Selumetinib Sulfate – Uses, Dosage, Side Effects, Interaction Selumetinib is an orally active, small molecule with potential antineoplastic activity. Selumetinib is an ATP-independent inhibitor of mitogen-activated protein kinase kinase (MEK or MAPK/ERK kinase) 1 and 2. MEK 1 and 2 are dual specificity kinases that are essential mediators in the activation of the RAS/RAF/MEK/ERK pathway, are often upregulated in various cancer cells, and are drivers of diverse cellular responses, including proliferation. Inhibition of both MEK1 and 2 by selumetinib prevents the activation of MEK1/2 dependent effector proteins and transcription factors, thereby leading to an inhibition of cellular proliferation in various cancers. Selumetinib is an oral, small-molecule inhibitor of the mitogen-activated protein kinase 1 and 2 (MEK1/2) that is used to treat symptomatic, refractory fibromas in neurofibromatosis type 1. Selumetinib is associated with transient and usually mild elevations in serum aminotransferase levels during therapy but has not been linked to cases of clinically apparent acute liver injury. Selumetinib is a member of the class of benzimidazoles that is 1-methyl-1H-benzimidazole which is substituted at positions 4, 5, and 6 by fluorine, (4-bromo-2-chlorophenyl)amino, and N-(2-hydroxyethoxy)aminocarbonyl groups, respectively. It is a MEK1 and MEK2 inhibitor. It has a role as an EC 2.7.11.24 (mitogen-activated protein kinase) inhibitor, an antineoplastic agent and an anticoronaviral agent. It is a member of benzimidazoles, a hydroxamic acid ester, a member of monochlorobenzenes, a member of bromobenzenes, an organofluorine compound and a secondary amino compound. Selumetinib Sulfate is the sulfate salt of selumetinib, an orally active, small molecule with potential antineoplastic activity. Selumetinib is an ATP-independent inhibitor of mitogen-activated protein kinase kinase (MEK or MAPK/ERK kinase) 1 and 2. MEK 1 and 2 are dual specificity kinases that are essential mediators in the activation of the RAS/RAF/MEK/ERK pathway, are often upregulated in various cancer cells, and are drivers of diverse cellular responses, including proliferation. Inhibition of both MEK1 and 2 by selumetinib prevents the activation of MEK1/2 dependent effector proteins and transcription factors, thereby leading to an inhibition of cellular proliferation in various cancers. Mechanism of Action The Ras-Raf-MEK-ERK signaling cascade is known to be activated in several types of cancer, and regulates the transcription of proteins involved in apoptosis. In addition, studies have shown that mutations of the Raf component of the pathway can contribute to chemotherapy drug resistance. Ras as well as several kinases and phosphatases are responsible for regulating the Raf-MEK-ERK pathway. Often in cancers, Ras (a G-protein coupled receptor) is deregulated, allowing downstream signalling to proceed unchecked. Through several complex steps, Raf phosphorylates and activates MEK, which then phosphorylates and activates ERK. ERK is then able to exert its effects on several downstream targets. As such, therapies inhibiting upstream components of this pathway have become attractive targets for cancer treatment. Selumetinib exerts its effects by selectively inhibiting MEK1 and MEK2 which can effectively blunt the pleiotropic effects of the Ras-Raf-MEK-ERK cascade. By inhibiting this oncogenic pathway, selumetinib reduces cell proliferation, and promotes pro-apoptotic signal transduction. Selumetinib is a non-ATP-competitive mitogen-activated protein kinase kinase 1 and 2 (MEK1 and MEK2) inhibitor. By selectively targeting MEK1 and MEK2, selumetinib is able to inhibit oncogenic downstream effects of the Raf-MEK-ERK signaling pathway, which is often overactive in certain types of cancer. Indeed, a study investigating the effects of selumetinib in children with NF-1 found that treatment with the anti-neoplastic resulted in reduced tumor size. Decreases in tumor-associated pain and improvements in overall function were also subjectively reported. Selumetinib has minimal off-target activity, contributing to its impressive safety profile. Activation of the Raf-MEK-ERK signaling pathway is known to be implemented in several types of malignancies, thus, mitogen-activated protein kinase kinase (MEK) inhibitors such as selumetinib are important tools that can target the problematic overactivity of this pathway.[rx] Results from clinical trials investigating earlier developed MEK inhibitors were underwhelming.[rx] However, selumetinib demonstrated impressive efficacy and tolerability in Phase I trials, leading to its continued investigation for the treatment of various types of tumors in Phase II trials.[rx] Currently, the novel MEK 1 / 2 inhibitor, selumetinib, is approved solely for the treatment of Neurofibromatosis type 1 (NF-1) in a limited age group. NF-1 is considered rare with an estimated incidence of 1/3000 individuals.[rx] It is a genetic, autosomal dominant condition resulting from mutations of the NF1 gene, which can lead to various complications including the development of multiple tumors in the nervous system. Some patients with this disorder develop plexiform neurofibromas (PN); however, this is considered to be relatively uncommon compared to other variants of NF-1.[rx] Luckily, the use of selumetinib in patients with NF-1 has shown efficacy in shrinking associated tumors and is linked to other positive clinical outcomes.[rx] Indications Although selumetinib has been investigated for the treatment of several types of cancer, it is currently only indicated for the treatment of neurofibromatosis type 1 (NF1) in patients ≥2 years who have symptomatic, inoperable plexiform neurofibromas (PN). Koselugo as monotherapy is indicated for the treatment of symptomatic, inoperable plexiform neurofibromas (PN) in paediatric patients with neurofibromatosis type 1 (NF1) aged 3 years and above. Selumetinib is an oral, small-molecule inhibitor of the mitogen-activated protein kinase 1 and 2 (MEK1/2) that is used to treat symptomatic, refractory fibromas in neurofibromatosis type 1. Use in Cancer Selumetinib sulfate is approved to treat: Neurofibromatosis type 1 (NF1) in children aged 2 years and older who have plexiform neurofibromas that are causing symptoms and cannot be removed by surgery. Selumetinib sulfate is also being studied in the treatment of other types of cancer. Contraindications decreased blood-clotting from low vitamin K increased risk of bleeding due to clotting disorder chronic heart failure inflammation of the large intestine a condition with muscle tissue breakdown called rhabdomyolysis diarrhea pregnancy a patient who is producing milk and breastfeeding increased creatine kinase levels detachment of retinal pigment epithelium Child-Pugh class B liver impairment Child-Pugh class C liver impairment Dosage Strengths: 10 mg; 25 mg Fibromatosis 2 years and older: 25 mg/m2 orally 2 times a day (approximately every 12 hours) until disease progression or unacceptable toxicity RECOMMENDED DOSE BASED ON BODY SURFACE AREA (BSA): BSA less than 0.55 mg/m2: No dose recommendation. BSA 0.55 to 0.69 m2: 20 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.7 to 0.89 m2: 20 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 0.9 to 1.09 m2: 25 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.1 to 1.29 m2: 30 mg/m2 orally in the morning and 30 mg/m2 in the evening BSA 1.3 to 1.49 m2: 35 mg/m2 orally in the morning and 35 mg/m2 in the evening BSA 1.5 to 1.69 m2: 40 mg/m2 orally in the morning and 40 mg/m2 in the evening BSA 1.7 to 1.89 m2: 45 mg/m2 orally in the morning and 45 mg/m2 in the evening BSA 1.9 mg/m2 or greater: 50 mg orally in the morning and 50 mg/m2 in the evening Treatment of pediatric patients 2 years and older with neurofibromatosis type 1 (NF1) who have symptomatic, inoperable plexiform neurofibromas (PN) Liver Dose Adjustments DOSE ADJUSTMENTS FOR HEPATIC IMPAIRMENT: MILD HEPATIC IMPAIRMENT (Child-Pugh A): No adjustment recommended. MODERATE HEPATIC IMPAIRMENT (Child-Pugh B): Body surface area (BSA) 0.55 to 0.69 m2: 10 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.7 to 0.89 m2: 20 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.9 to 1.09 m2: 20 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 1.1 to 1.29 m2: 25 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.3 to 1.49 m2: 30 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.5 to 1.69 m2: 35 mg/m2 orally in the morning and 30 mg/m2 in the evening BSA 1.7 to 1.89 m2: 35 mg/m2 orally in the morning and 35 mg/m2 in the evening BSA 1.9 mg/m2 or greater: 40 mg orally in the morning and 40 mg/m2 in the evening SEVERE HEPATIC IMPAIRMENT (Child-Pugh C): Not recommended. Dose Adjustments RECOMMENDED DOSE REDUCTIONS FOR ADVERSE REACTIONS: BSA 0.55 to 0.69 m2: First dose reduction: Reduce dose to 10 mg/m2 orally in the morning and 10 mg/m2 in the evening Second dose reduction: Reduce dose to 10 mg/m2 orally once a day BSA 0.7 to 0.89 m2: First dose reduction: Reduce dose to 20 mg/m2 orally in the morning and 10 mg/m2 in the evening Second dose reduction: Reduce dose to 10 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.9 to 1.09 m2: First dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 10 mg/m2 in the evening Second dose reduction: Reduce dose to 10 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 1.1 to 1.29 m2: First dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 20 mg/m2 in the evening Second dose reduction: Reduce dose to 20 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 1.3 to 1.49 m2: First dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 25 mg/m2 in the evening Second dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 1.5 to 1.69 m2: First dose reduction: Reduce dose to 30 mg/m2 orally in the morning and 30 mg/m2 in the evening Second dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 1.7 to 1.89 m2: First dose reduction: Reduce dose to 35 mg/m2 orally in the morning and 30 mg/m2 in the evening Second dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 1.9 m2 or greater: First dose reduction: Reduce dose to 35 mg/m2 orally in the morning and 35 mg/m2 in the evening Second dose reduction: Reduce dose to 25 mg/m2 orally in the morning and 25 mg/m2 in the evening *Permanently discontinue this drug in patients unable to tolerate it after 2 dose reductions. CARDIOMYOPATHY: Asymptomatic decrease in left ventricular ejection (LVEF) of 10% or greater from baseline and less than lower level of normal: Withhold therapy until resolution; resume at reduced dose. Symptomatic decreased LVEF: Permanently discontinue therapy. Grade 3 or 4 decreased LVEF: Permanently discontinue therapy. OCULAR TOXICITY: Retinal pigment epithelial detachment (RPED): Withhold therapy until resolution; resume at reduced dose. Retinal vein occlusion (RVO): Permanently discontinue therapy. GASTROINTESTINAL TOXICITY: Grade 3 diarrhea: Withhold until improved to Grade 0 or 1; resume at same dose; permanently discontinue if no improvement within 3 days. Grade 4 diarrhea: Permanently discontinue therapy. Grade 3 or 4 colitis: Permanently discontinue therapy. SKIN TOXICITY: Grade 3 or 4: Withhold therapy until improvement; resume at reduced dose. INCREASED CREATININE PHOSPHOKINASE (CPK): Grade 4 Increased CPK: Withhold therapy until improved to Grade 0 or 1; resume at reduced dose; permanently discontinue therapy if no improvement within 3 weeks. Any Increased CPK and myalgia: Withhold therapy until improved to Grade 0 or 1; resume at reduced dose; permanently discontinue therapy if no improvement within 3 weeks. Rhabdomyolysis: Permanently discontinue therapy. OTHER ADVERSE REACTIONS: Intolerable Grade 2: Withhold therapy until improved to Grade 0 or 1; resume at reduced dose. Grade 3: Withhold therapy until improved to Grade 0 or 1; resume at reduced dose. Grade 4: Withhold therapy until improved to Grade 0 or 1; resume at reduced dose; consider discontinuation of therapy. DOSE MODIFICATIONS FOR DRUG INTERACTIONS: STRONG OR MODERATE CYP450 3A4 INHIBITORS OR FLUCONAZOLE: Avoid coadministration of strong or moderate CYP450 3A4 inhibitors or fluconazole with this drug. If coadministration