Lupkynis

Increased risk of lymphomas, other malignancies (eg, skin). Avoid or limit sun exposure, UV light; examine for skin changes. Increased risk of infections (eg, bacterial, viral, fungal, protozoal), opportunistic infections, including cytomegalovirus, herpes zoster; monitor. Obtain eGFR at baseline; monitor closely every 2 weeks for the 1^st month, then every 4 weeks thereafter. Consider dose reduction or discontinuation with decreases in eGFR from baseline; if persistent, evaluate for chronic nephrotoxicity. Check BP at baseline; do not initiate if BP >165/105mmHg or with hypertensive emergency. Monitor BP every 2 weeks for the 1^st month after initiation, then as clinically indicated. Treat new-onset or exacerbations of pre-existing hypertension. Consider discontinuation if increases in BP is not manageable with dose reduction or other appropriate intervention. Monitor for neurologic symptoms (eg, tremors, paresthesias, headache, mental status changes, others); consider dose reduction or discontinuation if neurotoxicity occurs. Monitor serum potassium periodically during treatment. Consider discontinuing if pure red cell aplasia is diagnosed. Severe hepatic impairment (Child-Pugh C): avoid. Renal impairment (eGFR ≤45mL/min/1.73m<sup2): not recommended. Elderly. Pregnancy: avoid. Nursing mothers: not recommended (during and for at least 7 days after the last dose).