% of the original dose |
| Thrombocytopenia | |
| Clinically significant worsening of platelet counts >7 d | Hold PAC until platelets recover to baseline, and restart at 50% of the original dose |
| Bleeding | |
| Moderate bleeding necessitating intervention | Hold PAC until bleeding resolves and restart at the last given dose |
| Severe bleeding requiring transfusion, or hospitalization | Hold PAC until bleeding resolves and restart at 50% the last given dose |
| Life-threatening bleeding or recurrence of severe bleeding | Discontinue PAC |
| QTc prolongation | |
| >500 ms or >60 ms from baseline | Hold PAC |
| If QTc prolongation resolves to ≤480 ms or baseline ≤7 d, restart PAC at the same dose | |
| If time to resolution >7 d, restart PAC at 50% of the original dose |
| Symptoms/signs . | Dose modification . |
|---|---|
| Diarrhea | |
| New onset | Initiate antidiarrheal medications |
| Increase of at least 7 stools per day over baseline | Hold PAC until diarrhea resolves |
| Recurrence | Hold PAC until diarrhea resolves and restart at 50% of the original dose |
| Thrombocytopenia | |
| Clinically significant worsening of platelet counts >7 d | Hold PAC until platelets recover to baseline, and restart at 50% of the original dose |
| Bleeding | |
| Moderate bleeding necessitating intervention | Hold PAC until bleeding resolves and restart at the last given dose |
| Severe bleeding requiring transfusion, or hospitalization | Hold PAC until bleeding resolves and restart at 50% the last given dose |
| Life-threatening bleeding or recurrence of severe bleeding | Discontinue PAC |
| QTc prolongation | |
| >500 ms or >60 ms from baseline | Hold PAC |
| If QTc prolongation resolves to ≤480 ms or baseline ≤7 d, restart PAC at the same dose | |
| If time to resolution >7 d, restart PAC at 50% of the original dose |