with strong or moderate CYP450 3A4 inhibitors or fluconazole cannot be avoided, reduce the dose of this drug as recommended below. After discontinuation of the strong or moderate CYP450 3A4 inhibitor or fluconazole for 3 elimination half-lives, resume the selumetinib dose that was taken prior to initiating the inhibitor or fluconazole: RECOMMENDED DOSE OF SELUMETINIB FOR COADMINISTRATION WITH STRONG OR MODERATE CYP450 3A4 INHIBITORS OR FLUCONAZOLE: IF THE CURRENT DOSE IS 25 MG/M2 TWICE DAILY, REDUCE TO 20 MG/M2 TWICE DAILY: Daily doses for 20 mg/m2 twice daily: BSA 0.55 to 0.69 m2: 10 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.7 to 0.89 m2: 20 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.9 to 1.09 m2: 20 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 1.1 to 1.29 m2: 25 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.3 to 1.49 m2: 30 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.5 to 1.69 m2: 35 mg/m2 orally in the morning and 30 mg/m2 in the evening BSA 1.7 to 1.89 m2: 35 mg/m2 orally in the morning and 35 mg/m2 in the evening BSA 1.9 m2 or greater: 40 mg/m2 orally in the morning and 40 mg/m2 in the evening IF THE CURRENT DOSE IS 20 MG/M2 TWICE DAILY, REDUCE TO 15 MG/M2 TWICE DAILY: Daily doses for 15 mg/m2 twice daily: BSA 0.55 to 0.69 m2: 10 mg/m2 orally once daily BSA 0.7 to 0.89 m2: 10 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 0.9 to 1.09 m2: 20 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 1.1 to 1.29 m2: 25 mg/m2 orally in the morning and 10 mg/m2 in the evening BSA 1.3 to 1.49 m2: 25 mg/m2 orally in the morning and 20 mg/m2 in the evening BSA 1.5 to 1.69 m2: 25 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.7 to 1.89 m2: 30 mg/m2 orally in the morning and 25 mg/m2 in the evening BSA 1.9 m2 or greater: 30 mg/m2 orally in the morning and 30 mg/m2 in the evening Administration advice: This drug should be taken on an empty stomach 2 hours before or 1 hour after eating. Swallow capsules whole with water; do not chew, dissolve or open capsule. Do not administer to patients who are unable to swallow a whole capsule. Do not take a missed dose unless it is more than 6 hours until the next scheduled dose. If vomiting occurs after administration, do not take an additional dose, but continue with the next scheduled dose. Side Effects The Most Common vomiting constipation stomach pain nausea dry skin headache mouth ulcers itching redness around the fingernails nose bleeding fatigue loss of appetite hair loss or hair color changes fever unusual bleeding pale skin or tiredness blurred vision; loss of vision; dark spots in your vision; or other vision changes diarrhea rash, skin blisters or peeling muscle pain, aches, or weakness; or dark urine coughing or wheezing; shortness of breath; swelling of ankles and feet; or extreme tiredness More common Blistering, crusting, irritation, itching, or reddening of the skin blood in urine cracked, dry scaly skin diarrhea fast heartbeat itching, pain, redness, swelling, tenderness, warmth on the skin loosening of the fingernails muscle or bone pain nosebleeds redness or soreness around the fingernails swelling Constipation fever hair loss, thinning of the hair loss of appetite nausea stomach pain swelling or inflammation of the mouth unusual tiredness or weakness vomiting Rare Blurred vision change in vision difficult or labored breathing dizziness headache nervousness overbright appearance of lights pounding in the ears rapid weight gain seeing flashes or sparks of light seeing floating spots before the eyes, or a veil or curtain across part of your vision slow or fast heartbeat tightness in the chest Drug Interaction DRUG INTERACTION Abaloparatide The therapeutic efficacy of Abaloparatide can be decreased when used in combination with Selumetinib. Abametapir The serum concentration of Selumetinib can be increased when it is combined with Abametapir. Abatacept The metabolism of Selumetinib can be increased when combined with Abatacept. Abemaciclib Abemaciclib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Abiraterone The serum concentration of Selumetinib can be increased when it is combined with Abiraterone. Abrocitinib The serum concentration of Selumetinib can be increased when it is combined with Abrocitinib. Acalabrutinib The metabolism of Selumetinib can be decreased when combined with Acalabrutinib. Acenocoumarol The metabolism of Selumetinib can be decreased when combined with Acenocoumarol. Acetaminophen Selumetinib may increase the hepatotoxic activities of Acetaminophen. Acetohexamide The metabolism of Selumetinib can be decreased when combined with Acetohexamide. Acetyl sulfisoxazole The metabolism of Selumetinib can be decreased when combined with Acetyl sulfisoxazole. Acetylsalicylic acid The metabolism of Selumetinib can be decreased when combined with Acetylsalicylic acid. Acyclovir The metabolism of Selumetinib can be decreased when combined with Acyclovir. Adalimumab The metabolism of Selumetinib can be increased when combined with Adalimumab. Ademetionine The metabolism of Selumetinib can be decreased when combined with Ademetionine. Adenine The metabolism of Selumetinib can be decreased when combined with Adenine. Afatinib Afatinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Agomelatine The metabolism of Selumetinib can be decreased when combined with Agomelatine. Albendazole The metabolism of Selumetinib can be increased when combined with Albendazole. Aldesleukin The metabolism of Selumetinib can be decreased when combined with Aldesleukin. Alectinib Alectinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Alfentanil The metabolism of Selumetinib can be decreased when combined with Alfentanil. Almotriptan The metabolism of Selumetinib can be decreased when combined with Almotriptan. Alosetron The metabolism of Selumetinib can be decreased when combined with Alosetron. Alpelisib The serum concentration of Selumetinib can be decreased when it is combined with Alpelisib. Alprazolam The metabolism of Selumetinib can be decreased when combined with Alprazolam. Ambrisentan The serum concentration of Selumetinib can be increased when it is combined with Ambrisentan. Aminophenazone The metabolism of Selumetinib can be decreased when combined with Aminophenazone. Aminophylline The metabolism of Aminophylline can be decreased when combined with Selumetinib. Amiodarone The serum concentration of Selumetinib can be increased when it is combined with Amiodarone. Amitriptyline The metabolism of Selumetinib can be decreased when combined with Amitriptyline. Amodiaquine The metabolism of Selumetinib can be decreased when combined with Amodiaquine. Amprenavir The serum concentration of Selumetinib can be increased when it is combined with Amprenavir. Anagrelide The metabolism of Selumetinib can be decreased when combined with Anagrelide. Anakinra The metabolism of Selumetinib can be increased when combined with Anakinra. Anastrozole The metabolism of Selumetinib can be decreased when combined with Anastrozole. Antipyrine The metabolism of Selumetinib can be decreased when combined with Antipyrine. Apalutamide The serum concentration of Selumetinib can be decreased when it is combined with Apalutamide. Apixaban The metabolism of Selumetinib can be decreased when combined with Apixaban. Apomorphine The metabolism of Selumetinib can be decreased when combined with Apomorphine. Apremilast The metabolism of Selumetinib can be increased when combined with Apremilast. Aprepitant The serum concentration of Selumetinib can be increased when it is combined with Aprepitant. Arformoterol The metabolism of Selumetinib can be decreased when combined with Arformoterol. Aripiprazole The metabolism of Selumetinib can be decreased when combined with Aripiprazole. Aripiprazole laur The metabolism of Aripiprazole lauroxil can be decreased when combined with Selumetinib. Armodafinil The metabolism of Selumetinib can be decreased when combined with Armodafinil. Arsenic trioxide The serum concentration of Selumetinib can be increased when it is combined with Arsenic trioxide. Artemether The metabolism of Selumetinib can be decreased when combined with Artemether. Artenimol The metabolism of Selumetinib can be decreased when combined with Artenimol. Articaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Articaine. Asciminib The serum concentration of Selumetinib can be increased when it is combined with Asciminib. Asenapine The metabolism of Selumetinib can be decreased when combined with Asenapine. Astemizole The metabolism of Astemizole can be decreased when combined with Selumetinib. Asunaprevir The serum concentration of Selumetinib can be increased when it is combined with Asunaprevir. Atazanavir The serum concentration of Selumetinib can be increased when it is combined with Atazanavir. Atorvastatin The metabolism of Selumetinib can be decreased when combined with Atorvastatin. Atovaquone The metabolism of Selumetinib can be decreased when combined with Atovaquone. Avanafil The serum concentration of Avanafil can be increased when it is combined with Selumetinib. Avapritinib The metabolism of Selumetinib can be decreased when combined with Avapritinib. Avatrombopag Avatrombopag may decrease the excretion rate of Selumetinib which could result in a higher serum level. Axitinib The metabolism of Axitinib can be decreased when combined with Selumetinib. Azathioprine The metabolism of Selumetinib can be decreased when combined with Azathioprine. Azelastine The metabolism of Selumetinib can be decreased when combined with Azelastine. Beclomethasone Beclomethasone dipropionate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Belantamab The serum concentration of Belantamab mafodotin can be increased when it is combined with Selumetinib. Belinostat The serum concentration of Selumetinib can be increased when it is combined with Belinostat. Belumosudil Belumosudil may decrease the excretion rate of Selumetinib which could result in a higher serum level. Belzutifan The metabolism of Belzutifan can be decreased when combined with Selumetinib. Bendamustine The metabolism of Selumetinib can be decreased when combined with Bendamustine. Benzocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Benzocaine. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Benzyl alcohol. Berotralstat The serum concentration of Selumetinib can be increased when it is combined with Berotralstat. Betamethasone The metabolism of Selumetinib can be increased when combined with Betamethasone. Betamethasone The metabolism of Selumetinib can be increased when combined with Betamethasone phosphate. Betaxolol The metabolism of Selumetinib can be decreased when combined with Betaxolol. Betrixaban The serum concentration of Betrixaban can be increased when it is combined with Selumetinib. Bexarotene The serum concentration of Selumetinib can be decreased when it is combined with Bexarotene. Bezafibrate The metabolism of Selumetinib can be decreased when combined with Bezafibrate. Bifonazole The metabolism of Selumetinib can be decreased when combined with Bifonazole. Bimekizumab The metabolism of Selumetinib can be increased when combined with Bimekizumab. Binimetinib The metabolism of Binimetinib can be decreased when combined with Selumetinib. Bisoprolol The serum concentration of Selumetinib can be increased when it is combined with Bisoprolol. Boceprevir The serum concentration of Selumetinib can be increased when it is combined with Boceprevir. Bortezomib The metabolism of Selumetinib can be decreased when combined with Bortezomib. Bosentan The serum concentration of Selumetinib can be decreased when it is combined with Bosentan. Bosutinib The metabolism of Selumetinib can be decreased when combined with Bosutinib. Brentuximab ve The serum concentration of Brentuximab vedotin can be increased when it is combined with Selumetinib. Brigatinib The metabolism of Brigatinib can be decreased when combined with Selumetinib. Brivaracetam The metabolism of Selumetinib can be decreased when combined with Brivaracetam. Bromazepam The metabolism of Selumetinib can be decreased when combined with Bromazepam. Bromotheophy The metabolism of Bromotheophylline can be decreased