Selpercatinib is administered orally. The exact regimen depends on age, body weight, treatment indication and applicable prescribing information.
The current U.S. RETEVMO label recommends twice-daily dosing for adults and adolescents aged 12 years and older, with the dose based on body weight. Pediatric dosing for children from 2 to less than 12 years is based on body-surface area and may involve twice- or three-times-daily administration.
General administration principles
- Take selpercatinib exactly as prescribed.
- Swallow capsules or tablets whole.
- Do not crush or chew capsules or tablets.
- Follow the prescribed dosing schedule.
- Do not independently change the dose.
- Tell the healthcare team about all medicines and supplements being taken.
- Follow specific instructions concerning acid-reducing medicines.
Food and acid-reducing medicines
Selpercatinib can be taken with or without food unless it is being used with a proton-pump inhibitor (PPI).
Current U.S. labeling recommends avoiding PPIs, H2-receptor antagonists and locally acting antacids when possible. If a PPI cannot be avoided, RETEVMO should be taken with food. If an H2 blocker or locally acting antacid cannot be avoided, specific timing separation is required.
Swallowing difficulties
The current U.S. product contains tablets specifically designed to permit preparation of a dispersion for patients who cannot swallow capsules or tablets or who use certain feeding tubes. The label specifies that only 40 mg RETEVMO tablets should be used to create this dispersion.
This does not establish that Selcaxen 40 mg has the same formulation or administration characteristics.
Missed dose
The appropriate missed-dose instructions should be taken from the applicable product labeling and prescription instructions. Patients should not double doses unless specifically instructed by their healthcare professional.
Monitoring
Treatment can require monitoring of liver enzymes, blood pressure, QT interval, electrolytes and clinical symptoms. Liver enzymes are specifically monitored before treatment, every two weeks during the first three months and monthly thereafter under current U.S. labeling.