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Trametinib is a dual-kinase inhibitor that is used in the treatment of advanced malignant melanoma, usually in combination with dabrafenib. Trametinib therapy is associated with transient elevations in serum aminotransferase and alkaline phosphatase levels during therapy but has yet to be linked cases of clinically apparent acute liver injury.
Trametinib is an orally bioavailable inhibitor of mitogen-activated protein kinase kinase (MAP2K; MAPK/ERK kinase; MEK) 1 and 2, with potential antineoplastic activity. Upon oral administration, trametinib specifically binds to and inhibits MEK 1 and 2, resulting in an inhibition of growth factor-mediated cell signaling and cellular proliferation in various cancers. MEK 1 and 2, dual specificity serine/threonine and tyrosine kinases often upregulated in various cancer cell types, play a key role in the activation of the RAS/RAF/MEK/ERK signaling pathway that regulates cell growth.
Trametinib is a pyridopyrimidine that is used (as its dimethyl sulfoxide addition compound) for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations, and who have not received prior BRAF inhibitor treatment. It has a role as an EC 2.7.11.24 (mitogen-activated protein kinase) inhibitor, an antineoplastic agent, an anticoronaviral agent, and a geroprotector. It is a pyridopyrimidine, an organofluorine compound, an organoiodine compound, a member of acetamides, a ring assembly, a member of cyclopropanes and an aromatic amine
Trametinib Dimethyl Sulfoxide is a dimethyl sulfoxide (DMSO) solvated form of trametinib, an orally bioavailable inhibitor of mitogen-activated protein kinase kinase (MAP2K; MAPK/ERK kinase; MEK) 1 and 2, with potential antineoplastic activity. Upon oral administration, trametinib specifically binds to and inhibits MEK 1 and 2, resulting in an inhibition of growth factor-mediated cell signaling and cellular proliferation in various cancers. MEK 1 and 2, dual specificity serine/threonine and tyrosine kinases often upregulated in various cancer cell types, play a key role in the activation of the RAS/RAF/MEK/ERK signaling pathway that regulates cell growth.
Trametinib dimethyl sulfoxide is an addition compound obtained by combining equimolar amounts of trametinib and dimethyl sulfoxide. Used for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations, and who have not received prior BRAF inhibitor treatment. It has a role as an antineoplastic agent and an EC 2.7.11.24 (mitogen-activated protein kinase) inhibitor. It contains dimethyl sulfoxide and trametinib.
Trametinib is an orally bioavailable mitogen-activated extracellular signal-regulated kinase 1 (MEK1) and MEK2 inhibitor. It was first approved by the FDA in May 2013 for the treatment of melanoma.[rx] It was later approved by Health Canada on July 18, 2013 [rx] and by the European Commission on June 30, 2014.[rx] Trametinib is currently approved to treat a variety of cancers with BRAF mutations, such as non-small cell lung cancer and thyroid cancer, as monotherapy or in combination with dabrafenib, a BRAF inhibitor, for improved therapeutic efficacy. Originally developed by Japan Tobacco, trametinib was initially investigated for treating inflammation, but further studies for this indication were not pursued.[rx]
Mechanism of Action
Trametinib is a reversible, allosteric inhibitor of mitogen-activated extracellular signal-regulated kinase 1 _(MEK1)_ and _MEK2_ activation and of_ MEK1_ and _MEK2_ kinase activity. MEK proteins are upstream regulators of the extracellular signal-related kinase (ERK) pathway, which promotes cellular proliferation. Trametinib helps with melanoma with the BRAF V600E or V600K as the mutation results in the constitutive activation of the BRAF pathway which includes MEK1 and MEK2.
Trametinib is an anticancer agent which causes apoptosis (or programmed cell death) and inhibits cell proliferation, which are both important in the treatment of malignancies. Trametinib inhibits cell growth of various BRAF V600 mutation-positive tumors in vitro and in vivo. Trametinib is often used in combination with dabrafenib, a BRAF inhibitor. In BRAF-mutant colorectal cancer, induction of EGFR-mediated MAPK pathway re-activation has been identified as a mechanism of intrinsic resistance to BRAF inhibitors.7
Indications
- Trametinib is indicated as a single agent for the treatment of BRAF-inhibitor treatment-naïve patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FD-approved test. It is used in combination with [dabrafenib] for the: – Treatment of unresectable or metastatic melanoma with BRAF V600E or V600K mutations. – Adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations, as detected by an FDA-approved test, and involvement of lymph node(s), following complete resection. – Treatment of patients with metastatic non-small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. – Treatment of patients with locally advanced or metastatic anaplastic thyroid cancer (ATC) with BRAF V600E mutation and with no satisfactory locoregional treatment options.
- Melanoma: Trametinib as monotherapy or in combination with dabrafenib is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation. Trametinib monotherapy has not demonstrated clinical activity in patients who have progressed on a prior BRAF inhibitor therapy.
- Adjuvant treatment of melanoma: Trametinib in combination with dabrafenib is indicated for the adjuvant treatment of adult patients with Stage III melanoma with a BRAF V600 mutation, following complete resection.
- Non-small cell lung cancer (NSCLC): Trametinib in combination with dabrafenib is indicated for the treatment of adult patients with advanced non-small cell lung cancer with a BRAF V600 mutation.
- Trametinib is a dual-kinase inhibitor that is used in the treatment of advanced malignant melanoma, usually in combination with dabrafenib. Trametinib therapy is associated with transient elevations in serum aminotransferase and alkaline phosphatase levels during therapy but has yet to be linked to cases of clinically apparent acute liver injury.
- Trametinib dimethyl sulfoxide is approved to be used alone or with dabrafenib mesylate to treat patients whose cancer has a certain mutation in the BRAF gene, including:
• Anaplastic thyroid cancer that has spread and cannot be treated with local therapy. It is used with dabrafenib mesylate.
• Glioma that is low grade in children aged 1 year and older who require systemic therapy. It is used with dabrafenib mesylate.
• Melanoma. It is used:
• With dabrafenib mesylate in patients who have had surgery to remove cancer that has spread to the lymph nodes.
• Alone or with dabrafenib mesylate in patients whose cancer cannot be removed by surgery or has spread to other parts of the body.
• Non-small cell lung cancer that has spread to other parts of the body. It is used with dabrafenib mesylate.