when combined with Selumetinib. Budesonide The metabolism of Selumetinib can be increased when combined with Budesonide. Bupivacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Bupivacaine. Buprenorphine Buprenorphine may decrease the excretion rate of Selumetinib which could result in a higher serum level. Bupropion The metabolism of Selumetinib can be decreased when combined with Bupropion. Buspirone The metabolism of Selumetinib can be decreased when combined with Buspirone. Butacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Butacaine. Butamben The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Butamben. Cabazitaxel The metabolism of Cabazitaxel can be decreased when combined with Selumetinib. Cabergoline The serum concentration of Cabergoline can be increased when it is combined with Selumetinib. You Might Also Read Calcium Channel Blockers; Types, Side Effects, Interactions Cabozantinib The metabolism of Selumetinib can be decreased when combined with Cabozantinib. Caffeine The metabolism of Selumetinib can be decreased when combined with Caffeine. Canagliflozin The serum concentration of Selumetinib can be increased when it is combined with Canagliflozin. Canakinumab The metabolism of Selumetinib can be increased when combined with Canakinumab. Candesartan The metabolism of Selumetinib can be decreased when combined with Candesartan cilexetil. Cannabidiol Cannabidiol may decrease the excretion rate of Selumetinib which could result in a higher serum level. Capecitabine The serum concentration of Selumetinib can be increased when it is combined with Capecitabine. Capmatinib The serum concentration of Selumetinib can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Capsaicin. Carbamazepine The serum concentration of Selumetinib can be decreased when it is combined with Carbamazepine. Carbimazole The therapeutic efficacy of Carbimazole can be decreased when used in combination with Selumetinib. Carfilzomib The serum concentration of Selumetinib can be increased when it is combined with Carfilzomib. Carisoprodol The metabolism of Selumetinib can be decreased when combined with Carisoprodol. Carmustine The metabolism of Selumetinib can be decreased when combined with Carmustine. Carvedilol The serum concentration of Selumetinib can be increased when it is combined with Carvedilol. Celecoxib The metabolism of Selumetinib can be decreased when combined with Celecoxib. Cenobamate The serum concentration of Selumetinib can be decreased when it is combined with Cenobamate. Ceritinib The metabolism of Selumetinib can be decreased when combined with Ceritinib. Cerivastatin The metabolism of Selumetinib can be decreased when combined with Cerivastatin. Certolizumab pe The metabolism of Selumetinib can be increased when combined with Certolizumab pegol. Chloramphenicol The metabolism of Selumetinib can be decreased when combined with Chloramphenicol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Chloroprocaine. Chloroquine The metabolism of Selumetinib can be decreased when combined with Chloroquine. Chlorpheniramine The metabolism of Selumetinib can be decreased when combined with Chlorpheniramine. Chlorpromazine The metabolism of Selumetinib can be decreased when combined with Chlorpromazine. Chlorpropamide The metabolism of Selumetinib can be decreased when combined with Chlorpropamide. Chlorzoxazone The metabolism of Selumetinib can be decreased when combined with Chlorzoxazone. Cholesterol Cholesterol may increase the excretion rate of Selumetinib which could result in a lower serum level and potentially a reduction in efficacy. Cilostazol The metabolism of Selumetinib can be decreased when combined with Cilostazol. Cimetidine The metabolism of Selumetinib can be decreased when combined with Cimetidine. Cinacalcet The metabolism of Selumetinib can be decreased when combined with Cinacalcet. Cinchocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Cinchocaine. Cinnarizine The metabolism of Selumetinib can be decreased when combined with Cinnarizine. Cinoxacin The metabolism of Selumetinib can be decreased when combined with Cinoxacin. Ciprofloxacin The serum concentration of Selumetinib can be increased when it is combined with Ciprofloxacin. Cisapride The metabolism of Selumetinib can be decreased when combined with Cisapride. Citalopram The metabolism of Selumetinib can be decreased when combined with Citalopram. Clarithromycin The serum concentration of Selumetinib can be increased when it is combined with Clarithromycin. Clevidipine The metabolism of Selumetinib can be decreased when combined with Clevidipine. Clindamycin The metabolism of Selumetinib can be decreased when combined with Clindamycin. Clobazam The metabolism of Selumetinib can be decreased when combined with Clobazam. Clobetasol pro The metabolism of Selumetinib can be increased when combined with Clobetasol propionate. Clofazimine Clofazimine may decrease the excretion rate of Selumetinib which could result in a higher serum level. Clofibrate The metabolism of Selumetinib can be increased when combined with Clofibrate. Clomifene The serum concentration of Selumetinib can be increased when it is combined with Clomifene. Clomipramine The metabolism of Selumetinib can be decreased when combined with Clomipramine. Clonazepam The metabolism of Selumetinib can be decreased when combined with Clonazepam. Clonidine The metabolism of Clonidine can be decreased when combined with Selumetinib. Clopidogrel The metabolism of Selumetinib can be decreased when combined with Clopidogrel. Clozapine The serum concentration of Selumetinib can be increased when it is combined with Clozapine. Cobicistat The serum concentration of Selumetinib can be increased when it is combined with Cobicistat. Cobimetinib The serum concentration of Cobimetinib can be increased when it is combined with Selumetinib. Cocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Cocaine. Colchicine The serum concentration of Selumetinib can be increased when it is combined with Colchicine. Conivaptan The serum concentration of Selumetinib can be increased when it is combined with Conivaptan. Conjugated The metabolism of Selumetinib can be decreased when combined with Conjugated estrogens. Copanlisib The metabolism of Copanlisib can be decreased when combined with Selumetinib. Cortisone a The metabolism of Selumetinib can be increased when combined with Cortisone acetate. Crizotinib The serum concentration of Selumetinib can be increased when it is combined with Crizotinib. Curcumin The serum concentration of Selumetinib can be increased when it is combined with Curcumin. Cyclizine The metabolism of Selumetinib can be decreased when combined with Cyclizine. Cyclobenzaprine The metabolism of Selumetinib can be decreased when combined with Cyclobenzaprine. Cyclophosphamide The metabolism of Cyclophosphamide can be decreased when combined with Selumetinib. Cyclosporine The serum concentration of Selumetinib can be increased when it is combined with Cyclosporine. Cyproterone ac The metabolism of Selumetinib can be increased when combined with Cyproterone acetate. Dabigatran ete The serum concentration of Selumetinib can be increased when it is combined with Dabigatran etexilate. Dabrafenib The serum concentration of Selumetinib can be decreased when it is combined with Dabrafenib. Dacarbazine The metabolism of Selumetinib can be decreased when combined with Dacarbazine. Daclatasvir Daclatasvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Dacomitinib Dacomitinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Dactinomycin The serum concentration of Dactinomycin can be increased when it is combined with Selumetinib. Danazol The serum concentration of Selumetinib can be increased when it is combined with Danazol. Dapagliflozin The metabolism of Selumetinib can be decreased when combined with Dapagliflozin. Dapsone The metabolism of Selumetinib can be decreased when combined with Dapsone. Daptomycin The serum concentration of Selumetinib can be increased when it is combined with Daptomycin. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Selumetinib. Darolutamide The serum concentration of Selumetinib can be increased when it is combined with Darolutamide. Darunavir The serum concentration of Selumetinib can be increased when it is combined with Darunavir. Dasabuvir Dasabuvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Dasatinib The metabolism of Dasatinib can be decreased when combined with Selumetinib. Daunorubicin The metabolism of Selumetinib can be increased when combined with Daunorubicin. Deferasirox The serum concentration of Selumetinib can be increased when it is combined with Deferasirox. Delafloxacin The metabolism of Selumetinib can be increased when combined with Delafloxacin. Delavirdine The serum concentration of Selumetinib can be increased when it is combined with Delavirdine. Desipramine The metabolism of Selumetinib can be decreased when combined with Desipramine. Desogestrel The metabolism of Selumetinib can be increased when combined with Desogestrel. Desvenlafaxine The serum concentration of Selumetinib can be increased when it is combined with Desvenlafaxine. Deutetrabenazine The metabolism of Deutetrabenazine can be decreased when combined with Selumetinib. Dexamethasone The serum concentration of Selumetinib can be decreased when it is combined with Dexamethasone. Dexamethasone The serum concentration of Selumetinib can be decreased when it is combined with Dexamethasone acetate. Dexfenfluramine The metabolism of Selumetinib can be decreased when combined with Dexfenfluramine. Dexibuprofen The metabolism of Selumetinib can be decreased when combined with Dexibuprofen. Dexlansoprazole The metabolism of Selumetinib can be decreased when combined with Dexlansoprazole. Dexmedetomidine The metabolism of Selumetinib can be decreased when combined with Dexmedetomidine. Dextromethorphan The metabolism of Selumetinib can be decreased when combined with Dextromethorphan. Diacerein The metabolism of Selumetinib can be decreased when combined with Diacerein. Diazepam The metabolism of Selumetinib can be decreased when combined with Diazepam. Diclofenac The metabolism of Selumetinib can be decreased when combined with Diclofenac. Dicoumarol The metabolism of Selumetinib can be decreased when combined with Dicoumarol. Diethylstilbestrol The metabolism of Selumetinib can be decreased when combined with Diethylstilbestrol. Difluocortolone The metabolism of Selumetinib can be increased when combined with Difluocortolone. Digitoxin The serum concentration of Digitoxin can be increased when it is combined with Selumetinib. Digoxin The serum concentration of Digoxin can be increased when it is combined with Selumetinib. Dihydralazine The metabolism of Selumetinib can be decreased when combined with Dihydralazine. Diltiazem The serum concentration of Selumetinib can be increased when it is combined with Diltiazem. Dimethyl sulfo The metabolism of Selumetinib can be decreased when combined with Dimethyl sulfoxide. Diosmin The serum concentration of Selumetinib can be increased when it is combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Diphenhydramine. Disopyramide The metabolism of Selumetinib can be decreased when combined with Disopyramide. Disulfiram The metabolism of Selumetinib can be decreased when combined with Disulfiram. Docetaxel The metabolism of Docetaxel can be decreased when combined with Selumetinib. Doconexent The metabolism of Selumetinib can be decreased when combined with Doconexent. Dolutegravir The serum concentration of Selumetinib can be increased when it is combined with Dolutegravir. Domperidone The metabolism of Selumetinib can be decreased when combined with Domperidone. Donepezil The metabolism of Selumetinib can be decreased when combined with Donepezil. Doravirine The metabolism of Doravirine can be decreased when combined with Selumetinib. Dosulepin The metabolism of Selumetinib can be decreased when combined with Dosulepin. Doxazosin The metabolism of Selumetinib can be decreased when combined with Doxazosin. Doxepin The metabolism of Selumetinib can be decreased when combined with Doxepin. Dronabinol The metabolism of Selumetinib can be