Prescribing Information for the Patient
Mekinist®0.5Film-Coated Tablets
Mekinist®2Film-Coated Tablets
trametinib
Read this entire prescribing information carefully before starting to take this medication, as it contains important information for you.
Mekinist is a medication that contains the active ingredient trametinib. It is used alone or in combination with another medication that contains dabrafenib to treat a type of skin cancer called melanoma that has spread to other parts of the body, or cannot be removed by surgery.
Mekinist in combination with dabrafenib can also be used to prevent the recurrence of melanoma after it has been removed by surgery.
Mekinist in combination with dabrafenib is also used to treat a type of lung cancer called non-small cell lung cancer (NSCLC).
Both types of cancer have a specific change (mutation) in a gene called BRAF at position V600. This mutation in the gene may have caused the development of cancer. This medication acts on the proteins produced by the mutated gene and slows down or stops the development of cancer.
Mekinist can only be used to treat melanomas and CPNM that present BRAF mutation. Therefore, before starting treatment, your doctor will check if you have this mutation.
If your doctor decides that you take the combined treatment of Mekinist and dabrafenib,read dabrafenib prospectus as well as this prospectus carefully.
If you have additional questions about the use of this medication, ask your doctor, pharmacist, or nurse.
Do not take Mekinist
Consult your doctor if you think this may happen.
Warnings and precautions
Consult your doctor before starting to take this medication. Your doctor needs to know if you:
Before taking Mekinist in combination with dabrafenib, your doctor must know if you:
Consult your doctorif you think any of the above circumstances may affect you.
Conditions to pay attention to
Some people who take Mekinist develop other conditions that can be serious. You need to know what symptoms to pay attention to while taking this medication.
Bleeding
Taking Mekinist or Mekinist in combination with dabrafenib may cause severe bleeding in the brain, digestive system (such as stomach, rectum, or intestine), lungs, and other organs, which can cause death. The symptoms may be:
Inform your doctor as soon as possibleif you feel these symptoms.
Fever
The treatment with Mekinist or the combination of Mekinist with dabrafenib may cause fever, although it is more likely if you take the combination (see also section4). In some cases, people with fever develop low blood pressure, dizziness, and other symptoms.
Inform your doctor immediatelyif your temperature is over 38°C or if you feel feverish while taking this medication.
Heart disorder
Mekinist may cause heart problems, or may make existing problems worse (seein section4 of this prospectus “Heart conditions”) in people who take Mekinist in combination with dabrafenib.
Inform your doctor if you experience any heart problems. Before starting treatment and during treatment with this medication, your doctor will perform tests to check if your heart functions properly. Inform your doctor immediately if you feel that: your heart beats strongly, your heart rate accelerates, or beats irregularly, if you feel dizzy, tired, short of breath, or if your legs swell. If necessary, your doctor may decide to interrupt or suspend treatment.
Changes in the skin that may indicate a new skin cancer
Your doctor will check your skin before starting treatment with this medication, and regularly while taking it.Inform your doctor immediatelyif you notice any changes in your skin while taking this medication or after treatment (see also section4).
Eye problems
Your doctor must examine your eyes while taking this medication.
Consult your doctor immediatelyif you have eye redness and irritation, blurred vision, eye pain, or other changes in vision during treatment (see also section4).
Mekinist may cause eye problems, including blindness. Mekinist is not recommended if you have ever had a blockage in the veins that drain the eye (retinal vein occlusion). Inform your doctor immediately if during treatment you experience the following symptoms related to eye problems: blurred vision, loss of vision, or other changes in vision, if you see colored dots or halos (blurred vision around objects). If necessary, your doctor may decide to interrupt or suspend treatment.
Liver problems
Mekinist, or the combination with dabrafenib, may cause liver problems that can develop into diseases such as hepatitis or liver failure, which can be fatal. Your doctor will monitor you periodically. The signs that your liver is not functioning properly are:
Inform your doctor as soon as possibleif you feel these symptoms.
