Cotellic (Cobimetinib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Cotellic Used For?
Cotellic contains the active ingredient cobimetinib and belongs to a group of medicines called anti-neoplastic (anti-cancer) agents. It is specifically designed to treat advanced melanoma.
Primary Uses
Cotellic is used to treat a type of skin cancer called melanoma that has spread to other parts of the body and cannot be removed by surgery. It can only be used if your melanoma has a specific change (mutation) in the BRAF gene, which your doctor will test for before prescribing this medication.
How It Works
Cotellic is used in combination with another medicine called ZELBORAF (vemurafenib). Cotellic targets the ‘MEK’ protein while ZELBORAF targets the changed ‘BRAF’ protein. Both proteins are important in controlling cancer cell growth. When used together, these medicines slow down the growth of your cancer.
Good to know: Cotellic is not addictive and is available only with a doctor’s prescription.
How to Take Cotellic
Take Cotellic exactly as your doctor has prescribed. It’s important to follow the specific dosing schedule to get the best results from your treatment.
Dosage Instructions
The recommended dose is three tablets (a total of 60mg) once a day. Take Cotellic once daily for 21 days followed by a 7-day treatment break (no medicine) in a 28-day cycle. Start your next Cotellic treatment cycle after the 7-day treatment break. It is recommended you continue taking ZELBORAF during both the Cotellic treatment phase AND the 7-day Cotellic treatment break. Swallow the tablets whole with a glass of water. You can take Cotellic with or without food. Take your medicine at about the same time each day for best effect.
What If You Miss a Dose?
If it is more than 12 hours before your next dose, take the missed dose as soon as you remember. If it is less than 12 hours before your next dose, skip the missed dose and take the next dose at the usual time. If you vomit after taking Cotellic, do not take the same dose again – continue to take Cotellic as normal the next day.
Important: Do not take a double dose to make up for the dose that you missed. Never stop taking Cotellic or change the dose without first checking with your doctor.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Diarrhea, nausea, vomiting
- Fever, chills
- Dehydration symptoms (dry mouth, low urine output, dark yellow urine, no tears, sunken eyes)
- Anemia symptoms (tiredness, headaches, shortness of breath, dizziness, pale appearance)
- Skin problems (sunburn, sun sensitivity, rashes, spots, itching, dry or scaly skin, thickened skin areas, painful red lumps or warts)
- Coughing
- Sore mouth or mouth ulcers
- Changes in blood test results (liver enzymes, blood sugar, sodium, phosphate levels, blood pressure)
Seek immediate medical attention if you experience:
- Severe skin problems (widespread rash, blisters, peeling skin)
- Muscle damage (muscle aches, spasms, weakness, dark reddish urine)
- Serious bleeding (red or black stools, blood in urine, unusual vaginal bleeding, severe headaches, dizziness, weakness)
- Allergic reactions (shortness of breath, wheezing, swelling of face/lips/tongue, rash, hives)
- Heart problems (persistent coughing, shortness of breath, difficulty breathing, tiredness, increased heart rate, ankle/feet swelling)
- Severe eye or vision problems (blurred vision, vision loss, color changes, seeing blurred outlines, eye pain, swelling, redness)
Important Warnings
Before taking Cotellic, it’s crucial to discuss your medical history and current health conditions with your doctor to ensure this medication is safe for you.
Who Should Not Take Cotellic
Do not use Cotellic if you are allergic to cobimetinib or any of the ingredients listed. Signs of allergic reaction may include shortness of breath, wheezing, difficulty breathing, swelling of face/lips/tongue, or rash and hives. Do not use if the package is torn or shows signs of tampering, or if the expiry date has passed.
Medical Conditions to Discuss
Tell your doctor if you have any eye problems, heart problems, liver problems, medical conditions that increase bleeding risk, muscle problems, kidney problems, or allergies to other medicines, foods, preservatives or dyes. Your doctor may need to perform tests before and during treatment to monitor your heart, liver function, and overall health.
Pregnancy and Breastfeeding
Cotellic is not recommended during pregnancy as it is not known whether it is harmful to an unborn baby. Women who can get pregnant should use two effective forms of contraception during treatment and for at least 3 months following the final dose. It is not known whether Cotellic passes into breast milk, so discuss the risks and benefits with your doctor if you are breastfeeding or plan to breastfeed.
Safety in Children: Safety and effectiveness of Cotellic in children younger than 18 years have not been established.
Drug Interactions
Some medicines may interfere with Cotellic and affect how it works. Always tell your doctor or pharmacist about all medicines you are taking.
Grapefruit interaction: Avoid drinking grapefruit juice as it can increase the amount of Cotellic in your blood.
- Antifungal medicines: itraconazole, voriconazole, posaconazole, fluconazole, miconazole
- Antibiotics: clarithromycin, erythromycin, rifampicin
- HIV medicines: ritonavir, cobicistat, lopinavir, fosamprenavir
- Heart rhythm medicine: amiodarone
- Blood pressure medicines: diltiazem, verapamil
- Cancer medicine: imatinib
- Seizure medicines: carbamazepine, phenytoin
- Herbal medicine: St. John’s Wort
Alcohol & Driving
Be cautious with activities that require alertness and vision while taking Cotellic, as this medication can affect your ability to drive safely.
Alcohol
The source material does not provide specific information about alcohol interactions with Cotellic. Consult your doctor about alcohol consumption while taking this medication.
Driving and Operating Machinery
Be careful driving or operating machinery until you know how Cotellic affects you. If Cotellic affects your vision, consult your doctor before driving or operating machinery, as this medication may affect your vision.
Sun Exposure
Avoid going out in the sun as you may become more sensitive to sunlight and get severe sunburns more easily. If you must go in the sun, wear protective clothing covering your head, face, arms and legs, and use broad spectrum (UVA/UVB) sunscreen and lip balm with minimum SPF 30+, reapplied every 2-3 hours.
Storage
Keep your tablets in the blister pack until it is time to take them, as taking them out early may affect how well they keep. Store the tablets in a cool, dry place where the temperature stays below 30°C. Do not store Cotellic in the bathroom, near a sink, on a window sill, or in the car, as heat and dampness can destroy the medicine. Keep it in a locked cupboard at least one-and-a-half metres above the ground, away from young children.
Overdose Information
If you think that you or anyone else has taken too much Cotellic, you may need urgent medical attention. You should immediately phone the Poisons Information Centre (by calling 13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
How long you will be treated with Cotellic depends on how you are responding to treatment. Your doctor will discuss this with you and monitor your progress through regular appointments.
Yes, you can take Cotellic with or without food. Swallow the tablets whole with a glass of water.
No, Cotellic is not addictive. This medicine is available only with a doctor’s prescription.
Do not stop taking Cotellic suddenly without first checking with your doctor. Continue taking Cotellic until your doctor tells you to stop.
If it is more than 12 hours before your next dose, take the missed dose as soon as you remember. If it is less than 12 hours before your next dose, skip the missed dose and take the next dose at the usual time. Never take a double dose to make up for a missed dose.
Grapefruit juice can increase the amount of Cotellic in your blood, which could affect how the medication works or increase side effects.
If you vomit after taking Cotellic, do not take the same dose again. Continue to take Cotellic as normal the next day.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.