decreased when combined with Dronabinol. Dronedarone The serum concentration of Selumetinib can be increased when it is combined with Dronedarone. Duloxetine The metabolism of Selumetinib can be decreased when combined with Duloxetine. Dutasteride The metabolism of Selumetinib can be decreased when combined with Dutasteride. Duvelisib The serum concentration of Duvelisib can be increased when it is combined with Selumetinib. Dyclonine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Dyclonine. Echinacea The serum concentration of Selumetinib can be decreased when it is combined with Echinacea. Econazole The serum concentration of Selumetinib can be increased when it is combined with Econazole. Edoxaban The serum concentration of Selumetinib can be increased when it is combined with Edoxaban. Efavirenz The serum concentration of Selumetinib can be increased when it is combined with Efavirenz. Elagolix The serum concentration of Selumetinib can be increased when it is combined with Elagolix. Elbasvir Elbasvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Eletriptan The metabolism of Selumetinib can be decreased when combined with Eletriptan. Elexacaftor The metabolism of Elexacaftor can be decreased when combined with Selumetinib. Eliglustat The serum concentration of Selumetinib can be increased when it is combined with Eliglustat. Eltrombopag The metabolism of Selumetinib can be decreased when combined with Eltrombopag. Elvitegravir The serum concentration of Selumetinib can be increased when it is combined with Elvitegravir. Emapalumab The metabolism of Selumetinib can be increased when combined with Emapalumab. Enasidenib The metabolism of Enasidenib can be decreased when combined with Selumetinib. Enflurane The metabolism of Selumetinib can be decreased when combined with Enflurane. Enfortumab ved The serum concentration of Enfortumab vedotin can be increased when it is combined with Selumetinib. Enoxacin The metabolism of Selumetinib can be decreased when combined with Enoxacin. Entecavir The metabolism of Selumetinib can be decreased when combined with Entecavir. Entrectinib The serum concentration of Selumetinib can be increased when it is combined with Entrectinib. Enzalutamide The serum concentration of Selumetinib can be decreased when it is combined with Enzalutamide. Epinephrine The metabolism of Selumetinib can be decreased when combined with Epinephrine. Eplerenone The metabolism of Selumetinib can be decreased when combined with Eplerenone. Erdafitinib The serum concentration of Selumetinib can be increased when it is combined with Erdafitinib. Ergotamine The serum concentration of Selumetinib can be increased when it is combined with Ergotamine. Erlotinib The metabolism of Erlotinib can be decreased when combined with Selumetinib. Ertugliflozin The metabolism of Selumetinib can be decreased when combined with Ertugliflozin. Erythromycin The serum concentration of Selumetinib can be increased when it is combined with Erythromycin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Selumetinib. Escitalopram The metabolism of Selumetinib can be decreased when combined with Escitalopram. Esketamine The metabolism of Esketamine can be decreased when combined with Selumetinib. Eslicarbazepine The metabolism of Selumetinib can be decreased when combined with Eslicarbazepine. Eslicarbazepine ac The metabolism of Selumetinib can be decreased when combined with Eslicarbazepine acetate. Esomeprazole The metabolism of Selumetinib can be decreased when combined with Esomeprazole. Estradiol Estradiol may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estradiol acetate Estradiol acetate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estradiol benzoate Estradiol benzoate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estradiol cypionate Estradiol cypionate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estradiol dienanthate Estradiol dienanthate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estradiol valerate Estradiol valerate may decrease the excretion rate of Selumetinib which could result in a higher serum level. Estrone sulfate The metabolism of Selumetinib can be decreased when combined with Estrone sulfate. Eszopiclone The metabolism of Selumetinib can be decreased when combined with Eszopiclone. Etanercept The metabolism of Selumetinib can be increased when combined with Etanercept. Ethambutol The metabolism of Selumetinib can be decreased when combined with Ethambutol. Ethanol The metabolism of Selumetinib can be decreased when combined with Ethanol. Ethinylestradiol The metabolism of Selumetinib can be increased when combined with Ethinylestradiol. Ethosuximide The metabolism of Selumetinib can be decreased when combined with Ethosuximide. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Etidocaine. Etodolac The metabolism of Selumetinib can be decreased when combined with Etodolac. Etoposide The metabolism of Etoposide can be decreased when combined with Selumetinib. Etoricoxib The metabolism of Selumetinib can be decreased when combined with Etoricoxib. Etravirine The serum concentration of Selumetinib can be decreased when it is combined with Etravirine. Everolimus The serum concentration of Selumetinib can be increased when it is combined with Everolimus. Famotidine The metabolism of Selumetinib can be decreased when combined with Famotidine. Favipiravir The serum concentration of Selumetinib can be increased when it is combined with Favipiravir. Febuxostat The excretion of Selumetinib can be decreased when combined with Febuxostat. Fedratinib Fedratinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Felbamate The metabolism of Selumetinib can be decreased when combined with Felbamate. Felodipine The metabolism of Selumetinib can be decreased when combined with Felodipine. Fenfluramine The metabolism of Selumetinib can be decreased when combined with Fenfluramine. Fenofibrate The metabolism of Selumetinib can be decreased when combined with Fenofibrate. Fexinidazole The metabolism of Selumetinib can be decreased when combined with Fexinidazole. Fexofenadine The serum concentration of Selumetinib can be increased when it is combined with Fexofenadine. Finasteride The metabolism of Selumetinib can be decreased when combined with Finasteride. Finerenone The metabolism of Finerenone can be decreased when combined with Selumetinib. Fingolimod The metabolism of Selumetinib can be decreased when combined with Fingolimod. Flecainide The metabolism of Selumetinib can be decreased when combined with Flecainide. Flibanserin The serum concentration of Selumetinib can be increased when it is combined with Flibanserin. Floxuridine The metabolism of Selumetinib can be decreased when combined with Floxuridine. Fluconazole The serum concentration of Selumetinib can be increased when it is combined with Fluconazole. Fluindione The metabolism of Fluindione can be decreased when combined with Selumetinib. Flunarizine The metabolism of Selumetinib can be decreased when combined with Flunarizine. Flunitrazepam The metabolism of Selumetinib can be decreased when combined with Flunitrazepam. Fluocinonide The metabolism of Selumetinib can be increased when combined with Fluocinonide. Fluocortolone The metabolism of Selumetinib can be increased when combined with Fluocortolone. Fluorouracil The metabolism of Fluorouracil can be decreased when combined with Selumetinib. Fluoxetine The metabolism of Selumetinib can be decreased when combined with Fluoxetine. Flurazepam The metabolism of Selumetinib can be decreased when combined with Flurazepam. Flurbiprofen The metabolism of Selumetinib can be decreased when combined with Flurbiprofen. Flutamide The metabolism of Selumetinib can be decreased when combined with Flutamide. Fluticasone The metabolism of Selumetinib can be decreased when combined with Fluticasone. Fluticasone fur The metabolism of Selumetinib can be decreased when combined with Fluticasone furoate. Fluticasone pro The metabolism of Selumetinib can be decreased when combined with Fluticasone propionate. Fluvastatin The metabolism of Selumetinib can be decreased when combined with Fluvastatin. Fluvoxamine The serum concentration of Selumetinib can be increased when it is combined with Fluvoxamine. Follitropin The therapeutic efficacy of Follitropin can be decreased when used in combination with Selumetinib. Fomepizole The metabolism of Selumetinib can be decreased when combined with Fomepizole. Formoterol The metabolism of Selumetinib can be decreased when combined with Formoterol. Fosnetupitant The serum concentration of Selumetinib can be increased when it is combined with Fosnetupitant. Fosphenytoin The serum concentration of Selumetinib can be decreased when it is combined with Fosphenytoin. Fostamatinib Fostamatinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Fostemsavir Fostemsavir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Frovatriptan The metabolism of Selumetinib can be decreased when combined with Frovatriptan. Fusidic acid The serum concentration of Selumetinib can be increased when it is combined with Fusidic acid. Futibatinib The serum concentration of Futibatinib can be increased when it is combined with Selumetinib. Gatifloxacin The metabolism of Selumetinib can be decreased when combined with Gatifloxacin. Gefitinib Gefitinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Gemcitabine The serum concentration of Gemcitabine can be increased when it is combined with Selumetinib. Gemfibrozil The metabolism of Selumetinib can be decreased when combined with Gemfibrozil. Gemifloxacin The metabolism of Selumetinib can be decreased when combined with Gemifloxacin. Gilteritinib Gilteritinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Ginkgo biloba The metabolism of Selumetinib can be decreased when combined with Ginkgo biloba. Givosiran The serum concentration of Selumetinib can be increased when it is combined with Givosiran. Glasdegib Glasdegib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Glecaprevir Glecaprevir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Gliclazide The metabolism of Selumetinib can be decreased when combined with Gliclazide. Glimepiride The metabolism of Selumetinib can be decreased when combined with Glimepiride. Glipizide The metabolism of Selumetinib can be decreased when combined with Glipizide. Gliquidone The metabolism of Selumetinib can be decreased when combined with Gliquidone. Glyburide The metabolism of Selumetinib can be decreased when combined with Glyburide. Glycerin The metabolism of Selumetinib can be increased when combined with Glycerin. Golimumab The metabolism of Selumetinib can be increased when combined with Golimumab. Grazoprevir Grazoprevir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Grepafloxacin The metabolism of Selumetinib can be decreased when combined with Grepafloxacin. Guanabenz The metabolism of Selumetinib can be decreased when combined with Guanabenz. Halofantrine The metabolism of Selumetinib can be decreased when combined with Halofantrine. Haloperidol The serum concentration of Selumetinib can be increased when it is combined with Haloperidol. Halothane The metabolism of Selumetinib can be decreased when combined with Halothane. Hydrocortisone The metabolism of Selumetinib can be increased when combined with Hydrocortisone. Hydrocortisone ace The metabolism of Hydrocortisone acetate can be decreased when combined with Selumetinib. Hydrocortisone buty The metabolism of Hydrocortisone butyrate can be decreased when combined with Selumetinib. Hydrocortisone cypi The metabolism of Hydrocortisone cypionate can be decreased when combined with Selumetinib. Hydrocortisone pho The metabolism of Hydrocortisone phosphate can be decreased when combined with Selumetinib. Hydromorphone The metabolism of Selumetinib can be decreased when combined with Hydromorphone. Hydroxychloroquine The metabolism of Selumetinib can be decreased when combined with Hydroxychloroquine. Hydroxyprogesterone The metabolism of Selumetinib can be decreased when combined with Hydroxyprogesterone caproate. Hydroxyzine The metabolism of Selumetinib can be decreased when combined with Hydroxyzine. Ibrutinib The metabolism of