Respiratory or lung problems
Inform your doctor if you have respiratory or lung problems, including frequent difficulty breathing accompanied by dry cough, shortness of breath, and fatigue. Your doctor may ask you to have your pulmonary function checked before starting to take this medication.
Muscle pain
Mekinist may cause muscle deterioration (rhabdomyolysis).Inform your doctoras soon as possible if you notice any of the following symptoms:
If necessary, your doctor may decide to interrupt or suspend treatment.
Intestinal perforation
Taking Mekinist or Mekinist in combination with dabrafenib may increase the risk of developing intestinal wall perforation. If you feel severe abdominal pain, inform your doctor as soon as possible.
Severe skin reactions
Severe skin reactions have been reported in people who have taken Mekinist in combination with dabrafenib. Inform your doctor immediately if you notice any changes in your skin (see section4 to know the symptoms to pay attention to).
Inflammatory disease that mainly affects the skin, lungs, eyes, and lymph nodes
An inflammatory disease that mainly affects the skin, lungs, eyes, or lymph nodes (sarcoidosis). Common symptoms of sarcoidosis may include cough, shortness of breath, lymph node inflammation, visual disturbances, fever, fatigue, pain, joint inflammation, or painful skin nodules. If you experience any of these symptoms, contact a doctor.
Immune system disorders
Mekinist in combination with dabrafenib may cause a rare disease (hemophagocytic lymphohistiocytosis or LHH) in which the immune system produces too many cells to fight infections, called histiocytes and lymphocytes. The symptoms may include liver or spleen enlargement, skin rash, lymph node enlargement, respiratory problems, tendency to form bruises, renal abnormalities, and heart problems. Inform your doctor immediately if you experience several symptoms, such as fever, lymph node inflammation, bruises, or skin rash, at the same time.
Tumor lysis syndrome
If you experience the following symptoms, inform your doctor immediately, as it may be a potentially fatal condition: nausea, difficulty breathing, irregular heartbeats, muscle cramps, convulsions, cloudy urine, decreased urine production, and fatigue. These may be caused by a group of metabolic complications that can occur during cancer treatment and are caused by the breakdown products of dying cancer cells (tumor lysis syndrome or TLS) and can cause changes in kidney function (see also section 4).
Children and adolescents
Mekinist is not recommended for children and adolescents because the effects of Mekinist on people under 18years of age are unknown.
Other medications and Mekinist
Before starting treatment, inform your doctor, pharmacist, or nurse if you are taking,have taken recentlyor may need to take any other medication. This includes over-the-counter medications. Make a list of the medications you are taking, and show it to your doctor, pharmacist, or nurse if you start taking a new medication.
Use of Mekinist with food and drinks
It is essential to take Mekinist on an empty stomachbecause food may affect the absorption of this medication (see section3).
Pregnancy, breastfeeding, and fertility
The use of Mekinist is not recommended during pregnancy.
It is not recommended to use Mekinist during breastfeeding
The components of this medication are unknown to pass into breast milk.
If you are breastfeeding or plan to breastfeed, inform your doctor. It is recommended not to breastfeed while taking Mekinist. You and your doctor will decide whether to take this medication or to breastfeed.
Fertility of men and women
Mekinist may alter the fertility of men and women.
When taking Mekinist with dabrafenib: dabrafenib may permanently reduce male fertility. Men taking dabrafenib may experience reduced sperm count, and their sperm may not return to normal levels until they stop taking this medication.
Before starting treatment with dabrafenib, discuss your options for having children in the future with your doctor.
If you have additional questions about the effects of this medication on fertility, ask your doctor, pharmacist, or nurse.
Driving and using machines
Mekinist may cause side effects that affect your ability to drive or use machines.
Avoid driving or using machines if you feel tired or weak, if you have vision problems, or if you feel lacking in energy.
The description of these side effects can be found in other sections of this prospectus (see sections2 and4.). Read all the information included in this prospectus.
If you are unsure, consult your doctor, pharmacist, or nurse. Your ability to drive and use machines may be affected even by the disease, symptoms, or treatment itself.