• Solid tumors. It is used with dabrafenib mesylate in adults and children aged 6 years and older whose tumors cannot be removed by surgery or have spread to other parts of the body and have gotten worse after other treatments and cannot be treated with other therapies.
- Advanced Non-Small Cell Lung Cancer (NSCLC)
- Locally Advanced Anaplastic Thyroid Cancer
- Melanoma
- Metastatic Anaplastic Thyroid Cancer
- Metastatic Melanoma
- Metastatic Non-Small Cell Lung Cancer
- Stage III Melanoma
- Unresectable Melanoma
- Unresectable or Metastatic Solid Tumors
- This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, a confirmatory trial(s) must show that trametinib dimethyl sulfoxide provides a clinical benefit in these patients. Trametinib dimethyl sulfoxide is also being studied in the treatment of other types of cancer.
Use in Cancer
Trametinib dimethyl sulfoxide is approved to be used alone or with dabrafenib mesylate to treat patients whose cancer has a certain mutation in the BRAF gene, including:
- Anaplastic thyroid cancer has spread and cannot be treated with local therapy. It is used with dabrafenib mesylate.
- Glioma is low-grade in children aged 1 year and older who require systemic therapy. It is used with dabrafenib mesylate.
- Melanoma. It is used:
- With dabrafenib mesylate in patients who have had surgery to remove cancer that has spread to the lymph nodes.
- Alone or with dabrafenib mesylate in patients whose cancer cannot be removed by surgery or has spread to other parts of the body.
- Non-small cell lung cancer has spread to other parts of the body. It is used with dabrafenib mesylate.
- Solid tumors. It is used with dabrafenib mesylate in adults and children aged 6 years and older whose tumors cannot be removed by surgery or have spread to other parts of the body and have gotten worse after other treatments and cannot be treated with other therapies.¹
This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, a confirmatory trial(s) must show that trametinib dimethyl sulfoxide provides a clinical benefit in these patients.
Trametinib dimethyl sulfoxide is also being studied in the treatment of other types of cancer.
Contraindications
- an increased risk of bleeding
- detachment of the retina of the eye
- a clot in the lung
- cardiomyopathy, a disease of the heart muscle
- chronic heart failure
- blood clot in a deep vein of the extremities
- a body temperature higher than 101 degrees Fahrenheit
- high blood sugar
- pregnancy
- a patient who is producing milk and breastfeeding
- a rupture in the wall of the stomach or intestine
- lung tissue problem
Dosage
Strengths: 0.5 mg; 2 mg
Melanoma – Metastatic
Unresectable or Metastatic Melanoma:
- Single agent: 2 mg orally once a day
- Combination therapy: 2 mg orally once a day with dabrafenib (refer to the dabrafenib prescribing information for recommended dabrafenib dosing information)
- Duration of therapy: Until disease progression or unacceptable toxicity occurs.
Adjuvant Treatment of Melanoma:
- Combination therapy: 2 mg orally once a day with dabrafenib (refer to the dabrafenib prescribing information for recommended dabrafenib dosing information)
- Duration of therapy: Until disease progression or unacceptable toxicity occurs for up to one year.
- Confirm the presence of BRAF V600E or V600K mutation in tumor specimens prior to initiation.
- As a single agent for the treatment of BRAF-inhibitor treatment-naive patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FDA-approved test
- In combination with dabrafenib for patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FDA-approved test
- In combination with dabrafenib for patients with melanoma with BRAF V600E or V600K mutations, as detected by an FDA-approved test, and involvement of lymph node(s), following complete resection
Non-Small Cell Lung Cancer
- 2 mg orally once a day with dabrafenib (refer to the dabrafenib prescribing information for recommended dabrafenib dosing information)
Duration of therapy: Until disease progression or unacceptable toxicity occurs. - Confirm the presence of BRAF V600E mutation in tumor specimens prior to initiation of therapy with this drug and dabrafenib.
- In combination with dabrafenib for patients with metastatic non-small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test
Thyroid Cancer
- 2 mg orally once a day with dabrafenib (refer to the dabrafenib prescribing information for recommended dabrafenib dosing information)
Duration of therapy: Until disease progression or unacceptable toxicity occurs. - Confirm the presence of BRAF V600E mutation in tumor specimens prior to initiation of therapy with this drug and dabrafenib.
- In combination with dabrafenib for patients with locally advanced or metastatic anaplastic thyroid cancer (ATC) with BRAF V600E mutation and with no satisfactory locoregional treatment options
Dose Adjustments
Recommended Dose Reductions for Adverse Reactions:
- First dose reduction: 1.5 mg orally once a day
- Second dose reduction: 1 mg orally once a day
- Subsequent modification: Permanently discontinue therapy if unable to tolerate 1 mg orally once a day
Venous Thromboembolism:
- Uncomplicated DVT or PE: Withhold therapy for up to 3 weeks; if improved to Grade 0 or 1, resume at a lower dose level; if not improved, permanently discontinue therapy.
- Life threatening PE: Permanently discontinue therapy.
Cardiac Toxicity:
- Asymptomatic, absolute decrease in left ventricular ejection fraction (LVEF) of 10% or greater from baseline that is below institutional lower limits of normal (LLN) from pretreatment value: Withhold therapy for up to 4 weeks; if improved to normal LVEF value, resume therapy at a lower dose; if not improved to normal LVEF value, permanently discontinue therapy.
- Symptomatic congestive heart failure or an absolute decrease in LVEF of greater than 20% from baseline that is below LLN: Permanently discontinue therapy.
Ocular Toxicity:
- Retinal pigment epithelial detachments (RPED): Withhold therapy for up to 3 weeks; if improved, resume therapy at same or lower dose level; if not improved, discontinue therapy or resume at a lower dose.
- Retinal vein occlusion: Permanently discontinue therapy.
Pulmonary Toxicity:
Interstitial lung disease/pneumonitis: Permanently discontinue therapy.
Febrile Drug Reactions:
- Fever higher than 104F or fever complicated by rigors, hypotension, dehydration or renal failure: Withhold therapy until fever resolves, then resume at same or lower dose level.
Dermatologic Toxicity:
- Grade 3 or 4 or intolerable Grade 2: Withhold therapy for up to 3 weeks; if improved, resume therapy at a lower dose level; if not improved, permanently discontinue therapy.
