The following have been recommended:• Patients should be informed of the risk of serious and fatal infections.
• Treatment should not be started in patients with any evidence of ongoing systemic bacterial, fungal, or viral infection.
• All patients should receive prophylactic treatment for Pneumocystis jirovecii pneumonia throughout idelalisib treatment.
• There should be regular clinical and laboratory screening for cytomegalovirus infection. Stop treatment in patients with evidence of infection or viraemia.
• Monitor patients for signs and symptoms of respiratory disease throughout treatment and advise them to promptly report any new respiratory symptoms.
• Monitor absolute neutrophil counts in all patients at least every 2 weeks for the first 6 months of treatment, and at least weekly in those with a count fewer than 1000 per mm3.
The manufacturer has also sent a letter to healthcare professionals about these recommendations.