Mekinist contains sodium
This medication contains less than 1mmol sodium (23mg) per tablet; this is, essentially “sodium-free”.
Follow exactly the administration instructions of this medication as indicated by your doctor, pharmacist or nurse. In case of doubt, consult your doctor, pharmacist or nurse again.
How much to take
The recommended dose of Mekinist, whether used alone or in combination with dabrafenib, is 1tablet of 2mg once a day. The recommended dose of dabrafenib, when used in combination with Mekinist, is 150mg twice a day.
Your doctor will decide if it is necessary to reduce the dose based on the adverse effects you have.
Do not take more Mekinist than your doctor has recommended,as it could increase the risk of adverse effects.
How to take it
Swallow the tablets whole with the help of a full glass of water.
Take Mekinist once a day, on an empty stomach (at least 1hour before eating or 2hours after eating). That is:
Take Mekinist at the same time of day, every day.
If you take more Mekinist than you should
If you take too many Mekinist tablets, contact your doctor, pharmacist or nurse. If possible, show them the Mekinist packaging along with this leaflet.
If you forget to take Mekinist
If less than 12hours have passed since the usual time you should have taken Mekinist, take it as soon as you remember.
If more than 12hours have passed since the usual time you should have taken Mekinist, skip this dose and take the next one at your usual time. Then, continue taking the tablets at your usual time.
Do not take a double dose to compensate for the missed doses.
If you interrupt treatment with Mekinist
Take Mekinist for the time your doctor has recommended. Do not stop taking this medication unless your doctor recommends it.
If you have any other doubts about the use of this medication, ask your doctor, pharmacist or nurse.
How to take Mekinist in combination with dabrafenib
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
Severe possible side effects
Heart problems
Mekinist may affect the functioning of your heart. It is more likely to affect people with an existing heart problem. During treatment with Mekinist, you will undergo heart tests. Among the signs and symptoms related to heart problems are:
If you experience any of these symptoms,inform your doctoras soon as possible, whether they occur for the first time or if they worsen.
High blood pressure
Mekinist may increase blood pressure (hypertension) or worsen it. Your doctor or nurse must check your blood pressure during treatment with Mekinist. Contact your doctor or nurse immediately if you experience high blood pressure, if blood pressure worsens, or if you experience severe headaches, feel dizzy, or feel nauseous.
Bleeding problems
Mekinist may cause severe bleeding problems, especially in the brain or stomach. Contact your doctor or nurse, and seek immediate medical attention if you experience unusual signs of bleeding, including:
Eye problems (vision)
Mekinist may cause eye problems. It is not recommended to take Mekinist if you have ever had a blockage in the veins that drain the eyes (retinal vein occlusion). Your doctor will advise you to undergo an eye check before starting treatment with Mekinist and during treatment. Your doctor may ask you to stop taking Mekinist or refer you to a specialist if you experience signs and symptoms of vision problems, including:
Skin changes
Severe skin reactions have been reported in people taking Mekinist in combination with dabrafenib (frequency unknown). If you notice any of the following:
Up to 3 out of 100 people who take Mekinist in combination with dabrafenib may develop a different type of skin cancer called Cutaneous Squamous Cell Carcinoma (CSCC). Others may develop a type of cancer called Basal Cell Carcinoma (BCC). Normally, these changes only affect the skin locally and can be removed with surgery and continue treatment with Mekinist and dabrafenib without interrupting it.
Some people who take Mekinist in combination with dabrafenib may also notice that they have new melanomas. These melanomas are usually removed with surgery and treatment with Mekinist and dabrafenib can continue without interrupting it.
Your doctor will examine your skin before starting treatment with dabrafenib, monthly while taking dabrafenib, and during the 6 months after treatment ends. The reason for these reviews is to look for new skin cancer lesions.
Your doctor will also examine your head, neck, mouth, and lymph nodes and perform regular chest and abdominal CT scans. They may also perform blood tests. These reviews are to detect if you have developed other cancers, including squamous cell carcinoma. It is recommended that both at the beginning and at the end of treatment, a pelvic exam (in women) and anal exam be performed.