Other Adverse Reactions (dose modifications are not recommended for this drug when administered with dabrafenib for the following adverse reactions of dabrafenib: non-cutaneous malignancies and uveitis; dose modification of this drug is not required for new primary cutaneous malignancies):
- Any Grade 3 or intolerable Grade 2 adverse reaction: Withhold therapy; if improved to Grade 0 to 1, resume therapy at a lower dose level, if not improved, permanently discontinue therapy.
- First occurrence of any Grade 4 adverse reaction: Withhold therapy until adverse reaction improves to Grade 0 to 1, then resume therapy at a lower dose level; if not improved, permanently discontinue therapy.
- Recurrent Grade 4 adverse reaction: Permanently discontinue therapy.
Side Effects
The Most Common
- dry skin
- sores on the mouth and tongue
- dry mouth
- vomiting
- loss of appetite
- change in ability to taste food
- tiredness
- unusual bleeding or bruising
- bloody or black, tarry stools
- coughing up or vomiting blood or material that looks like coffee grounds
- nosebleed
- severe diarrhea
- stomach pain
- nausea
- fever
- chills
- rapid, irregular, or pounding heartbeat
- difficulty breathing
- chest pain
- swelling of the face, arms, legs, ankles, or feet
- dizziness, lightheadedness, or weakness
- shortness of breath
- leg pain, swelling, tenderness, redness, or warmth
- severe headache
- cough
- blurred vision
- change in vision, including seeing halos (blurred outline around objects) or colored dots
- loss of vision
- eye pain
- dry, red, or swollen eyes
- rash, red skin, or pimples
- wart
- a reddish bump that bleeds or does not heal
- change in size or color of a mole
- itching
- blisters, ulcers, or sores on the skin or nails
- tingling, burning, redness, swelling, peeling or flaking, blisters, or sores on the palms of the hands or soles of the feet
- frequent urination
- increased thirst
More common
- Acne, pimples
- burning, itching, and pain in hairy areas, pus at the root of the hair
- canker sores
- change in taste
- dark urine
- dry eyes
- dry mouth
- dry skin
- itching, pain, redness, swelling, tenderness, or warmth on the skin
- loosening of the fingernails
- loss of taste
- redness or soreness around the fingernails
- sores, ulcers, or white spots on the lips or tongue or inside the mouth
- swelling or inflammation of the mouth
- thirst
- Bleeding from the rectum or bloody stools
- bleeding gums
- blemishes on the skin
- blistering, crusting, irritation, itching, or reddening of the skin
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody nose
- blurred vision
- chest discomfort, pain, or tightness
- cracked, dry, or scaly skin
- coughing up blood
- decreased urine output
- diarrhea
- difficulty in moving
- difficulty with breathing or swallowing
- dilated neck veins
- extreme tiredness or weakness
- fast, slow, irregular, or pounding heartbeat
- headache
- increased menstrual flow or vaginal bleeding
- irregular breathing
- joint pain
- lightheadedness, dizziness, or fainting
- muscle aches, cramps, pain, or stiffness
- nervousness
- nosebleeds
- paralysis
- pimples
- pounding in the ears
- prolonged bleeding from cuts
- rapid weight gain
- rash
- red or black, tarry stools
- red or dark brown urine
- redness, swelling, or pain of the skin
- scaling of the skin on the hands and feet
- swelling of the hands, ankles, feet, or lower legs
- tingling of the hands and feet
- ulceration of the skin
- unusual tiredness or weakness
- unusual weight gain or loss
Rare
- Change in vision
- seeing flashes or sparks of light
- seeing floating spots before the eyes, or a veil or curtain across part of your vision
- stomach cramps, pain, or tenderness
- watery or bloody diarrhea
- Blistering, peeling, loosening of the skin
- chills
- itching
- red skin lesions, often with a purple center
- sore throat
- sores, ulcers, or white spots in the mouth or on lips
- swollen glands
- unusual bleeding or bruising
Drug interactions
| DRUG | INTERACTION |
|---|---|
| Abacavir | Abacavir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Aceclofenac | Aceclofenac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Acemetacin | Acemetacin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Acetaminophen | Acetaminophen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Acetazolamide | Acetazolamide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Acetylsalicylic a | Acetylsalicylic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Aclidinium | Aclidinium may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Acrivastine | Trametinib may decrease the excretion rate of Acrivastine which could result in a higher serum level. |
| Acyclovir | Acyclovir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Adefovir dipivoxil | Adefovir dipivoxil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Albutrepenonacog | Trametinib may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level. |
| Alclofenac | Alclofenac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Aldesleukin | Aldesleukin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Allopurinol | Allopurinol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Almasilate | Trametinib may decrease the excretion rate of Almasilate which could result in a higher serum level. |
| Almotriptan | Almotriptan may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Alogliptin | Alogliptin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Alprazolam | Alprazolam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amantadine | Amantadine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amikacin | Trametinib may decrease the excretion rate of Amikacin which could result in a higher serum level. |
| Amiloride | Amiloride may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Aminophenazone | Aminophenazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amitriptyline | Amitriptyline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ammonium chloride | Ammonium chloride may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amoxicillin | Amoxicillin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amphetamine | Amphetamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amphotericin B | Amphotericin B may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ampicillin | Ampicillin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Amrinone | Amrinone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ancestim | Trametinib may decrease the excretion rate of Ancestim which could result in a higher serum level. |
| Antihemophilic f | Trametinib may decrease the excretion rate of Antihemophilic factor (recombinant), PEGylated which could result in a higher serum level. |
| Antipyrine | Antipyrine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Antithrombin III | Trametinib may decrease the excretion rate of Antithrombin III human which could result in a higher serum level. |
| Antrafenine | Antrafenine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Apalutamide | Trametinib may decrease the excretion rate of Apalutamide which could result in a higher serum level. |
| Apremilast | Apremilast may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Arformoterol | Arformoterol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Arsenic trioxide | Arsenic trioxide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Articaine. |
| Atazanavir | Atazanavir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Atomoxetine | Atomoxetine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Auranofin | Auranofin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Aurothioglucose | Trametinib may decrease the excretion rate of Aurothioglucose which could result in a higher serum level. |
| Azacitidine | Azacitidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Azathioprine | Azathioprine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Azelaic acid | Azelaic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Aztreonam | Aztreonam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bacitracin | Bacitracin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Baclofen | Baclofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Balsalazide | Balsalazide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Baricitinib | Trametinib may decrease the excretion rate of Baricitinib which could result in a higher serum level. |
| Bendroflumethiazide | Bendroflumethiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Benorilate | Benorilate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Benoxaprofen | Benoxaprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Benserazide | Trametinib may decrease the excretion rate of Benserazide which could result in a higher serum level. |
| Benzatropine | Benzatropine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Benznidazole | Trametinib may decrease the excretion rate of Benznidazole which could result in a higher serum level. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Benzocaine. |
| Benzthiazide | Benzthiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Benzydamine | Benzydamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Benzyl alcohol. |
| Bepotastine | Bepotastine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bicisate | Trametinib may decrease the excretion rate of Bicisate which could result in a higher serum level. |
| Bismuth subgallate | Trametinib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level. |
| Bisoprolol | Bisoprolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bisoxatin | Trametinib may decrease the excretion rate of Bisoxatin which could result in a higher serum level. |
