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Cotellic (cobimetinib) Disease Interactions

There are 5 disease interactions with Cotellic (cobimetinib):

Moderate

Cobimetinib (Includes Cotellic) ↔ Cardiomyopathy

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiomyopathy

Cardiomyopathy, defined as symptomatic and asymptomatic decline in left ventricular ejection fraction (LVEF), can occur with the use of cobimetinib. Evaluate LVEF prior to, 1 month after initiation, and every 3 months thereafter until discontinuation of cobimetinib. It is recommended to manage events of left ventricular dysfunction through treatment interruption, dose reduction, or discontinuation of therapy. If restarting cobimetinib after a dose reduction or interruption it is recommended to evaluate LVEF as clinically indicated. Care should be exercised when using cobimetinib as the safety of cobimetinib has not been established in patients with a baseline LVEF that is either below institutional lower limit of normal (LLN) or below 50%.

Moderate

Cobimetinib (Includes Cotellic) ↔ Hepatotoxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Hepatotoxicity can occur with the use of cobimetinib. It is recommended to monitor liver function tests before initiation of therapy, monthly during treatment, or more frequently as clinically indicated. Manage Grade 3 and 4 liver laboratory abnormalities with dose interruption, reduction, or discontinuation of therapy. Close monitoring is recommended.

Moderate

Cobimetinib (Includes Cotellic) ↔ Ocular Toxicities

Moderate Potential Hazard, Moderate plausibility

Applies to: Visual Defect/Disturbance

Ocular toxicities can occur with cobimetinib, including serous retinopathy. Consider ophthalmologic examinations including retinal evaluation before treatment and at regular intervals during, and any time a patient reports new or worsening visual disturbances. If serous retinopathy is diagnosed, interrupt treatment with cobimetinib until visual symptoms improve. Manage serous retinopathy with treatment interruption, dose reduction, or with treatment discontinuation. Close monitoring is recommended.

Moderate

Cobimetinib (Includes Cotellic) ↔ Rhabdomyolysis

Moderate Potential Hazard, Moderate plausibility

Applies to: Myopathy

Rhabdomyolysis can occur with the use of cobimetinib. It is recommended to obtain baseline serum creatine phosphokinase (CPK) and creatinine levels prior to initiating therapy with cobimetinib and periodically during treatment as clinically indicated. If CPK is elevated, evaluate for signs and symptoms of rhabdomyolysis or other causes. Depending on the severity of symptoms or CPK elevation, dose interruption or discontinuation may be required. Care should be taken when using this agent in patients at risk for rhabdomyolysis.

Moderate

Multikinase Inhibitors (Includes Cotellic) ↔ Lung Toxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Interstitial Pneumonitis, Pulmonary Impairment

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.

Cotellic (cobimetinib) drug Interactions

There are 290 drug interactions with Cotellic (cobimetinib)

Cotellic (cobimetinib) alcohol/food Interactions

There is 1 alcohol/food interaction with Cotellic (cobimetinib)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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