Selumetinib can be decreased when combined with Ibrutinib. Ibuprofen The metabolism of Selumetinib can be decreased when combined with Ibuprofen. Idarubicin The metabolism of Selumetinib can be decreased when combined with Idarubicin. Idelalisib The serum concentration of Selumetinib can be increased when it is combined with Idelalisib. Ifosfamide The metabolism of Ifosfamide can be decreased when combined with Selumetinib. Iloperidone The metabolism of Selumetinib can be decreased when combined with Iloperidone. Imatinib The metabolism of Selumetinib can be decreased when combined with Imatinib. Imipramine The metabolism of Selumetinib can be decreased when combined with Imipramine. Indacaterol The serum concentration of Selumetinib can be increased when it is combined with Indacaterol. Indinavir The serum concentration of Selumetinib can be increased when it is combined with Indinavir. Indomethacin The metabolism of Selumetinib can be decreased when combined with Indomethacin. Infliximab The metabolism of Selumetinib can be increased when combined with Infliximab. Inotuzumab The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Selumetinib. Insulin beef The metabolism of Selumetinib can be increased when combined with Insulin beef. Insulin pork The metabolism of Selumetinib can be increased when combined with Insulin pork. Interferon alfa-2a The metabolism of Selumetinib can be decreased when combined with Interferon alfa-2a. Interferon alfa-2b The metabolism of Selumetinib can be decreased when combined with Interferon alfa-2b. Interferon alfa-n1 The metabolism of Selumetinib can be decreased when combined with Interferon alfa-n1. Interferon alfa-n3 The metabolism of Selumetinib can be decreased when combined with Interferon alfa-n3. Interferon alfacon-1 The metabolism of Selumetinib can be decreased when combined with Interferon alfacon-1. Interferon beta-1a The metabolism of Selumetinib can be decreased when combined with Interferon beta-1a. Interferon beta-1b The metabolism of Selumetinib can be decreased when combined with Interferon beta-1b. Interferon gamma The metabolism of Selumetinib can be decreased when combined with Interferon gamma-1b. Irbesartan The metabolism of Selumetinib can be decreased when combined with Irbesartan. Irinotecan The metabolism of Selumetinib can be decreased when combined with Irinotecan. Isavuconazole The serum concentration of Selumetinib can be increased when it is combined with Isavuconazole. Isavuconazonium The serum concentration of Selumetinib can be increased when it is combined with Isavuconazonium. Isoflurane The metabolism of Selumetinib can be decreased when combined with Isoflurane. Isoniazid The serum concentration of Selumetinib can be increased when it is combined with Isoniazid. Isosorbide dinitrate The metabolism of Selumetinib can be decreased when combined with Isosorbide dinitrate. Isradipine The serum concentration of Selumetinib can be increased when it is combined with Isradipine. Istradefylline Istradefylline may decrease the excretion rate of Selumetinib which could result in a higher serum level. Itraconazole The serum concentration of Selumetinib can be increased when it is combined with Itraconazole. Ivacaftor The serum concentration of Selumetinib can be increased when it is combined with Ivacaftor. Ivosidenib The metabolism of Selumetinib can be increased when combined with Ivosidenib. Ixabepilone The serum concentration of Selumetinib can be increased when it is combined with Ixabepilone. Ketamine The metabolism of Selumetinib can be decreased when combined with Ketamine. Ketoconazole The serum concentration of Selumetinib can be increased when it is combined with Ketoconazole. Ketoprofen The metabolism of Selumetinib can be decreased when combined with Ketoprofen. Ketorolac The metabolism of Selumetinib can be decreased when combined with Ketorolac. Labetalol The metabolism of Selumetinib can be decreased when combined with Labetalol. Lacosamide The metabolism of Selumetinib can be decreased when combined with Lacosamide. Lamotrigine The metabolism of Selumetinib can be increased when combined with Lamotrigine. Lansoprazole The metabolism of Selumetinib can be decreased when combined with Lansoprazole. Lapatinib The serum concentration of Selumetinib can be increased when it is combined with Lapatinib. Larotrectinib The serum concentration of Larotrectinib can be increased when it is combined with Selumetinib. Lasmiditan The serum concentration of Selumetinib can be increased when it is combined with Lasmiditan. Ledipasvir Ledipasvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Lefamulin The serum concentration of Lefamulin can be increased when it is combined with Selumetinib. You Might Also Read Fluocinolone - Uses, Dosage, Side Effects, Interactions Leflunomide The serum concentration of Selumetinib can be decreased when it is combined with Leflunomide. Lemborexant The serum concentration of Lemborexant can be increased when it is combined with Selumetinib. Lenvatinib The serum concentration of Selumetinib can be increased when it is combined with Lenvatinib. Lercanidipine The metabolism of Selumetinib can be decreased when combined with Lercanidipine. Lesinurad The metabolism of Selumetinib can be decreased when combined with Lesinurad. Letermovir Letermovir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Letrozole The metabolism of Selumetinib can be decreased when combined with Letrozole. Levamlodipine The metabolism of Selumetinib can be decreased when combined with Levamlodipine. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Levobupivacaine. Levoketoconazole The serum concentration of Selumetinib can be increased when it is combined with Levoketoconazole. Levomilnacipran The metabolism of Selumetinib can be decreased when combined with Levomilnacipran. Levonorgestrel The metabolism of Selumetinib can be decreased when combined with Levonorgestrel. Levothyroxine The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Selumetinib. Lidocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Lidocaine. Linagliptin The serum concentration of Selumetinib can be increased when it is combined with Linagliptin. Linzagolix The serum concentration of Selumetinib can be increased when it is combined with Linzagolix. Liothyronine The therapeutic efficacy of Liothyronine can be decreased when used in combination with Selumetinib. Liotrix The therapeutic efficacy of Liotrix can be decreased when used in combination with Selumetinib. Lofexidine The metabolism of Selumetinib can be decreased when combined with Lofexidine. Lomefloxacin The metabolism of Selumetinib can be decreased when combined with Lomefloxacin. Lomitapide The serum concentration of Selumetinib can be increased when it is combined with Lomitapide. Lonafarnib The serum concentration of Selumetinib can be increased when it is combined with Lonafarnib. Lonapegsomatropin The metabolism of Selumetinib can be increased when combined with Lonapegsomatropin. Loncastuximab tes The serum concentration of Loncastuximab tesirine can be increased when it is combined with Selumetinib. Loperamide The metabolism of Selumetinib can be decreased when combined with Loperamide. Lopinavir The serum concentration of Selumetinib can be increased when it is combined with Lopinavir. Loratadine The metabolism of Selumetinib can be decreased when combined with Loratadine. Lorcaserin The metabolism of Selumetinib can be decreased when combined with Lorcaserin. Lorlatinib The metabolism of Lorlatinib can be decreased when combined with Selumetinib. Lornoxicam The metabolism of Selumetinib can be decreased when combined with Lornoxicam. Losartan The metabolism of Selumetinib can be decreased when combined with Losartan. Lovastatin The serum concentration of Selumetinib can be increased when it is combined with Lovastatin. Loxapine The serum concentration of Selumetinib can be increased when it is combined with Loxapine. Luliconazole The serum concentration of Selumetinib can be increased when it is combined with Luliconazole. Lumacaftor The serum concentration of Selumetinib can be decreased when it is combined with Lumacaftor. Lumiracoxib The metabolism of Selumetinib can be decreased when combined with Lumiracoxib. Lusutrombopag The serum concentration of Lusutrombopag can be increased when it is combined with Selumetinib. Lynestrenol The metabolism of Lynestrenol can be decreased when combined with Selumetinib. Manidipine The metabolism of Selumetinib can be decreased when combined with Manidipine. Mannitol The serum concentration of Selumetinib can be increased when it is combined with Mannitol. Maprotiline The metabolism of Selumetinib can be decreased when combined with Maprotiline. Maribavir Maribavir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Mavacamten The serum concentration of Selumetinib can be decreased when it is combined with Mavacamten. Medroxyprog The metabolism of Selumetinib can be decreased when combined with Medroxyprogesterone acetate. Mefenamic acid The metabolism of Selumetinib can be decreased when combined with Mefenamic acid. Mefloquine The serum concentration of Selumetinib can be increased when it is combined with Mefloquine. Melatonin The metabolism of Selumetinib can be decreased when combined with Melatonin. Meloxicam The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Meloxicam. Memantine The metabolism of Selumetinib can be decreased when combined with Memantine. Mephenytoin The metabolism of Selumetinib can be decreased when combined with Mephenytoin. Mepivacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Mepivacaine. Meprednisone The metabolism of Selumetinib can be increased when combined with Meprednisone. Mestranol The metabolism of Selumetinib can be decreased when combined with Mestranol. Methadone The metabolism of Selumetinib can be decreased when combined with Methadone. Methimazole The serum concentration of Selumetinib can be increased when it is combined with Methimazole. Methotrimeprazine The metabolism of Selumetinib can be decreased when combined with Methotrimeprazine. Methoxsalen The metabolism of Selumetinib can be decreased when combined with Methoxsalen. Methoxy p The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Selumetinib. Methoxyflurane The metabolism of Selumetinib can be decreased when combined with Methoxyflurane. Methsuximide The metabolism of Selumetinib can be decreased when combined with Methsuximide. Methylene blue The serum concentration of Selumetinib can be increased when it is combined with Methylene blue. Methylphenobarbital The metabolism of Selumetinib can be decreased when combined with Methylphenobarbital. Metoclopramide The metabolism of Selumetinib can be decreased when combined with Metoclopramide. Metreleptin The metabolism of Selumetinib can be increased when combined with Metreleptin. Metronidazole The metabolism of Selumetinib can be decreased when combined with Metronidazole. Mexiletine The metabolism of Selumetinib can be decreased when combined with Mexiletine. Mianserin The metabolism of Selumetinib can be decreased when combined with Mianserin. Miconazole The serum concentration of Selumetinib can be increased when it is combined with Miconazole. Midazolam The metabolism of Selumetinib can be decreased when combined with Midazolam. Midostaurin The serum concentration of Selumetinib can be increased when it is combined with Midostaurin. Mifepristone The serum concentration of Selumetinib can be increased when it is combined with Mifepristone. Milnacipran The serum concentration of Selumetinib can be increased when it is combined with Milnacipran. Mirabegron The serum concentration of Selumetinib can be increased when it is combined with Mirabegron. Mirtazapine The metabolism of Selumetinib can be decreased when combined with Mirtazapine. Mitapivat The metabolism of Selumetinib can be increased when combined with Mitapivat. Mitotane The serum concentration of Selumetinib can be decreased when it is combined with Mitotane. Mitoxantrone The metabolism of Selumetinib can be increased when combined with Mitoxantrone. Mobocertinib The metabolism of Mobocertinib can be decreased when combined with Selumetinib. Moclobemide The