| Bleomycin | Bleomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Brivaracetam | Brivaracetam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bromazepam | Bromazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bromotheophylline | Bromotheophylline may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Budesonide | Budesonide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bumadizone | Bumadizone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Bumetanide | Bumetanide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Bupivacaine. |
| Bupropion | Bupropion may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Buspirone | Buspirone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Butabarbital | Butabarbital may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Butamben. |
| Canagliflozin | Canagliflozin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Canrenoic acid | Canrenoic acid may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Capecitabine | Capecitabine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Capreomycin | Trametinib may decrease the excretion rate of Capreomycin which could result in a higher serum level. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Capsaicin. |
| Carbamazepine | Trametinib may decrease the excretion rate of Carbamazepine which could result in a higher serum level. |
| Carbidopa | Carbidopa may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Carboplatin | Carboplatin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Carmustine | Carmustine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Carprofen | Carprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefaclor | Cefaclor may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefadroxil | Cefadroxil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefalotin | Cefalotin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefamandole | Cefamandole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefapirin | Cefapirin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefazolin | Cefazolin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefdinir | Cefdinir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefditoren | Cefditoren may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefepime | Cefepime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefmenoxime | Cefmenoxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefmetazole | Cefmetazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefonicid | Cefonicid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefoperazone | Cefoperazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceforanide | Ceforanide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefotaxime | Cefotaxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefotetan | Cefotetan may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefotiam | Cefotiam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefoxitin | Cefoxitin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefpiramide | Cefpiramide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefpirome | Cefpirome may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefpodoxime | Cefpodoxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefprozil | Cefprozil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefradine | Cefradine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftaroline | Ceftaroline fosamil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftazidime | Ceftazidime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftibuten | Ceftibuten may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftizoxime | Ceftizoxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftobiprole | Ceftobiprole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ceftolozane | Trametinib may decrease the excretion rate of Ceftolozane which could result in a higher serum level. |
| Ceftriaxone | Ceftriaxone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cefuroxime | Cefuroxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Celecoxib | Celecoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cephalexin | Cephalexin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cephaloglycin | Cephaloglycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Certolizumab p | Certolizumab pegol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cetirizine | Cetirizine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cevimeline | Cevimeline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Chloral hydrate | Chloral hydrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Chloroprocaine. |
| Chloroquine | Chloroquine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Chlorothiazide | Chlorothiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Chlorpromazine | Chlorpromazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Chlorpropamide | Chlorpropamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Chlorthalidone | Chlorthalidone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Chlorzoxazone | Chlorzoxazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Choline C 11 | Trametinib may decrease the excretion rate of Choline C 11 which could result in a higher serum level. |
| Choline magnesium | Choline magnesium trisalicylate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Choline salicylate | Trametinib may decrease the excretion rate of Choline salicylate which could result in a higher serum level. |
| Chondroitin sulfate | Trametinib may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level. |
| Chromic chloride | Trametinib may decrease the excretion rate of Chromic chloride which could result in a higher serum level. |
| Chromic nitrate | Trametinib may decrease the excretion rate of Chromic nitrate which could result in a higher serum level. |
| Chromium | Trametinib may decrease the excretion rate of Chromium which could result in a higher serum level. |
| Chromium gluconate | Trametinib may decrease the excretion rate of Chromium gluconate which could result in a higher serum level. |
| Chromium nicotinate | Trametinib may decrease the excretion rate of Chromium nicotinate which could result in a higher serum level. |
| Chromous sulfate | Trametinib may decrease the excretion rate of Chromous sulfate which could result in a higher serum level. |
| Cidofovir | Cidofovir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cilostazol | Cilostazol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cimetidine | Cimetidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Cinchocaine. |
| Ciprofloxacin | Ciprofloxacin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cisplatin | Trametinib may decrease the excretion rate of Cisplatin which could result in a higher serum level. |
| Clevidipine | Clevidipine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clobazam | Clobazam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clofarabine | Clofarabine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clomipramine | Clomipramine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clonazepam | Clonazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clorazepic acid | Clorazepic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Clove oil | Trametinib may decrease the excretion rate of Clove oil which could result in a higher serum level. |
| Clozapine | Clozapine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Cocaine. |
| Colchicine | Colchicine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Colistimethate | Colistimethate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Colistin | Trametinib may decrease the excretion rate of Colistin which could result in a higher serum level. |
| Conivaptan | Conivaptan may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Conjugated estrogens | Conjugated estrogens may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Corifollitropin alfa | Trametinib may decrease the excretion rate of Corifollitropin alfa which could result in a higher serum level. |
| Cyanocobalamin | Cyanocobalamin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cyclopenthiazide | Cyclopenthiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Cyclosporine | Cyclosporine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Cyclothiazide | Cyclothiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Dabigatran etexilate | Dabigatran etexilate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dabrafenib | The risk or severity of adverse effects can be increased when Trametinib is combined with Dabrafenib. |
| Dacarbazine | Dacarbazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dalfampridine | Dalfampridine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Daptomycin | Daptomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Trametinib. |
| Deferiprone | Deferiprone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Delafloxacin | Trametinib may decrease the excretion rate of Delafloxacin which could result in a higher serum level. |
| Desipramine | Desipramine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Desmopressin | Desmopressin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Desvenlafaxine | Desvenlafaxine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Deutetrabenazine | Trametinib may decrease the excretion rate of Deutetrabenazine which could result in a higher serum level. |
| Dexibuprofen | Dexibuprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dexketoprofen | Dexketoprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dexmedetomidine | Dexmedetomidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dexpanthenol | Trametinib may decrease the excretion rate of Dexpanthenol which could result in a higher serum level. |
| Dexrazoxane | Dexrazoxane may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dextran | Trametinib may decrease the excretion rate of Dextran which could result in a higher serum level. |