Mekinist, both in monotherapy and in combination with dabrafenib, may cause acne-like eruptions or eruptions. Follow your doctor's instructions to know what to do to prevent the appearance of an eruption. If you experience any of these symptoms for the first time or if they worsen, inform your doctor or nurse as soon as possible.
Contact your doctor immediatelyif you experience severe skin eruptions with any of the following symptoms: blisters on the skin, blisters or sores in the mouth, skin peeling, fever, redness or swelling in the face, blisters on the soles of the feet.
If you experience skin eruptions or if they worsen, inform your doctor or nurse as soon as possible.
Muscle pain
Mekinist may cause muscle damage (rhabdomyolysis). Inform your doctor or nurse if you experience a new symptom or if any of the following symptoms worsen:
Respiratory or lung problems
Mekinist may cause lung inflammation (pneumonitis or interstitial lung disease). Inform your doctor or nurse if you experience new symptoms or worsening symptoms associated with breathing difficulties or lung problems, including:
Immune system disorders
If you experience simultaneous symptoms, such as fever, swollen lymph nodes, bruises, or skin rash, inform your doctor immediately. It may be a sign of a disease in which the immune system produces too many cells to fight infections, called histiocytes and lymphocytes, which can cause various symptoms (known as hemophagocytic lymphohistiocytosis); see section 2 (rare frequency).
Tumor lysis syndrome
Inform your doctor immediately if you experience the following symptoms: nausea, difficulty breathing, irregular heartbeats, muscle cramps, seizures, cloudy urine, decreased urine production, and fatigue. These may be signs of a condition resulting from rapid cell breakdown in cancer cells that in some people can be fatal (tumor lysis syndrome or TLS), see section 2 (unknown frequency).
Side effects when taking Mekinist alone
Side effects that can be observed while taking only Mekinist:
Very common side effects (may affect more than 1 in 10 people):
Very common side effects that may appear in blood tests:
Common side effects (may affect up to 1 in 10 people):
Common side effects that may appear in blood tests:
Rare side effects (may affect up to 1 in 100 people):
Side effects of unknown frequency (cannot be estimated from available data):
Side effects when taking Mekinist with dabrafenib
When taking Mekinist with dabrafenib, you may experience any of the side effects listed above, although their frequency may change (increase or decrease)
You may also experience new side effects due to taking dabrafenib at the same time as Mekinist, which are listed below.
Inform your doctor as soon as possible if you noticeboth that the symptoms appear for the first time and if they worsen.
Read the dabrafenib prospectus for more details on side effects or that may appear while taking this medicine.
The side effects that may be seen while taking Mekinist in combination with dabrafenib are as follows:
Very common side effects (may affect more than 1 in 10 people):
Very common side effects that may appear in blood tests:
Common side effects (may affect up to 1 in 10 people):
Common side effects that may appear in blood tests:
Rare side effects (may affect up to 1 in 100 people):
Rare side effects (may affect up to 1 in 1,000 people):
Side effects of unknown frequency (cannot be estimated from available data):
Reporting side effects
If you experienceany type of side effect, consult your doctor, pharmacist, or nurse, even if it is apossibleside effect that does not appear in this prospectus.You can also report them directly through the national notification system included in theAppendix V.By reporting side effects, you can contribute to providing more information about the safety of this medicine.
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the label of the bottle and on the packaging, after the abbreviation CAD. The expiration date is the last day of the month indicated.
This medication does not require any special storage temperature.
Store in the original packaging to protect it from light and moisture.
Keep the container perfectly closed with the desiccant inside (small cylindrical container).
Once opened, the bottle can be stored for 30 days at a temperature below 30°C.
Medicines should not be thrown down the drains or in the trash.Ask your pharmacist how to dispose ofthe containers and the medications that you no longerneed.This will help protect the environment.
Composition of Mekinist
Appearance of the product and contents of the pack
Mekinist 0.5mg: the film-coated tablets are yellow, oval, biconvex, marked with the company logo on one face and ‘TT’ on the opposite face.
