Retevmo (Selpercatinib)

Description

Retevmo (Selpercatinib) is a medication used to treat specific types of advanced cancer by targeting alterations in the RET gene. It works by blocking the activity of the RET proteins, which can drive cancer growth when mutated or fused. Classified as a kinase inhibitor due to its ability to block these proteins, Retevmo is mainly used in treating non-small cell lung cancer (NSCLC) and thyroid cancer when these cancers are advanced or metastatic and test positive for RET gene changes. Patients take Retevmo orally, typically as part of a broader cancer treatment regimen.

Directions

Retevmo is taken in capsule form. Patients typically take it twice a day, with or without food. It's crucial to swallow capsules whole, not to crush, chew, or open them. The standard dosage depends on various factors, including the patient's weight and overall health, and should follow the physician's guidance closely. Generally, adults start with 160 mg twice daily for individuals who weigh 50 kg or more, and 120 mg twice daily for those under 50 kg.

Ingredients

Retevmo contains the active ingredient Selpercatinib. Inactive ingredients may include microcrystalline cellulose and colloidal silicon dioxide.

Contraindications

No contraindications are listed on the drug label. However, it should be avoided in people with a known allergy to Selpercatinib or any of the ingredients within the drug formulation.

Cautions

• Consult a healthcare provider about the following before starting treatment with Retevmo:
• Whether you have any allergies
• Whether you’re pregnant or breastfeeding
• If you have other medical conditions
• If you take other medications
• Before and while on Retevmo, you'll need regular blood tests to check how your liver is doing because Retevmo can cause liver issues. Depending on the test results, your doctor might adjust your dosage or stop the treatment.
• If you notice any new or getting-worse lung problems (like coughing more than usual or feeling short of breath), tell your doctor right away. These symptoms could lead to changes in how you take Retevmo.
• High blood pressure should be controlled before starting Retevmo. Your doctor will keep a close eye on your blood pressure regularly after you start treatment, and may need to make changes based on what they find.
• Retevmo can affect the rhythm of your heart, so if you're at risk for heart issues, your doctor will want to keep a closer watch on you, especially if you're taking other meds that can also impact your heart's rhythm.
• Should you have serious bleeding while on Retevmo, the drug may have to be stopped for good.
• In case of an allergic reaction to Retevmo, treatment might be paused, and you could be given steroids to help manage the reaction. Once things are under control, you might be able to restart Retevmo at a lower dose and slowly work back up.
• This condition can happen when cancer cells break down quickly and release their contents into your blood. It's something your doctor will monitor for and manage if it happens.
• Because Retevmo can interfere with wound healing, you'll need to stop taking it at least a week before any planned surgery and not start again until your wound has properly healed, which could take at least two weeks after surgery.
• Your doctor will test your thyroid function before you start Retevmo and keep an eye on it during treatment, as Retevmo can affect your thyroid.
• Retevmo can harm an unborn baby, so if you're able to get pregnant, you'll need to use effective birth control during your treatment and for some time after finishing Retevmo. Your doctor will talk with you about the risks and how to protect against pregnancy.

Side Effects

Patients taking Retevmo may experience edema (swelling of arms, legs, hands, and feet), along with stomach pain, diarrhea, constipation, fatigue, rash, dry mouth, nausea, high blood pressure, and headaches. Retevmo side effects are typically the body's initial reaction to the medication.

Retevmo carries the risk of significant health concerns, including liver issues marked by jaundice, dark urine, and stomach pain; lung problems characterized by shortness of breath and cough; severe high blood pressure; changes in heart rhythm; and serious bleeding events. It can also cause allergic reactions, tumor lysis syndrome leading to kidney failure and abnormal heart rhythms, problems with wound healing, and hypothyroidism. Furthermore, Retevmo may impact fertility in both genders. Patients should have regular health check-ups to monitor for these conditions and report any severe side effects to their healthcare provider immediately.

References:

1. Retevmo (Selpercatinib) Product Monograph. Indianapolis, IN: Eli Lilly and Company; 2022.
2. Retevmo (Selpercatinib) Drug Label Information. Indianapolis, IN: Eli Lilly and Company; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....