| Diatrizoate | Diatrizoate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Diazepam | Diazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dichlorobenzyl | Trametinib may decrease the excretion rate of Dichlorobenzyl alcohol which could result in a higher serum level. |
| Diclofenac | Diclofenac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Diclofenamide | Diclofenamide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Dicyclomine | Dicyclomine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Didanosine | Didanosine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dienogest | Trametinib may decrease the excretion rate of Dienogest which could result in a higher serum level. |
| Diflunisal | Diflunisal may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Difluocortolone | Trametinib may decrease the excretion rate of Difluocortolone which could result in a higher serum level. |
| Digoxin | Trametinib may decrease the excretion rate of Digoxin which could result in a higher serum level. |
| Dihydrostreptomycin | Dihydrostreptomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dimercaprol | Dimercaprol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dimethyl sulfoxide | Dimethyl sulfoxide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Diphenhydramine. |
| Disopyramide | Disopyramide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| DL-Methylephedrine | Trametinib may decrease the excretion rate of DL-Methylephedrine which could result in a higher serum level. |
| Dobutamine | Dobutamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dopamine | Dopamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Doripenem | Doripenem may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Doxacurium | Doxacurium may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Doxepin | Doxepin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Doxycycline | Doxycycline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Drospirenone | Drospirenone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Droxidopa | Droxidopa may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Duloxetine | Duloxetine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Dyclonine. |
| Dyphylline | Dyphylline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Edoxaban | Trametinib may decrease the excretion rate of Edoxaban which could result in a higher serum level. |
| Edrophonium | Edrophonium may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Enalaprilat | Trametinib may decrease the excretion rate of Enalaprilat which could result in a higher serum level. |
| Enzalutamide | Enzalutamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Eplerenone | Eplerenone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Epoprostenol | Epoprostenol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ertapenem | Ertapenem may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Trametinib. |
| Estazolam | Estazolam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Estradiol | Estradiol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Estradiol acetate | Trametinib may decrease the excretion rate of Estradiol acetate which could result in a higher serum level. |
| Estradiol cypionate | Trametinib may decrease the excretion rate of Estradiol cypionate which could result in a higher serum level. |
| Estradiol dienanthate | Trametinib may decrease the excretion rate of Estradiol dienanthate which could result in a higher serum level. |
| Estradiol valerate | Trametinib may decrease the excretion rate of Estradiol valerate which could result in a higher serum level. |
| Estrone sulfate | Estrone sulfate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Eszopiclone | Eszopiclone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Etacrynic acid | Etacrynic acid may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Etafedrine | Trametinib may decrease the excretion rate of Etafedrine which could result in a higher serum level. |
| Ethambutol | Ethambutol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Etidocaine. |
| Etodolac | Etodolac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Etomidate | Etomidate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Etonogestrel | Etonogestrel may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Etoricoxib | Etoricoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Eucalyptus oil | Trametinib may decrease the excretion rate of Eucalyptus oil which could result in a higher serum level. |
| Ezogabine | Ezogabine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fenbufen | Fenbufen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fenofibrate | Fenofibrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fenofibric acid | Trametinib may decrease the excretion rate of Fenofibric acid which could result in a higher serum level. |
| Fenoldopam | Fenoldopam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fenoprofen | Fenoprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fentanyl | Fentanyl may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fesoterodine | Fesoterodine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Finerenone | Finerenone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Flavoxate | Flavoxate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Floctafenine | Floctafenine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Florbetaben (18F) | Trametinib may decrease the excretion rate of Florbetaben (18F) which could result in a higher serum level. |
| Florbetapir (18F) | Trametinib may decrease the excretion rate of Florbetapir (18F) which could result in a higher serum level. |
| Floxuridine | Floxuridine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fluconazole | Fluconazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Flucytosine | Flucytosine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fludeoxyglucose | Trametinib may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level. |
| Flumazenil | Flumazenil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fluocinolone a | Fluocinolone acetonide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Flurazepam | Flurazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Flurbiprofen | Flurbiprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Flutamide | Flutamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fluvoxamine | Fluvoxamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Folic acid | Folic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fomepizole | Fomepizole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fondaparinux | Fondaparinux may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Formestane | Formestane may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Foscarnet | Foscarnet may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fosfomycin | Fosfomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Fosinopril | Fosinopril may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Framycetin | Framycetin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Furosemide | Furosemide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Gabapentin enacarbil | Gabapentin enacarbil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gadobenic acid | Gadobenic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gadodiamide | Gadodiamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gadofosveset tris | Gadofosveset trisodium may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gadopentetic acid | Gadopentetic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gadoteric acid | Trametinib may decrease the excretion rate of Gadoteric acid which could result in a higher serum level. |
| Gadoteridol | Gadoteridol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ganciclovir | Ganciclovir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gemcitabine | Gemcitabine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gemfibrozil | Gemfibrozil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Gentamicin | Trametinib may decrease the excretion rate of Gentamicin which could result in a higher serum level. |
| Gimeracil | Trametinib may decrease the excretion rate of Gimeracil which could result in a higher serum level. |
| Givosiran | Givosiran may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Glipizide | Glipizide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Glycerol phenylbut | Glycerol phenylbutyrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Golodirsen | Trametinib may decrease the excretion rate of Golodirsen which could result in a higher serum level. |
| Goserelin | Goserelin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Guanethidine | Guanethidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Guanfacine | Guanfacine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Haloperidol | Haloperidol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Hydralazine | Hydralazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Hydrochlorothiazide | Hydrochlorothiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydroflumethiazide | Hydroflumethiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Hydromorphone | Hydromorphone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Hydroxocobalamin | Hydroxocobalamin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Hydroxyethyl Starch | Trametinib may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level. |
| Ibuprofen | Ibuprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ibutilide | Ibutilide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Icatibant | Icatibant may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Icosapent | Icosapent may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Idarucizumab | Trametinib may decrease the excretion rate of Idarucizumab which could result in a higher serum level. |
