Starting cancer treatment for you or a loved one can be a stressful and confusing time. You may have questions about the medications your doctor is giving you, their names, and side effects. So today we're going to talk about one such special cancer drug, Selpercatinib . You may know it by the brand name Retevmo. Let's talk about this drug, what it does, and what to be aware of in a simple, easy-to-understand way.
What really happens with this medicine?
Simply put, Selpercatinib is not like traditional chemotherapy. It works like a "targeted therapy." Certain proteins in our bodies send signals to cancer cells to "grow more, spread faster." Think of it like a switch that makes cancer cells grow. What Selpercatinib does is deactivate the protein that sends the wrong signal . It's like turning off that switch. Then the growth and spread of cancer cells throughout the body is controlled.
Things you need to tell your doctor before starting medication
Before starting this treatment, your doctor should have a complete picture of your health. Be sure to tell them about any of the following conditions, especially if you have any:
| Do you have this condition? | Why is notification important? |
|---|---|
| Bleeding disorders | This medicine may increase the risk of bleeding. |
| Having recently undergone or is scheduled for surgery in the future | The medicine may delay wound healing. |
| High blood pressure | The medication can further increase blood pressure. |
| Irregular heartbeat | Changes in heart rate may occur. |
| Liver or lung diseases | The function of these organs may be affected. |
| Allergies to other medications, foods, or dyes | It is important to know if you are allergic to the medicine or any of its ingredients. |
| Being pregnant or trying to get pregnant | This medicine can cause serious harm to the unborn baby. |
| Breastfeeding | The medicine can be transmitted to the baby through breast milk. |
How should I use this medicine?
This is a capsule that you take by mouth. It is very important to take it at the same time every day , exactly as your doctor has prescribed.
- Swallow the capsule whole with water . Do not break, crush, or chew the capsule.
- You can take this with or without food. However, if you feel a little upset stomach, it is best to take it with a meal.
- Continue treatment until your doctor tells you to stop.
- Very important: Avoid drinking grapefruit juice completely while taking this medicine.
What if I miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is more than 18 hours past your next dose (meaning there are less than 6 hours until your next dose), skip the missed dose and take your next dose at the regular time. Never take two doses at once to make up for a missed dose.
What if I take too much medicine?
If you think you have taken more medicine than you think, don't panic. Go to the nearest hospital Emergency Department (ETU) immediately. Or, call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other things that may interact with this medicine
Some medications may interact with Selpercatinib, changing its effectiveness or increasing side effects.
Warning: If you are taking any of the following medications, do not take Selpercatinib. Talk to your doctor about this.
* Cisapride
* Dronedarone
* Ketoconazole
* Levoketoconazole
* Pimozide
* Thioridazine
Additionally, other medications, herbal products, and foods may interact with this medication. Therefore, it is important to tell your doctor about all medications you are taking (including vitamins, herbal remedies, and supplements).
- Some high blood pressure medications (diltiazem or verapamil)
- Some antiviral drugs for HIV or Hepatitis
- Medicines for fungal infections (itraconazole, posaconazole)
- Grapefruit juice
- Other drugs that alter heart rate
- Repaglinide for diabetes
- Rifampin for tuberculosis
- Herbal products such as St. John's Wort
- Medicines that reduce stomach acid (such as cimetidine, famotidine, ranitidine, lansoprazole, omeprazole)
Things to be especially careful about while taking the medicine
- Feeling unwell: It is normal to feel a little unwell or unwell while taking this medicine. This is because this medicine affects both cancer cells and healthy cells to some extent. However, do not stop treatment until your doctor tells you to. Tell your doctor about any side effects you experience.
- Surgery: If you are going to have surgery (even if it's something minor like having a tooth extracted), tell your doctor. This medicine may delay wound healing. Therefore, you will usually need to stop taking the medicine at least 7 days before the surgery and start again 2 weeks after the surgery, when the wound has fully healed.
- Pregnancy and breastfeeding: For women: Avoid becoming pregnant while taking this medicine and for one week after stopping the medicine. This is why it is essential to use a reliable form of birth control. You should take a pregnancy test before starting the medicine to make sure you are not pregnant. Also, avoid breastfeeding during this time and for one week after stopping the medicine. For men: Always use a condom if you have sex with a woman who could become pregnant while you are taking this medicine and for one week after stopping the medicine. If your partner becomes pregnant, it can be harmful to the baby in the womb.
- Fertility: This medicine may affect your ability to have children. Talk to your doctor if you have any concerns about this.
- Blood pressure: Check your blood pressure regularly as directed by your doctor. Know what it should be and when to call your doctor.
What side effects might I experience?
Like any medicine, Selpercatinib can cause side effects. Some are serious, while others are common.
| Side effect | Description |
|---|---|
| Side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Abnormal bleeding | Black or bloody stools, vomiting blood that looks like coffee grounds, dark brown/red urine, red/purple spots on the skin. |
| Breathing difficulties | Dry cough, difficulty breathing. |
| Changes in heart rate | Heart palpitations, dizziness, chest pain. |
| Liver injury | Pain in the upper right side of the stomach, loss of appetite, yellowing of the skin or eyes, light-colored stools, dark yellow/brown urine. |
| Hypothyroidism | Unusual fatigue, inability to tolerate cold, constipation, hair loss, dry skin, weight gain. |
| Tumor Lysis Syndrome (TLS) | Vomiting, diarrhea, decreased urination, muscle twitching, joint pain, confusion. |
| Tell your doctor if it persists or is bothersome. | |
| Constipation, diarrhea, dry mouth, nausea, skin rash, swelling of the ankles, feet, and hands. | |
This list does not include all possible side effects. If you experience anything unusual, talk to your doctor about it.
Take-Home Message
- Selpercatinib is a drug that targets and deactivates a specific protein involved in cancer cell growth.
- Take the medicine at the same time every day as prescribed by your doctor. Never take it with grapefruit juice.
- Tell your doctor about all other medications (including vitamins and herbal products) you are taking.
- This medicine is not suitable if you are pregnant, trying to become pregnant, or breastfeeding. It is essential that both women and men use appropriate birth control during treatment and for one week afterwards.
- If you experience any serious side effects such as difficulty breathing, excessive bleeding, or severe allergic symptoms, seek medical advice immediately.
- Don't be afraid to talk to your doctor about any questions or concerns you may have. Remember that you are not alone.
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