Why is this medication prescribed?

Cotellic (cobimetinib) is a prescription medication used in combination with vemurafenib to treat certain types of skin cancer called melanoma that has spread or cannot be removed by surgery and has a certain type of abnormal gene (BRAF V600 mutation).

How should this medicine be used?

Here’s how Cotellic should be used:

• Dosage: The typical dose of Cotellic is usually determined by your doctor based on your specific condition and other medications you are taking. It is generally taken once daily for 21 days followed by a 7-day break (a 28-day treatment cycle). This cycle may be repeated as prescribed by your doctor.
• Combination Therapy: Cotellic is always used in combination with vemurafenib (Zelboraf), another medication that targets melanoma with the BRAF V600 mutation. These two drugs work together to block the action of abnormal proteins that promote the growth of cancer cells.
• Administration: Cotellic is usually taken orally (by mouth) with or without food. It’s important to take it exactly as prescribed by your doctor. Swallow the tablets whole with a glass of water.
• Monitoring: During treatment with Cotellic and vemurafenib, your doctor will monitor you closely for any side effects and to assess the response to treatment. Blood tests may be done regularly to check for any changes in your health.
• Duration of Treatment: Treatment with Cotellic and vemurafenib may continue as long as it is effective and tolerated by the patient. Your doctor will determine the duration of treatment based on your individual response and any side effects experienced.

It’s crucial to follow your doctor’s instructions carefully when taking Cotellic and to communicate any concerns or side effects promptly. This medication should only be used under the supervision of a healthcare professional experienced in the treatment of cancer.

Other uses for this medicine

Cotellic (cobimetinib) is primarily used in combination with vemurafenib for the treatment of melanoma that has a BRAF V600 mutation. Its use is limited to this specific indication, and it is not typically prescribed for other conditions or cancers.

What special precautions should I follow?

Special Precautions for Cotellic:

• Liver Function Monitoring: Cotellic can affect liver function, so your doctor will likely perform blood tests to monitor your liver enzymes regularly during treatment. If you develop signs of liver problems such as yellowing of the skin or eyes (jaundice), dark urine, or persistent nausea/vomiting, notify your doctor immediately.
• Heart Health: Cotellic can cause heart-related side effects such as heart failure or decreased heart function. Your doctor may perform heart function tests (such as an echocardiogram) before starting treatment and periodically during treatment to monitor for any changes.
• Eye Problems: Some patients may experience eye problems such as blurred vision, flashing lights, or other visual disturbances. Inform your doctor if you experience any changes in your vision during treatment.
• Skin Reactions: Skin reactions, including rash, photosensitivity (increased sensitivity to sunlight), and severe skin reactions (such as Stevens-Johnson syndrome), have been reported with Cotellic. Take precautions to protect your skin from sun exposure and report any skin changes to your doctor promptly.
• Bleeding Risk: Cotellic may increase the risk of bleeding. Inform your healthcare provider if you have any history of bleeding disorders or if you are taking medications that increase the risk of bleeding (e.g., blood thinners).
• Pregnancy and Contraception: Cotellic can harm an unborn baby. It is important to use effective contraception during treatment and for at least 2 weeks after the last dose of Cotellic for females of reproductive potential. Discuss with your doctor about the risks and appropriate contraceptive methods.
• Drug Interactions: Inform your doctor about all medications you are taking, including prescription, over-the-counter, vitamins, and herbal supplements, as Cotellic can interact with other drugs and affect how they work.
• Side Effects: Be aware of potential side effects such as diarrhea, nausea, vomiting, headache, and muscle pain. Report any side effects to your doctor promptly.

Always follow your doctor’s instructions carefully when taking Cotellic and attend all recommended medical appointments and monitoring visits. It’s important to have open communication with your healthcare team throughout your treatment to ensure the best possible outcomes and management of any side effects.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Cotellic. However, it’s important to maintain a balanced diet and stay well-hydrated during treatment. If you experience diarrhea or other gastrointestinal symptoms, your doctor may recommend adjustments to your diet or medications to manage these symptoms effectively.

What should I do if I forget a dose?

If you miss a dose of Cotellic, take it as soon as you remember on the same day. However, if it is almost time for your next scheduled dose, skip the missed dose and take your next dose at the regular time. Do not take two doses to make up for a missed dose.

What side effects can this medication cause?