metabolism of Selumetinib can be decreased when combined with Moclobemide. Modafinil The serum concentration of Selumetinib can be decreased when it is combined with Modafinil. Mometasone furoate The metabolism of Selumetinib can be decreased when combined with Mometasone furoate. Montelukast The metabolism of Selumetinib can be decreased when combined with Montelukast. Morphine The metabolism of Selumetinib can be decreased when combined with Morphine. Moxifloxacin The metabolism of Selumetinib can be decreased when combined with Moxifloxacin. Mycophenolate mo The metabolism of Selumetinib can be decreased when combined with Mycophenolate mofetil. Nabilone The metabolism of Selumetinib can be decreased when combined with Nabilone. Nabumetone The metabolism of Selumetinib can be decreased when combined with Nabumetone. Nafcillin The serum concentration of Selumetinib can be decreased when it is combined with Nafcillin. Nalidixic acid The metabolism of Selumetinib can be decreased when combined with Nalidixic acid. Naproxen The metabolism of Selumetinib can be decreased when combined with Naproxen. Nateglinide The metabolism of Selumetinib can be decreased when combined with Nateglinide. Nebivolol The metabolism of Selumetinib can be decreased when combined with Nebivolol. Nefazodone The serum concentration of Selumetinib can be increased when it is combined with Nefazodone. Nelfinavir The serum concentration of Selumetinib can be increased when it is combined with Nelfinavir. Neratinib The serum concentration of Selumetinib can be increased when it is combined with Neratinib. Netupitant The serum concentration of Selumetinib can be increased when it is combined with Netupitant. Nevirapine The metabolism of Selumetinib can be decreased when combined with Nevirapine. Niacin The metabolism of Selumetinib can be decreased when combined with Niacin. Nicardipine The serum concentration of Selumetinib can be increased when it is combined with Nicardipine. Niclosamide The metabolism of Selumetinib can be decreased when combined with Niclosamide. Nicotine The metabolism of Selumetinib can be increased when combined with Nicotine. Nifedipine The metabolism of Selumetinib can be decreased when combined with Nifedipine. Nilotinib The serum concentration of Selumetinib can be increased when it is combined with Nilotinib. Nilutamide The metabolism of Selumetinib can be decreased when combined with Nilutamide. Nilvadipine The serum concentration of Selumetinib can be increased when it is combined with Nilvadipine. Nintedanib The serum concentration of Selumetinib can be increased when it is combined with Nintedanib. Nisoldipine The metabolism of Selumetinib can be decreased when combined with Nisoldipine. Nitrendipine The metabolism of Selumetinib can be decreased when combined with Nitrendipine. Norethisterone The metabolism of Selumetinib can be decreased when combined with Norethisterone. Norfloxacin The metabolism of Selumetinib can be decreased when combined with Norfloxacin. Norgestimate The serum concentration of Selumetinib can be increased when it is combined with Norgestimate. Nortriptyline The serum concentration of Nortriptyline can be increased when it is combined with Selumetinib. Noscapine The metabolism of Selumetinib can be decreased when combined with Noscapine. Novobiocin Novobiocin may decrease the excretion rate of Selumetinib which could result in a higher serum level. Obeticholic acid The metabolism of Selumetinib can be decreased when combined with Obeticholic acid. Olanzapine The metabolism of Selumetinib can be decreased when combined with Olanzapine. Olaparib The metabolism of Olaparib can be decreased when combined with Selumetinib. Olodaterol The metabolism of Selumetinib can be decreased when combined with Olodaterol. Omadacycline The serum concentration of Omadacycline can be increased when it is combined with Selumetinib. Ombitasvir The metabolism of Selumetinib can be decreased when combined with Ombitasvir. Omeprazole The metabolism of Selumetinib can be decreased when combined with Omeprazole. Ondansetron The metabolism of Selumetinib can be decreased when combined with Ondansetron. Oritavancin The metabolism of Selumetinib can be decreased when combined with Oritavancin. Orphenadrine The metabolism of Selumetinib can be decreased when combined with Orphenadrine. Osilodrostat The metabolism of Selumetinib can be decreased when combined with Osilodrostat. Osimertinib The serum concentration of Selumetinib can be decreased when it is combined with Osimertinib. Ospemifene The metabolism of Selumetinib can be decreased when combined with Ospemifene. Oteseconazole The serum concentration of Selumetinib can be increased when it is combined with Oteseconazole. Oxandrolone The metabolism of Selumetinib can be decreased when combined with Oxandrolone. Oxcarbazepine The metabolism of Selumetinib can be increased when combined with Oxcarbazepine. Oxetacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Oxetacaine. Oxtriphylline The metabolism of Selumetinib can be decreased when combined with Oxtriphylline. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Oxybuprocaine. Oxybutynin The metabolism of Selumetinib can be decreased when combined with Oxybutynin. Oxycodone The metabolism of Selumetinib can be decreased when combined with Oxycodone. Ozanimod The metabolism of Ozanimod can be decreased when combined with Selumetinib. Paclitaxel The metabolism of Paclitaxel can be decreased when combined with Selumetinib. Pacritinib The serum concentration of Selumetinib can be increased when it is combined with Pacritinib. Palbociclib Palbociclib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Paliperidone The serum concentration of Selumetinib can be increased when it is combined with Paliperidone. Panobinostat The serum concentration of Panobinostat can be increased when it is combined with Selumetinib. Pantoprazole Pantoprazole may decrease the excretion rate of Selumetinib which could result in a higher serum level. Paramethadione The metabolism of Selumetinib can be decreased when combined with Paramethadione. Parathyroid hor The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Selumetinib. Parecoxib The metabolism of Selumetinib can be decreased when combined with Parecoxib. Paritaprevir Paritaprevir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Paroxetine The metabolism of Selumetinib can be decreased when combined with Paroxetine. Pazopanib The metabolism of Pazopanib can be decreased when combined with Selumetinib. Pefloxacin The metabolism of Selumetinib can be decreased when combined with Pefloxacin. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Selumetinib. Peginterferon alfa The metabolism of Selumetinib can be decreased when combined with Peginterferon alfa-2a. Peginterferon alfa The serum concentration of Selumetinib can be increased when it is combined with Peginterferon alfa-2b. Pemetrexed The metabolism of Selumetinib can be decreased when combined with Pemetrexed. Penciclovir The metabolism of Selumetinib can be decreased when combined with Penciclovir. Pentamidine The metabolism of Selumetinib can be decreased when combined with Pentamidine. Pentobarbital The serum concentration of Selumetinib can be decreased when it is combined with Pentobarbital. Pentoxifylline The metabolism of Selumetinib can be decreased when combined with Pentoxifylline. Perampanel The metabolism of Selumetinib can be decreased when combined with Perampanel. Perphenazine The metabolism of Selumetinib can be decreased when combined with Perphenazine. Pexidartinib The metabolism of Selumetinib can be decreased when combined with Pexidartinib. Phenobarbital The serum concentration of Selumetinib can be decreased when it is combined with Phenobarbital. Phenol The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Phenol. Phenprocoumon The metabolism of Phenprocoumon can be decreased when combined with Selumetinib. Phenylbutazone The metabolism of Selumetinib can be decreased when combined with Phenylbutazone. Phenylephrine The metabolism of Selumetinib can be increased when combined with Phenylephrine. Phenytoin The serum concentration of Selumetinib can be decreased when it is combined with Phenytoin. Pibrentasvir Pibrentasvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Pimozide The metabolism of Pimozide can be decreased when combined with Selumetinib. Pioglitazone The metabolism of Selumetinib can be decreased when combined with Pioglitazone. Piperaquine The metabolism of Selumetinib can be increased when combined with Piperaquine. Pirfenidone The metabolism of Selumetinib can be decreased when combined with Pirfenidone. Piroxicam The metabolism of Selumetinib can be decreased when combined with Piroxicam. Pitavastatin The metabolism of Selumetinib can be decreased when combined with Pitavastatin. Pitolisant The serum concentration of Selumetinib can be decreased when it is combined with Pitolisant. Pomalidomide The metabolism of Selumetinib can be decreased when combined with Pomalidomide. Ponatinib The metabolism of Ponatinib can be decreased when combined with Selumetinib. Ponesimod The metabolism of Ponesimod can be decreased when combined with Selumetinib. Posaconazole The serum concentration of Selumetinib can be increased when it is combined with Posaconazole. Potassium Iodide The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Selumetinib. Potassium perchlo The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Selumetinib. Pralsetinib Pralsetinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Pramocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Pramocaine. Prasugrel The metabolism of Selumetinib can be decreased when combined with Prasugrel. Pravastatin Pravastatin may decrease the excretion rate of Selumetinib which could result in a higher serum level. Praziquantel The metabolism of Selumetinib can be decreased when combined with Praziquantel. Prednisolone phosp The metabolism of Selumetinib can be increased when combined with Prednisolone phosphate. Prednisone acetate The metabolism of Selumetinib can be increased when combined with Prednisone acetate. Pretomanid The serum concentration of Selumetinib can be increased when it is combined with Pretomanid. Prilocaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Prilocaine. Primaquine The serum concentration of Selumetinib can be increased when it is combined with Primaquine. Primidone The serum concentration of Selumetinib can be decreased when it is combined with Primidone. Probenecid The metabolism of Selumetinib can be decreased when combined with Probenecid. Procaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Procaine. Progesterone Progesterone may decrease the excretion rate of Selumetinib which could result in a higher serum level. Proguanil The metabolism of Selumetinib can be decreased when combined with Proguanil. Promazine The metabolism of Selumetinib can be decreased when combined with Promazine. Promethazine The metabolism of Selumetinib can be decreased when combined with Promethazine. Propafenone The serum concentration of Selumetinib can be increased when it is combined with Propafenone. Proparacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Proparacaine. Propofol The metabolism of Selumetinib can be decreased when combined with Propofol. Propoxycaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Propoxycaine. Propranolol The metabolism of Selumetinib can be decreased when combined with Propranolol. Propylthiouracil The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Selumetinib. Protirelin The therapeutic efficacy of Protirelin can be decreased when used in combination with Selumetinib. Pyrimethamine The metabolism of Selumetinib can be decreased when combined with Pyrimethamine. Quazepam The metabolism of Selumetinib can be decreased when combined with Quazepam. Quetiapine The metabolism of Selumetinib can be decreased when combined with Quetiapine. Quinidine The metabolism of Selumetinib can be decreased when combined with Quinidine. Quinine The metabolism of Selumetinib can be decreased when combined with Quinine. Rabeprazole Rabeprazole may decrease the excretion rate of Selumetinib which could result in a higher serum level. Raloxifene The metabolism of Selumetinib can be decreased when combined with Raloxifene. Ramelteon The metabolism of Selumetinib can be decreased when combined with Ramelteon. Ranitidine The metabolism of Selumetinib can be decreased when combined with Ranitidine. Ranolazine The serum concentration of Selumetinib can be increased when it is combined with Ranolazine. Rasagiline The metabolism of Selumetinib can be decreased when combined with Rasagiline. Regorafenib Regorafenib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Relugolix The serum concentration of Relugolix can be increased when it is combined with Selumetinib. Repaglinide The metabolism of Selumetinib can be decreased when combined with Repaglinide. Reserpine The serum concentration of Selumetinib can be increased when it is combined with Reserpine. Revefenacin The serum concentration of Revefenacin can be increased when it is combined with Selumetinib. Ribociclib The serum concentration of Selumetinib can be increased when it is combined with Ribociclib. Rifabutin The metabolism of Selumetinib can be increased when combined with Rifabutin. Rifampicin The serum concentration of Selumetinib can be decreased when it is combined with Rifampicin. Rifamycin The serum concentration of Selumetinib can be decreased when it is combined with Rifamycin. Rifapentine The serum concentration of Selumetinib can be decreased when it is combined with Rifapentine. Rilonacept The metabolism of Selumetinib can be increased when combined with Rilonacept. Rilpivirine Rilpivirine may decrease the excretion rate of Selumetinib which could result in a higher serum level. Riluzole The metabolism of Selumetinib can be decreased when combined with Riluzole. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Selumetinib. Rimexolone The serum concentration of Selumetinib can be decreased when it is combined with Rimexolone. Riociguat The metabolism of Selumetinib can be decreased when combined with Riociguat. Ripretinib Ripretinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Risperidone The metabolism of Selumetinib can be decreased when combined with Risperidone. Ritonavir The serum concentration of Selumetinib can be increased when it is combined with Ritonavir. Rivaroxaban The serum concentration of Selumetinib can be increased when it is combined with Rivaroxaban. Rofecoxib The metabolism of Selumetinib can be decreased when combined with Rofecoxib. Roflumilast The metabolism of Selumetinib can be decreased when combined with Roflumilast. Rolapitant Rolapitant may decrease the excretion rate of Selumetinib which could result in a higher serum level. Romidepsin The serum concentration of Romidepsin can be increased when it is combined with Selumetinib. Ropeginterferon The metabolism of Selumetinib can be decreased when combined with Ropeginterferon alfa-2b. Ropivacaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Ropivacaine. Rosiglitazone The metabolism of Selumetinib can be decreased when combined with Rosiglitazone. Rosoxacin The metabolism of Selumetinib can be decreased when combined with Rosoxacin. Rosuvastatin The metabolism of Selumetinib can be decreased when combined with Rosuvastatin. Roxadustat The serum concentration of Selumetinib can be increased when it is combined with Roxadustat. Rucaparib Rucaparib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Rufinamide The metabolism of Selumetinib can be decreased when combined with Rufinamide. Rupatadine The metabolism of Selumetinib can be decreased when combined with Rupatadine. Ruxolitinib The metabolism of Selumetinib can be decreased when combined with Ruxolitinib. Safinamide Safinamide may decrease the excretion rate of Selumetinib which could result in a higher serum level. Salicylic acid The metabolism of Selumetinib can be decreased when combined with Salicylic acid. Salmeterol The metabolism of Selumetinib can be decreased when combined with Salmeterol. Salmon calcitonin The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Selumetinib. Sapropterin The serum concentration of Selumetinib can be increased when it is combined with Sapropterin. Saquinavir The serum concentration of Selumetinib can be increased when it is combined with Saquinavir. Sarecycline The serum concentration of Selumetinib can be increased when it is combined with Sarecycline. Satralizumab The serum concentration of Selumetinib can be decreased when it is combined with Satralizumab. Saxagliptin The metabolism of Selumetinib can be decreased when combined with Saxagliptin. Secobarbital The metabolism of Selumetinib can be increased when combined with Secobarbital. Secukinumab The metabolism of Selumetinib can be increased when combined with Secukinumab. Selegiline The metabolism of Selumetinib can be decreased when combined with Selegiline. Selexipag The metabolism of Selumetinib can be decreased when combined with Selexipag. Selpercatinib The serum concentration of Selumetinib can be increased when it is combined with Selpercatinib. Sertraline The metabolism of Selumetinib can be decreased when combined with Sertraline. Sevoflurane The metabolism of Selumetinib can be decreased when combined with Sevoflurane. Sildenafil The serum concentration of Selumetinib can be increased when it is combined with Sildenafil. Silodosin The serum concentration of Selumetinib can be increased when it is combined with Silodosin. Siltuximab The metabolism of Selumetinib can be increased when combined with Siltuximab. Simeprevir The serum concentration of Selumetinib can be increased when it is combined with Simeprevir. Simvastatin The serum concentration of Selumetinib can be increased when it is combined with Simvastatin. Siponimod The metabolism of Siponimod can be decreased when combined with Selumetinib. Sirolimus The metabolism of Sirolimus can be decreased when combined with Selumetinib. Sitagliptin The metabolism of Selumetinib can be decreased when combined with Sitagliptin. Sitaxentan The metabolism of Selumetinib can be decreased when combined with Sitaxentan. Sodium aurothio The metabolism of Selumetinib can be decreased when combined with Sodium aurothiomalate. Sofosbuvir The serum concentration of Selumetinib can be increased when it is combined with Sofosbuvir. Somapacitan The metabolism of Selumetinib can be decreased when combined with Somapacitan. Somatotropin The metabolism of Selumetinib can be increased when combined with Somatotropin. Somatrem The metabolism of Selumetinib can be increased when combined with Somatrem. Somatrogon The metabolism of Selumetinib can be increased when combined with Somatrogon. Sorafenib The metabolism of Sorafenib can be decreased when combined with Selumetinib. Sotagliflozin Sotagliflozin may decrease the excretion rate of Selumetinib which could result in a higher serum level. Sotorasib The serum concentration of Selumetinib can be decreased when it is combined with Sotorasib. Spironolactone The metabolism of Selumetinib can be decreased when combined with Spironolactone. St. John’s Wort The serum concentration of Selumetinib can be decreased when it is combined with St. John’s Wort. Stiripentol The serum concentration of Selumetinib can be increased when it is combined with Stiripentol. Sulfadiazine The metabolism of Selumetinib can be decreased when combined with Sulfadiazine. Sulfamethizole The metabolism of Selumetinib can be decreased when combined with Sulfamethizole. Sulfamethoxazole The metabolism of Selumetinib can be decreased when combined with Sulfamethoxazole. Sulfaphenazole The metabolism of Selumetinib can be decreased when combined with Sulfaphenazole. Sulfapyridine The metabolism of Selumetinib can be decreased when combined with Sulfapyridine. Sulfasalazine Sulfasalazine may decrease the excretion rate of Selumetinib which could result in a higher serum level. Sulfinpyrazone The metabolism of Selumetinib can be decreased when combined with Sulfinpyrazone. Sulfisoxazole The metabolism of Selumetinib can be decreased when combined with Sulfisoxazole. Sunitinib The metabolism of Sunitinib can be decreased when combined with Selumetinib. Suvorexant The serum concentration of Selumetinib can be increased when it is combined with Suvorexant. Tacrine The metabolism of Selumetinib can be decreased when combined with Tacrine. Tacrolimus The metabolism of Tacrolimus can be decreased when combined with Selumetinib. Tadalafil The metabolism of Selumetinib can be decreased when combined with Tadalafil. Tafamidis The serum concentration of Selumetinib can be increased when it is combined with Tafamidis. You Might Also Read Riboflavin, Uses, Dosage, Side Effects, Warning Talazoparib The serum concentration of Talazoparib can be increased when it is combined with Selumetinib. Tamoxifen The metabolism of Tamoxifen can be decreased when combined with Selumetinib. Tasimelteon The metabolism of Selumetinib can be decreased when combined with Tasimelteon. Taurocholic acid Taurocholic acid may decrease the excretion rate of Selumetinib which could result in a higher serum level. Tazarotene The metabolism of Selumetinib can be decreased when combined with Tazarotene. Tazemetostat The serum concentration of Tazemetostat can be increased when it is combined with Selumetinib. Technetium T The serum concentration of Selumetinib can be increased when it is combined with Technetium Tc-99m sestamibi. Tecovirimat The metabolism of Selumetinib can be decreased when combined with Tecovirimat. Tegafur The metabolism of Tegafur can be decreased when combined with Selumetinib. Tegaserod The metabolism of Selumetinib can be decreased when combined with Tegaserod. Telaprevir The serum concentration of Selumetinib can be increased when it is combined with Telaprevir. Telithromycin The serum concentration of Selumetinib can be increased when it is combined with Telithromycin. Telmisartan Telmisartan may decrease the excretion rate of Selumetinib which could result in a higher serum level. Telotristat ethyl The serum concentration of Selumetinib can be decreased when it is combined with Telotristat ethyl. Temsirolimus The metabolism of Temsirolimus can be decreased when combined with Selumetinib. Teniposide The metabolism of Teniposide can be decreased when combined with Selumetinib. Tenofovir disoproxil The serum concentration of Selumetinib can be increased when it is combined with Tenofovir disoproxil. Tenoxicam The metabolism of Selumetinib can be decreased when combined with Tenoxicam. Tepotinib The serum concentration of Selumetinib can be increased when it is combined with Tepotinib. Terbinafine The metabolism of Selumetinib can be decreased when combined with Terbinafine. Terfenadine The serum concentration of Selumetinib can be increased when it is combined with Terfenadine. Teriflunomide The serum concentration of Selumetinib can be decreased when it is combined with Teriflunomide. Teriparatide The therapeutic efficacy of Teriparatide can be decreased when used in combination with Selumetinib. Testosterone The metabolism of Selumetinib can be decreased when combined with Testosterone. Testosterone cy The metabolism of Testosterone cypionate can be decreased when combined with Selumetinib. Testosterone en The metabolism of Testosterone enanthate can be decreased when combined with Selumetinib. Testosterone pro The metabolism of Selumetinib can be increased when combined with Testosterone propionate. Tetracaine The risk or severity of methemoglobinemia can be increased when Selumetinib is combined with Tetracaine. Tezacaftor The serum concentration of Tezacaftor can be increased when it is combined with Selumetinib. Thalidomide The metabolism of Selumetinib can be increased when combined with Thalidomide. Theophylline The metabolism of Theophylline can be decreased when combined with Selumetinib. Thiabendazole The metabolism of Selumetinib can be decreased when combined with Thiabendazole. Thiamylal The metabolism of Selumetinib can be decreased when combined with Thiamylal. Thiopental The metabolism of Selumetinib can be decreased when combined with Thiopental. Thioridazine The metabolism of Selumetinib can be decreased when combined with Thioridazine. Thiothixene The metabolism of Selumetinib