Drug Action
Binimetinib inhibits the mitogen-activated protein kinase (MAPK) pathway, specifically mitogen- activated extracellular kinases MEK 1 and 2, thereby inhibiting BRAF V600 mutation-positive cell growth.
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Drug reference
Binimetinib inhibits the mitogen-activated protein kinase (MAPK) pathway, specifically mitogen- activated extracellular kinases MEK 1 and 2, thereby inhibiting BRAF V600 mutation-positive cell growth.
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Unresectable or metastatic melanoma with a BRAF V600 mutation (in combination with encorafenib) (specialist use only) ▶BY MOUTH ▶Adult: 45 mg twice daily, for dose adjustments due to side-effects, consult product literature
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History of retinal vein occlusion
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Left ventricular dysfunction (ejection fraction below 50%, or below the institutional lower limits of normal). neuromuscular conditions associated with elevated creatine kinase and rhabdomyolysis. risk factors for retinal vein occlusion. risk factors for venous thromboembolism
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NICE decisions ▶Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma (February 2019) NICE TA562 Encorafenib with binimetinib (Mektovi ®) is recommended, within its marketing authorisation, as an option for treating unresectable or metastatic BRAF V600 mutation- positive melanoma in adults. It is recommended only if the manufacturer provides binimetinib according to the commercial arrangements. www.nice.org.uk/guidance/ta562
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RISKS OF INCORRECT DOSING OF ORAL ANTI-CANCER MEDICINES See Cytotoxic drugs p. 938.
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▶Common or very common Alopecia. anaemia. angioedema . arthralgia. constipation. detachment of retinal pigment epithelium. diarrhoea. dizziness. embolism and thrombosis. eye inflammation. fatigue. fever. fluid retention. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. headache. heart failure. hypersensitivity. hypersensitivity vasculitis. hypertension . intracranial haemorrhage. left ventricular dysfunction. lip squamous cell carcinoma. muscle complaints. muscle weakness. myopathy. nausea. neoplasms. nerve disorders . oedema. pain. panniculitis. photosensitivity reaction. renal failure. skin reactions. taste altered. ulcerative colitis. vision disorders. vomiting ▶Uncommon Facial paralysis. pancreatitis. paresis ▶Frequency not known Respiratory disorders. retinal occlusion (discontinue permanently)
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Manufacturer advises women of child-bearing potential should use effective contraception during and for at least one month after stopping treatment.
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Manufacturer advises avoid—toxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid in moderate or severe impairment (increased exposure).
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▶Manufacturer advises monitor liver function before treatment, at least monthly during the first 6 months, and thereafter as clinically indicated. ▶Manufacturer advises assess left ventricular ejection fraction before treatment, one month after starting treatment, then every 3 months or more frequently as clinically indicated. ▶Manufacturer advises monitor for visual disturbances. ▶Manufacturer advises monitor blood pressure before and during treatment. ▶Manufacturer advises monitor creatine kinase and creatinine levels monthly during the first 6 months of treatment, and as clinically indicated.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 3, 25 ▶Mektovi (Pierre Fabre Ltd) A Binimetinib 15 mg Mektovi 15mg tablets | 84 tablet P £2,240.00 (Hospital only)
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Missed doses Manufacturer advises if a dose is more than 6 hours late, the missed dose should not be taken and the next dose should be taken at the normal time. Driving and skilled tasks Manufacturer advises patients and carers should be counselled on the effects on driving and performance of skilled tasks—increased risk of visual disturbances.
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45 mg twice daily, for dose adjustments due to
First-line fragment. Read the complete Indications and Dose section above.
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