Mekinist 2mg: the film-coated tablets are pink, round, biconvex, marked with the company logo on one face and ‘LL’ on the opposite face.
The film-coated tablets are supplied in white opaque plastic bottles with plastic screw caps. A bottle contains 7 or 30tablets.
The bottles include a silica gel desiccant in a small cylindrical container. The desiccant must be kept inside the bottle and must not be ingested.
Marketing Authorization Holder
Novartis Europharm Limited
Vista Building
Elm Park, Merrion Road
Dublin 4
Ireland
Responsible Person
Lek Pharmaceuticals d.d.
Verovskova ulica 57
1526, Ljubljana
Slovenia
Novartis Pharmaceutical Manufacturing LLC
Verovskova ulica 57
1000, Ljubljana
Slovenia
Novartis Pharma GmbH
Roonstraße 25
D-90429 Nuremberg
Germany
Glaxo Wellcome, S.A.
Avda. Extremadura, 3
09400, Aranda de Duero
Burgos
Spain
Novartis Pharma GmbH
Sophie-Germain-Strasse 10
90443 Nürnberg
Germany
For further information about this medicinal product, please contact the local representative of the marketing authorization holder:
België/Belgique/Belgien Novartis Pharma N.V. Tel/Tel: +32 2 246 16 11 | Lietuva SIA Novartis Baltics Lietuvos filialas Tel: +370 5 269 16 50 |
Bulgaria Novartis Bulgaria EOOD Tel: +359 2 489 98 28 | Luxembourg/Luxemburg Novartis Pharma N.V. Tél/Tel: +32 2 246 16 11 |
Ceská republika Novartis s.r.o. Tel: +420 225 775 111 | Magyarország Novartis Hungária Kft. Tel.: +36 1 457 65 00 |
Danmark Novartis Healthcare A/S Tlf.: +45 39 16 84 00 | Malta Novartis Pharma Services Inc. Tel: +356 21222872 |
Deutschland Novartis Pharma GmbH Tel: +49 911 273 0 | Nederland Novartis Pharma B.V. Tel: +3188 04 52555 |
Eesti SIA Novartis Baltics Eesti filiaal Tel: +372 66 30 810 | Norge Novartis Norge AS Tlf: +47 23 05 20 00 |
Ελλ?δα Novartis (Hellas) A.E.B.E. Τηλ: +30 210 281 17 12 | Österreich Novartis Pharma GmbH Tel: +43 1 86 6570 |
España Novartis Farmacéutica, S.A. Tel: +34 93 306 42 00 | Polska Novartis Poland Sp. z o.o. Tel.: +48 22 375 4888 |
France Novartis Pharma S.A.S. Tél: +33 1 55 47 66 00 | Portugal Novartis Farma - Produtos Farmacêuticos, S.A. Tel: +351 21 000 8600 |
Hrvatska Novartis Hrvatska d.o.o. Tel. +385 1 6274 220 | România Novartis Pharma Services Romania SRL Tel: +40 21 31299 01 |
Ireland Novartis Ireland Limited Tel: +353 1 260 12 55 | Slovenija Novartis Pharma Services Inc. Tel: +386 1 300 75 50 |
Ísland Vistor hf. Sími: +354 535 7000 | Slovenská republika Novartis Slovakia s.r.o. Tel: +421 2 5542 5439 |
Italia Novartis Farma S.p.A. Tel: +39 02 96 54 1 | Suomi/Finland Novartis Finland Oy Puh/Tel: +358(0)10 6133 200 |
Κ?προς Novartis Pharma Services Inc. Τηλ: +357 22 690 690 | Sverige Novartis Sverige AB Tel: +46 8 732 32 00 |
Latvija SIA Novartis Baltics Tel: +371 67 887 070 |
Last update of this leaflet:
Other sources of information
The detailed information on this medicinal product is available on the website of the European Medicines Agency:https://www.ema.europa.eu.
This leaflet is available in all languages of the European Union/European Economic Area on the website of the European Medicines Agency.
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