can be decreased when combined with Thiothixene. Thyroid, porcine The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Selumetinib. Thyrotropin alfa The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Selumetinib. Ticagrelor The serum concentration of Selumetinib can be increased when it is combined with Ticagrelor. Ticlopidine The metabolism of Selumetinib can be decreased when combined with Ticlopidine. Timolol The metabolism of Selumetinib can be decreased when combined with Timolol. Tioconazole The serum concentration of Selumetinib can be increased when it is combined with Tioconazole. Tipranavir The serum concentration of Selumetinib can be increased when it is combined with Tipranavir. Tivozanib Tivozanib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Tizanidine The metabolism of Selumetinib can be decreased when combined with Tizanidine. Tocainide The metabolism of Selumetinib can be decreased when combined with Tocainide. Tocilizumab The metabolism of Selumetinib can be increased when combined with Tocilizumab. Tolazamide The metabolism of Selumetinib can be decreased when combined with Tolazamide. Tolbutamide The metabolism of Selumetinib can be decreased when combined with Tolbutamide. Tolterodine The metabolism of Selumetinib can be decreased when combined with Tolterodine. Tolvaptan The serum concentration of Tolvaptan can be increased when it is combined with Selumetinib. Topiramate The metabolism of Selumetinib can be decreased when combined with Topiramate. Topotecan The serum concentration of Topotecan can be increased when it is combined with Selumetinib. Torasemide The metabolism of Selumetinib can be decreased when combined with Torasemide. Toremifene The serum concentration of Selumetinib can be increased when it is combined with Toremifene. Trabectedin The metabolism of Trabectedin can be decreased when combined with Selumetinib. Trametinib The metabolism of Selumetinib can be decreased when combined with Trametinib. Tranylcypromine The metabolism of Selumetinib can be decreased when combined with Tranylcypromine. Trastuzumab em The metabolism of Trastuzumab emtansine can be decreased when combined with Selumetinib. Trazodone The metabolism of Selumetinib can be decreased when combined with Trazodone. Treprostinil The metabolism of Selumetinib can be decreased when combined with Treprostinil. Tretinoin The metabolism of Selumetinib can be decreased when combined with Tretinoin. Triamcinolone The metabolism of Selumetinib can be increased when combined with Triamcinolone. Triamterene The metabolism of Selumetinib can be decreased when combined with Triamterene. Triazolam The metabolism of Selumetinib can be decreased when combined with Triazolam. Triclabendazole The metabolism of Selumetinib can be decreased when combined with Triclabendazole. Trifluoperazine The metabolism of Selumetinib can be decreased when combined with Trifluoperazine. Trilaciclib The metabolism of Selumetinib can be increased when combined with Trilaciclib. Trimethadione The metabolism of Selumetinib can be decreased when combined with Trimethadione. Trimethoprim The metabolism of Selumetinib can be decreased when combined with Trimethoprim. Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Selumetinib. Troglitazone The metabolism of Selumetinib can be decreased when combined with Troglitazone. Troleandomycin The serum concentration of Selumetinib can be increased when it is combined with Troleandomycin. Trovafloxacin The metabolism of Selumetinib can be decreased when combined with Trovafloxacin. Tucatinib Tucatinib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Selumetinib. Udenafil The metabolism of Selumetinib can be decreased when combined with Udenafil. Umbralisib The serum concentration of Selumetinib can be increased when it is combined with Umbralisib. Umeclidinium The serum concentration of Selumetinib can be increased when it is combined with Umeclidinium. Valbenazine The metabolism of Valbenazine can be decreased when combined with Selumetinib. Valdecoxib The metabolism of Selumetinib can be decreased when combined with Valdecoxib. Valproic acid The metabolism of Selumetinib can be decreased when combined with Valproic acid. Valsartan The metabolism of Selumetinib can be decreased when combined with Valsartan. Vandetanib Vandetanib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Vardenafil The serum concentration of Selumetinib can be increased when it is combined with Vardenafil. Vayarin The metabolism of Selumetinib can be decreased when combined with Vayarin. Velpatasvir Velpatasvir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Vemurafenib The serum concentration of Selumetinib can be increased when it is combined with Vemurafenib. Venetoclax The serum concentration of Selumetinib can be increased when it is combined with Venetoclax. Venlafaxine Venlafaxine may increase the excretion rate of Selumetinib which could result in a lower serum level and potentially a reduction in efficacy. Verapamil The serum concentration of Selumetinib can be increased when it is combined with Verapamil. Vilazodone The metabolism of Selumetinib can be decreased when combined with Vilazodone. Viloxazine The metabolism of Selumetinib can be decreased when combined with Viloxazine. Vinblastine The serum concentration of Vinblastine can be increased when it is combined with Selumetinib. Vincristine The metabolism of Vincristine can be decreased when combined with Selumetinib. Vinflunine The serum concentration of Vinflunine can be increased when it is combined with Selumetinib. Vismodegib Vismodegib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Vitamin E The risk or severity of bleeding can be increased when Vitamin E is combined with Selumetinib. Voclosporin The serum concentration of Selumetinib can be increased when it is combined with Voclosporin. Vonoprazan The metabolism of Selumetinib can be decreased when combined with Vonoprazan. Vorapaxar The serum concentration of Selumetinib can be increased when it is combined with Vorapaxar. Voriconazole The serum concentration of Selumetinib can be increased when it is combined with Voriconazole. Vortioxetine The metabolism of Selumetinib can be decreased when combined with Vortioxetine. Voxelotor The metabolism of Voxelotor can be decreased when combined with Selumetinib. Voxilaprevir Voxilaprevir may decrease the excretion rate of Selumetinib which could result in a higher serum level. Warfarin The metabolism of Selumetinib can be decreased when combined with Warfarin. Ximelagatran The metabolism of Selumetinib can be decreased when combined with Ximelagatran. Zafirlukast The metabolism of Selumetinib can be decreased when combined with Zafirlukast. Zaleplon The metabolism of Selumetinib can be decreased when combined with Zaleplon. Zidovudine The metabolism of Selumetinib can be increased when combined with Zidovudine. Zileuton The metabolism of Selumetinib can be decreased when combined with Zileuton. Zimelidine The serum concentration of Selumetinib can be increased when it is combined with Zimelidine. Ziprasidone The serum concentration of Selumetinib can be increased when it is combined with Ziprasidone. Zolmitriptan The metabolism of Selumetinib can be decreased when combined with Zolmitriptan. Zolpidem The metabolism of Selumetinib can be decreased when combined with Zolpidem. Zonisamide The serum concentration of Selumetinib can be increased when it is combined with Zonisamide. Zopiclone The metabolism of Selumetinib can be decreased when combined with Zopiclone. Zotepine The metabolism of Selumetinib can be decreased when combined with Zotepine. Pregnancy and Lactation US FDA pregnancy category: Not assigned. Pregnancy Based on findings from animal studies and its mechanism of action, KOSELUGO can cause fetal harm when administered to a pregnant woman. There are no available data on the use of KOSELUGO in pregnant women to evaluate drug-associated risk. In animal reproduction studies, administration of selumetinib to mice during organogenesis caused reduced fetal weight, adverse structural defects, and effects on embryo-fetal survival at exposures approximately > 5 times the human exposure at the clinical dose of 25 mg/m2 twice daily (see Data). Advise pregnant women of the potential risk to the fetus. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Lactation There are no data on the presence of selumetinib or its active metabolite in human milk or their effects on the breastfed child or milk production. Selumetinib and its active metabolite were present in the milk of lactating mice (see Data). Due to the potential for adverse reactions in a breastfed child, advise women not to breastfeed during treatment with KOSELUGO and for 1 week after the last dose. Why is this medication prescribed? Selumetinib is used to treat neurofibromatosis type 1 (NF1; a nervous system disorder that causes tumors to grow on nerves) in children 2 years of age and older who have plexiform neurofibromas (PN; soft tumors) that cannot be completely removed by surgery. Selumetinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals the tumors to grow. This helps to stop or slow tumor growth. How should this medicine be used? Selumetinib comes as a capsule to take by mouth. It is usually taken twice a day on an empty stomach. Do not eat any food 2 hours before or for 1 hour after each dose. Take selumetinib at around the same time(s) every day, approximately 12 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take selumetinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsules whole with water; do not open, chew, or crush them. If you vomit after taking selumetinib, do not take another dose. Continue your regular dosing schedule. Your doctor may decrease your dose or temporarily or permanently stop your treatment if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with selumetinib. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before taking selumetinib, tell your doctor and pharmacist if you are allergic to selumetinib, any other medications, or any of the ingredients in selumetinib capsules. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); aprepitant (Emend); clarithromycin (Biaxin, in Prevpac); clopidogrel (Plavix); corticosteroids such as betamethasone (Celestone), budesonide (Entocort), cortisone (Cortone), dexamethasone (Decadron, Dexpak, Dexasone, others), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol, Meprolone, others), prednisolone (Prelone, others), and prednisone (Rayos); diltiazem (Cardizem, Dilacor, Tiazac, others); erythromycin (E.E.S., E-Mycin, Erythrocin); certain medications for HIV including indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase); idelalisib (Zydelig); nefazodone; phenobarbital; rifabutin (Mycobutin); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); verapamil (Calan, Covera); and vitamin E supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor what herbal products you are taking, especially St. John’s wort. tell your doctor if you have or have ever had vision problems, difficulty swallowing, or heart or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or if you plan on fathering a child. If you are female, you will need to take a pregnancy test before you start treatment and use birth control to prevent pregnancy during your treatment and for at least 1 week after your final dose. If you are a male, you and your partner should use birth control during your treatment with selumetinib and for 1 week after your final dose. Talk to your doctor about birth control methods that you can use during your treatment. If you or your partner become pregnant while taking selumetinib, call your doctor immediately. Selumetinib may harm the fetus. tell your doctor if you are breastfeeding. You should not breastfeed while you are taking selumetinib and for 1 week after the final dose. What special dietary instructions should I follow? Avoid eating grapefruit or drinking grapefruit juice while taking this medication. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is within 6 hours of the next dose, skip the missed dose and continue your regular dosing schedule. 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