Cotellic (cobimetinib) can cause a range of side effects, some of which can be serious. It’s important to be aware of these potential side effects and to report any concerning symptoms to your healthcare provider promptly. Here are some common and serious side effects associated with Cotellic:

Common Side Effects:

• Diarrhea: This is one of the most common side effects of Cotellic. It may be mild to moderate in severity.
• Nausea and Vomiting: These gastrointestinal symptoms are also frequently reported.
• Skin Reactions: These can include rash, dry skin, itching, and photosensitivity (increased sensitivity to sunlight).
• Fatigue: Feeling tired or weak is a common side effect.
• Muscle Pain: Musculoskeletal pain or discomfort may occur.
• Headache: Mild to moderate headaches can occur.
• Decreased Appetite: Some patients may experience a reduced desire to eat.

Serious Side Effects:

• Liver Problems: Cotellic can affect liver function, leading to elevated liver enzymes or more serious liver damage. Symptoms may include yellowing of the skin or eyes (jaundice), dark urine, abdominal pain, or unusual tiredness.
• Heart Problems: Cotellic may cause heart-related side effects such as decreased heart function or heart failure. Symptoms may include shortness of breath, swelling of ankles or feet, or rapid weight gain.
• Eye Problems: Visual disturbances or changes in vision can occur.
• Severe Skin Reactions: Rarely, Cotellic may cause severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis. These are serious conditions that require immediate medical attention.
• Bleeding: Cotellic may increase the risk of bleeding, which can manifest as nosebleeds, easy bruising, or blood in the urine or stools.
• Fever: Some patients may experience fever, which could indicate an infection or other underlying issue.
• Other Effects: Other less common but potentially serious side effects include high blood pressure (hypertension), kidney problems, and changes in electrolyte levels.

It’s important to note that not all individuals will experience these side effects, and some may experience different symptoms not listed here. Your healthcare provider will monitor you closely for side effects during treatment with Cotellic and will provide guidance on managing them. If you experience any unexpected or concerning symptoms while taking Cotellic, contact your doctor or seek medical attention promptly. Early detection and management of side effects can help optimize your treatment outcomes.

What should I know about storage and disposal of this medication?

Storage of Cotellic:

• Room Temperature: Store Cotellic tablets at room temperature between 68°F to 77°F (20°C to 25°C).
• Protect from Light: Keep the medication in its original container and protect it from light.
• Dry Place: Store Cotellic in a dry place away from moisture and humidity.
• Childproof: Keep Cotellic out of reach of children and pets.
• Original Container: Store the medication in its original container with the lid tightly closed.

Disposal of Cotellic:

• Unused Medication: Dispose of any unused Cotellic tablets safely and according to local regulations or guidelines.
• Community Programs: Check if there are community drug take-back programs in your area where you can safely dispose of unused medications.
• Do Not Flush: Do not flush Cotellic down the toilet unless instructed to do so by specific disposal instructions.

In case of emergency/overdose

• Seek Medical Attention: If you suspect an overdose of Cotellic or experience severe symptoms such as severe diarrhea, vomiting, or unusual bleeding, seek immediate medical attention or call your local poison control center at 1-800-222-1222.
• Symptom Management: Depending on the severity of the overdose, medical professionals may provide supportive care to manage symptoms.

What other information should I know?

• Follow Doctor’s Instructions: Take Cotellic exactly as prescribed by your healthcare provider. Do not change your dose or stop taking the medication without consulting your doctor.
• Regular Monitoring: Attend all scheduled appointments for monitoring your condition and response to treatment.
• Communication: Inform all healthcare providers involved in your care about all medications you are taking, including Cotellic, to avoid potential interactions or complications.
• Pregnancy and Breastfeeding: Cotellic can cause harm to an unborn baby, so effective contraception should be used during treatment and for at least 2 weeks after the last dose. It is not known if Cotellic passes into breast milk; discuss breastfeeding considerations with your doctor.
• Driving and Activities: Cotellic may cause fatigue or visual disturbances. Use caution when driving or operating machinery until you know how this medication affects you.
• Allergies: Inform your healthcare provider about any allergies you have, especially to medications.
• Patient Support: Consider joining patient support programs or networks for individuals receiving treatment with Cotellic to access additional resources and support.

Always keep Cotellic and all medications out of sight and reach of children and pets. If you have any questions or concerns about Cotellic or its use, discuss them with your healthcare provider or pharmacist for personalized guidance.