| Idebenone | Trametinib may decrease the excretion rate of Idebenone which could result in a higher serum level. |
| Ifosfamide | Ifosfamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Imipramine | Imipramine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Indapamide | Indapamide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Indigotindisulfonic | Trametinib may decrease the excretion rate of Indigotindisulfonic acid which could result in a higher serum level. |
| Indomethacin | Indomethacin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Inosine pranobex | Trametinib may decrease the excretion rate of Inosine pranobex which could result in a higher serum level. |
| Inositol | Trametinib may decrease the excretion rate of Inositol which could result in a higher serum level. |
| Inotersen | Inotersen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Iobenguane sulfat | Trametinib may decrease the excretion rate of Iobenguane sulfate I-123 which could result in a higher serum level. |
| Iodixanol | Iodixanol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ioflupane I-123 | Ioflupane I-123 may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Iopromide | Trametinib may decrease the excretion rate of Iopromide which could result in a higher serum level. |
| Iothalamic acid | Trametinib may decrease the excretion rate of Iothalamic acid which could result in a higher serum level. |
| Ioversol | Trametinib may decrease the excretion rate of Ioversol which could result in a higher serum level. |
| Ioxilan | Trametinib may decrease the excretion rate of Ioxilan which could result in a higher serum level. |
| Ipecac | Trametinib may decrease the excretion rate of Ipecac which could result in a higher serum level. |
| Ipilimumab | Ipilimumab may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Isoniazid | Isoniazid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Isosorbide | Isosorbide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Isosorbide mononit | Isosorbide mononitrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Isosulfan blue | Trametinib may decrease the excretion rate of Isosulfan blue which could result in a higher serum level. |
| Isotretinoin | Isotretinoin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Isoxicam | Isoxicam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Isradipine | Isradipine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ixazomib | Trametinib may decrease the excretion rate of Ixazomib which could result in a higher serum level. |
| Kanamycin | Trametinib may decrease the excretion rate of Kanamycin which could result in a higher serum level. |
| Ketamine | Ketamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ketazolam | Ketazolam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ketoprofen | Ketoprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ketorolac | Ketorolac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Labetalol | Labetalol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lamivudine | Lamivudine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lamotrigine | Lamotrigine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Latamoxef | Latamoxef may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ledipasvir | Trametinib may decrease the excretion rate of Ledipasvir which could result in a higher serum level. |
| Lenalidomide | Lenalidomide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lesinurad | Trametinib may decrease the excretion rate of Lesinurad which could result in a higher serum level. |
| Leuprolide | Leuprolide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Levobupivacaine. |
| Levocarnitine | Levocarnitine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Levocetirizine | Levocetirizine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Levofloxacin | Levofloxacin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Levomilnacipran | Trametinib may decrease the excretion rate of Levomilnacipran which could result in a higher serum level. |
| Levosalbutamol | Trametinib may decrease the excretion rate of Levosalbutamol which could result in a higher serum level. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Lidocaine. |
| Liothyronine | Liothyronine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lisinopril | Lisinopril may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lithium carbonate | Trametinib may decrease the excretion rate of Lithium carbonate which could result in a higher serum level. |
| Lithium citrate | Lithium citrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lixisenatide | Trametinib may decrease the excretion rate of Lixisenatide which could result in a higher serum level. |
| Lofexidine | Lofexidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lopinavir | Lopinavir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Loracarbef | Loracarbef may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lorazepam | Lorazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lorcaserin | Lorcaserin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lornoxicam | Lornoxicam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lorpiprazole | Trametinib may decrease the excretion rate of Lorpiprazole which could result in a higher serum level. |
| Loxoprofen | Loxoprofen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lubiprostone | Lubiprostone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Lumiracoxib | Lumiracoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Macitentan | Trametinib may decrease the excretion rate of Macitentan which could result in a higher serum level. |
| Magnesium carb | Trametinib may decrease the excretion rate of Magnesium carbonate which could result in a higher serum level. |
| Magnesium chloride | Trametinib may decrease the excretion rate of Magnesium chloride which could result in a higher serum level. |
| Magnesium hydro | Trametinib may decrease the excretion rate of Magnesium hydroxide which could result in a higher serum level. |
| Magnesium trisil | Trametinib may decrease the excretion rate of Magnesium trisilicate which could result in a higher serum level. |
| Mangafodipir | Mangafodipir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mannitol | Mannitol may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Maprotiline | Maprotiline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mecamylamine | Mecamylamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Meclofenamic acid | Meclofenamic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Medroxyprogeste | Medroxyprogesterone acetate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mefenamic acid | Mefenamic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Megestrol acetate | Megestrol acetate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Meloxicam. |
| Memantine | Memantine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Meperidine | Meperidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Mepivacaine. |
| Meropenem | Meropenem may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mesalazine | Mesalazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metamfetamine | Metamfetamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metamizole | Metamizole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metaxalone | Metaxalone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metformin | Metformin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methadone | Methadone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methazolamide | Methazolamide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Methimazole | Methimazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methotrexate | Methotrexate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methoxsalen | Methoxsalen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methoxy polyethyl | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Trametinib. |
| Methyldopa | Methyldopa may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methylene blue | Trametinib may decrease the excretion rate of Methylene blue which could result in a higher serum level. |
| Methylnaltrexone | Methylnaltrexone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Methyltestosterone | Methyltestosterone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Meticrane | Meticrane may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoclopramide | Metoclopramide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metolazone | Metolazone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Metoprolol | Metoprolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Metyrapone | Metyrapone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Midazolam | Midazolam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Migalastat | Migalastat may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Milnacipran | Milnacipran may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Milrinone | Milrinone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mirabegron | Mirabegron may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Moxisylyte | Trametinib may decrease the excretion rate of Moxisylyte which could result in a higher serum level. |
| Muzolimine | Muzolimine may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Mycophenolate mof | Mycophenolate mofetil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Mycophenolic acid | Mycophenolic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| N-acetyltyrosine | Trametinib may decrease the excretion rate of N-acetyltyrosine which could result in a higher serum level. |
| Nabumetone | Nabumetone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nadolol | Nadolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Naldemedine | Trametinib may decrease the excretion rate of Naldemedine which could result in a higher serum level. |
