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Table 5 Calculating Child–Pugh status and everolimus dosage recommendations [19, 55]

From: Management of everolimus-associated adverse events in patients with tuberous sclerosis complex: a practical guide

Factor 1 point 2 points 3 points
 Total bilirubin (μmol/L) <34 34–50 >50
 Serum albumin (g/L) >35 28–35 <28
 PT INR <1.7 1.71–2.30 >2.30
 Ascites None Mild to moderate Severe/refractory
 Hepatic encephalopathy None Grade I–II (or suppressed with medication) Grade III–IV (or refractory)
Child–Pugh class Class A Class B Class C
 Total points 5–6 7–9 10–15
Recommendation in patients with AML The recommended dose is 7.5 mg daily The recommended dose is 5 mg daily Everolimus is only recommended if the desired benefit outweighs the risk; a dose of 2.5 mg daily must not be exceeded
Recommendation in patients with SEGA 75% of the recommended starting dose, calculation based on BSA (rounded to the nearest strength) 25% of the recommended starting dose, calculation based on BSA (rounded to the nearest strength) Everolimus is not recommended
  1. PT INR prothrombin time and international normalized ratio