Decitabine and cedazuridine combination tablet is an oral anticancer drug used to treat myelodysplastic syndromes and acute myeloid leukemia.

I. Medication Precautions

1. Strictly Take on an Empty Stomach

(1) This medication must be taken on an empty stomach, i.e., at least 2 hours before or 2 hours after a meal.

(2) High-fat meals significantly reduce the absorption of decitabine, thereby affecting efficacy.

2. Regular Blood Count Monitoring

(1) A complete blood count must be checked before treatment and before each cycle.

(2) This medication can cause severe myelosuppression, manifested as decreased white blood cells (especially neutrophils), platelets, and hemoglobin.

(3) If fever, chills, unusual bleeding or bruising, or extreme fatigue occur, seek immediate medical attention.

3. Infection Prevention

(1) Due to neutropenia, the risk of infection is significantly increased.

(2) During treatment, pay attention to hand hygiene, avoid crowded places, and use prophylactic antibiotics or white blood cell growth factors as directed by your physician.

4. Contraception and Pregnancy

(1) This medication can cause fetal harm.

(2) Women of childbearing potential must use effective contraception during treatment and for 6 months after the last dose, and pregnancy status should be confirmed before starting treatment.

(3) Men with partners of childbearing potential must use effective contraception during treatment and for 3 months after the last dose.

5. Breastfeeding and Fertility

(1) Breastfeeding is not recommended during treatment and for 2 weeks after the last dose.

(2) This medication may impair male fertility, manifested as reduced sperm count.

6. Missed Dose and Vomiting Management

If a missed dose is within 12 hours of the scheduled time, take it as soon as possible and extend the cycle to complete 5 doses; if beyond 12 hours, skip the missed dose and take the next dose as scheduled. Do not take an extra dose if vomiting occurs after taking the medication.

7. Drug Interactions

(1) Avoid concomitant use with medications metabolized by cytidine deaminase to reduce the risk of increased toxicity.

(2) When taken with venetoclax, separate the administration of the two drugs by at least 2 hours.

8. Storage Requirements

(1) Store at 20-25°C (room temperature), keep in the original container to protect from light and moisture.

(2) This medication is a hazardous drug. Consult your healthcare provider for disposal.

II. Insurance Coverage

1. National Insurance Status in China

INQOVI (decitabine and cedazuridine combination tablet) is not yet included in the National Reimbursement Drug List.

2. Ways to Obtain Accurate Information

The drug list is updated periodically. It is recommended to confirm the latest status by: consulting the pharmacy or insurance office at your hospital; checking the official website of your local health insurance bureau or calling the insurance service hotline; asking your physician or clinical pharmacist.

III. Treatment Outcomes

1. Efficacy for MDS or CMML

(1) Clinical studies have shown that INQOVI monotherapy for MDS or CMML results in a relatively high complete response rate.

(2) Among patients who were transfusion-dependent at baseline, the majority became transfusion-independent after treatment.

2. Efficacy for AML (in combination with venetoclax)

INQOVI combined with venetoclax is highly effective for newly diagnosed acute myeloid leukemia (for patients aged 75 years or older, or those unfit for intensive induction chemotherapy).

3. Factors Affecting Efficacy

(1) Higher decitabine exposure is associated with a greater likelihood of adverse reactions such as neutropenia and thrombocytopenia.

(2) Patients with lower body surface area or body weight may have increased decitabine exposure and require close monitoring.

4. Overall Assessment

Individual responses vary considerably. Specific outcomes should be evaluated based on disease subtype, mutation status, and timing of treatment.