| Nalmefene | Nalmefene may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Naloxone | Naloxone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Naproxen | Naproxen may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nateglinide | Nateglinide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nedaplatin | Trametinib may decrease the excretion rate of Nedaplatin which could result in a higher serum level. |
| Nedocromil | Nedocromil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nefazodone | Nefazodone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Neomycin | Trametinib may decrease the excretion rate of Neomycin which could result in a higher serum level. |
| Netilmicin | Trametinib may decrease the excretion rate of Netilmicin which could result in a higher serum level. |
| Nicorandil | Trametinib may decrease the excretion rate of Nicorandil which could result in a higher serum level. |
| Nifedipine | Nifedipine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nilutamide | Nilutamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nimesulide | Nimesulide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nisoldipine | Nisoldipine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nitric Oxide | Nitric Oxide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nitrofurantoin | Nitrofurantoin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Nitroprusside | Nitroprusside may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Octinoxate | Trametinib may decrease the excretion rate of Octinoxate which could result in a higher serum level. |
| Olsalazine | Olsalazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Opium | Trametinib may decrease the excretion rate of Opium which could result in a higher serum level. |
| Oseltamivir | Oseltamivir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxacillin | Oxacillin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxaprozin | Oxaprozin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxazepam | Oxazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Oxetacaine. |
| Oxybenzone | Oxybenzone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Oxybuprocaine. |
| Oxyphenbutazone | Oxyphenbutazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Oxyquinoline | Trametinib may decrease the excretion rate of Oxyquinoline which could result in a higher serum level. |
| Paliperidone | Paliperidone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Palonosetron | Palonosetron may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pamidronic acid | Pamidronic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pantoprazole | Pantoprazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Parecoxib | Parecoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Paromomycin | Paromomycin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Patent Blue | Trametinib may decrease the excretion rate of Patent Blue which could result in a higher serum level. |
| Pegaptanib | Pegaptanib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Trametinib. |
| Pemetrexed | Trametinib may decrease the excretion rate of Pemetrexed which could result in a higher serum level. |
| Penbutolol | Penbutolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pentaerythritol tet | Pentaerythritol tetranitrate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pentamidine | Pentamidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pentastarch | Trametinib may decrease the excretion rate of Pentastarch which could result in a higher serum level. |
| Pentetic acid | Trametinib may decrease the excretion rate of Pentetic acid which could result in a higher serum level. |
| Pentobarbital | Pentobarbital may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pentostatin | Trametinib may decrease the excretion rate of Pentostatin which could result in a higher serum level. |
| Pentoxifylline | Pentoxifylline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Perindopril | Perindopril may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Permethrin | Permethrin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Phenazopyridine | Phenazopyridine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Phenelzine | Phenelzine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Phenol. |
| Phentolamine | Phentolamine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Phenylbutazone | Phenylbutazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pholcodine | Trametinib may decrease the excretion rate of Pholcodine which could result in a higher serum level. |
| Phosphoric acid | Trametinib may decrease the excretion rate of Phosphoric acid which could result in a higher serum level. |
| Phylloquinone | Phylloquinone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Picosulfuric acid | Trametinib may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. |
| Pindolol | Pindolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Piperacillin | Piperacillin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Piracetam | Trametinib may decrease the excretion rate of Piracetam which could result in a higher serum level. |
| Piretanide | Piretanide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Piroxicam | Piroxicam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pitolisant | Trametinib may decrease the excretion rate of Pitolisant which could result in a higher serum level. |
| Plazomicin | Trametinib may decrease the excretion rate of Plazomicin which could result in a higher serum level. |
| Plerixafor | Plerixafor may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Polythiazide | Polythiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Pomalidomide | Pomalidomide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Potassium | Potassium may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium acetate | Trametinib may decrease the excretion rate of Potassium acetate which could result in a higher serum level. |
| Potassium bicarbo | Trametinib may decrease the excretion rate of Potassium bicarbonate which could result in a higher serum level. |
| Potassium cation | Potassium cation may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium chloride | Potassium chloride may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Potassium citrate | Potassium citrate may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Potassium nitrate | Trametinib may decrease the excretion rate of Potassium nitrate which could result in a higher serum level. |
| Potassium perchlorate | Trametinib may decrease the excretion rate of Potassium perchlorate which could result in a higher serum level. |
| Potassium sulfate | Trametinib may decrease the excretion rate of Potassium sulfate which could result in a higher serum level. |
| Pralatrexate | Pralatrexate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pralidoxime | Pralidoxime may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pramipexole | Pramipexole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Pramocaine. |
| Prasugrel | Prasugrel may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Prednisone | Prednisone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pregabalin | Pregabalin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Prilocaine. |
| Probenecid | Probenecid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Procainamide | Trametinib may decrease the excretion rate of Procainamide which could result in a higher serum level. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Procaine. |
| Procaine benzyl | Trametinib may decrease the excretion rate of Procaine benzylpenicillin which could result in a higher serum level. |
| Promethazine | Promethazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Propantheline | Propantheline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Proparacaine. |
| Propiverine | Trametinib may decrease the excretion rate of Propiverine which could result in a higher serum level. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Propoxycaine. |
| Propranolol | Propranolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Prucalopride | Prucalopride may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pyrantel | Trametinib may decrease the excretion rate of Pyrantel which could result in a higher serum level. |
| Pyrazinamide | Pyrazinamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Pyridoxine | Pyridoxine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Quetiapine | Quetiapine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Quinethazone | Quinethazone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Quinidine | Trametinib may decrease the excretion rate of Quinidine which could result in a higher serum level. |
| Rabeprazole | Rabeprazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ramelteon | Ramelteon may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ranitidine | Ranitidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ranolazine | Ranolazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Rasagiline | Rasagiline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Reserpine | Reserpine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Resorcinol | Trametinib may decrease the excretion rate of Resorcinol which could result in a higher serum level. |
| Ribavirin | Ribavirin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ribostamycin | Trametinib may decrease the excretion rate of Ribostamycin which could result in a higher serum level. |
| Rivaroxaban | Rivaroxaban may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Rizatriptan | Rizatriptan may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Rofecoxib | Rofecoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Roflumilast | Roflumilast may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Ropivacaine. |
