Grade 1:
Increased number of bowel movements, but < 4 x/day. No abdominal pain.

Grade 1:
Maintain TKI dose. Start loperamide treatment as required 2 mg 1–2 times daily. It may be possible to combine with HUSK (with or without calcium).

Grade 1:
Instruct the patient to take loperamide regularly, if necessary and possibly increase the dose if there is insufficient effect (see Grade 2).
Instruct the patient on good dietary guidelines (see below) and adequate fluid intake.

Grade 2:
Increased bowel movements 4–6 x/day.

Grade 2:
Maintain TKI dose. As described under Grade 1. The dose of loperamide may be increased to 4 mg x 2 or 6 mg x 2.

Grade 2:
See above.
If no improvement, consider other causes of diarrhoea (incl. infection – faeces samples for intestinal pathogenic bacteria, clostridium difficile, and immune-related colitis, if immunotherapy was previously given).

Grade 3:
Diarrhea > 7 x/day, incontinence, affected general condition, hospital admission may be necessary.

Grade 3:
Pause TKI until Grade 2 or less. Resume TKI at reduced dose.

Grade 3:
See above.
Check fluid and infection counts.

Grade 4:
Life-threatening consequences (e.g. haemodynamic collapse).

Grade 4:
Discontinue TKI.

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