| Rosiglitazone | Rosiglitazone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ruxolitinib | Ruxolitinib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sacubitril | Trametinib may decrease the excretion rate of Sacubitril which could result in a higher serum level. |
| Salbutamol | Salbutamol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Salicylamide | Salicylamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Salicylic acid | Salicylic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Salmon calcitonin | Salmon calcitonin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Salsalate | Salsalate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Saxagliptin | Saxagliptin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Secobarbital | Secobarbital may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Selenious acid | Trametinib may decrease the excretion rate of Selenious acid which could result in a higher serum level. |
| Selenium | Trametinib may decrease the excretion rate of Selenium which could result in a higher serum level. |
| Sibutramine | Sibutramine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sitagliptin | Sitagliptin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sodium acetate | Trametinib may decrease the excretion rate of Sodium acetate which could result in a higher serum level. |
| Sodium aurothi | Trametinib may decrease the excretion rate of Sodium aurothiomalate which could result in a higher serum level. |
| Sodium fluoride | Trametinib may decrease the excretion rate of Sodium fluoride which could result in a higher serum level. |
| Sodium sulfate | Trametinib may decrease the excretion rate of Sodium sulfate which could result in a higher serum level. |
| Sofosbuvir | Trametinib may decrease the excretion rate of Sofosbuvir which could result in a higher serum level. |
| Solriamfetol | Trametinib may decrease the excretion rate of Solriamfetol which could result in a higher serum level. |
| Sorafenib | Sorafenib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sorbitol | Sorbitol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Spironolactone | Spironolactone may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Stiripentol | Trametinib may decrease the excretion rate of Stiripentol which could result in a higher serum level. |
| Streptomycin | Trametinib may decrease the excretion rate of Streptomycin which could result in a higher serum level. |
| Strontium chloride | Trametinib may decrease the excretion rate of Strontium chloride which could result in a higher serum level. |
| Sucralfate | Sucralfate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sulbactam | Trametinib may decrease the excretion rate of Sulbactam which could result in a higher serum level. |
| Sulfadiazine | Sulfadiazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sulfamethoxazole | Sulfamethoxazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sulfasalazine | Sulfasalazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sulindac | Sulindac may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Sumatriptan | Sumatriptan may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Synthetic Conjug | Trametinib may decrease the excretion rate of Synthetic Conjugated Estrogens, A which could result in a higher serum level. |
| S Estrogens, B | Trametinib may decrease the excretion rate of Synthetic Conjugated Estrogens, B which could result in a higher serum level. |
| Tacrolimus | Tacrolimus may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tadalafil | Tadalafil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tamsulosin | Tamsulosin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tasimelteon | Trametinib may decrease the excretion rate of Tasimelteon which could result in a higher serum level. |
| Tech exametazime | Trametinib may decrease the excretion rate of Technetium Tc-99m exametazime which could result in a higher serum level. |
| Te mebrofenin | Trametinib may decrease the excretion rate of Technetium Tc-99m mebrofenin which could result in a higher serum level. |
| Tech oxidronate | Trametinib may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level. |
| Technetium Tc-99m | Trametinib may decrease the excretion rate of Technetium Tc-99m pyrophosphate which could result in a higher serum level. |
| Teduglutide | Teduglutide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tegafur | Trametinib may decrease the excretion rate of Tegafur which could result in a higher serum level. |
| Telavancin | Telavancin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Temazepam | Temazepam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Temozolomide | Temozolomide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tenofovir alafenamide | The serum concentration of Tenofovir alafenamide can be increased when it is combined with Trametinib. |
| Tenofovir disoproxil | Tenofovir disoproxil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tenoxicam | Tenoxicam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Terbutaline | Terbutaline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Testolactone | Testolactone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Testosterone | Testosterone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Testosterone cypionate | Trametinib may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level. |
| Testosterone en | Trametinib may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level. |
| Testosterone pro | Testosterone propionate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Testosterone unde | Trametinib may decrease the excretion rate of Testosterone undecanoate which could result in a higher serum level. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Trametinib is combined with Tetracaine. |
| Tetracycline | Tetracycline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tetradecyl hydroge | Trametinib may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level. |
| Thiabendazole | Thiabendazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Thiethylperazine | Thiethylperazine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tiaprofenic acid | Tiaprofenic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Ticlopidine | Ticlopidine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tiludronic acid | Tiludronic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Timolol | Timolol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tinidazole | Tinidazole may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tiopronin | Tiopronin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tiotropium | Tiotropium may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tirofiban | Tirofiban may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tixocortol | Trametinib may decrease the excretion rate of Tixocortol which could result in a higher serum level. |
| Tobramycin | Trametinib may decrease the excretion rate of Tobramycin which could result in a higher serum level. |
| Tocopherol | Trametinib may decrease the excretion rate of Tocopherol which could result in a higher serum level. |
| Tolazamide | Tolazamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolbutamide | Tolbutamide may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolcapone | Tolcapone may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolfenamic acid | Tolfenamic acid may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolmetin | Tolmetin may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolterodine | Tolterodine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tolvaptan | Tolvaptan may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Topiramate | Topiramate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Topotecan | Topotecan may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Torasemide | Torasemide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Tositumomab | Tositumomab may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tramadol | Tramadol may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Triamterene | Triamterene may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Triazolam | Triazolam may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trichlormethiazide | Trichlormethiazide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
| Triethylenetetramine | Triethylenetetramine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trifluridine | Trifluridine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trimebutine | Trametinib may decrease the excretion rate of Trimebutine which could result in a higher serum level. |
| Trimethoprim | Trimethoprim may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Trimetrexate | Trimetrexate may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Tropisetron | Trametinib may decrease the excretion rate of Tropisetron which could result in a higher serum level. |
| Vaborbactam | Trametinib may decrease the excretion rate of Vaborbactam which could result in a higher serum level. |
| Valaciclovir | Valaciclovir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Valbenazine | Trametinib may decrease the excretion rate of Valbenazine which could result in a higher serum level. |
| Valdecoxib | Valdecoxib may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Valganciclovir | Valganciclovir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Vancomycin | Trametinib may decrease the excretion rate of Vancomycin which could result in a higher serum level. |
| Varenicline | Varenicline may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Venlafaxine | Venlafaxine may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Verapamil | Verapamil may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Vilanterol | Trametinib may decrease the excretion rate of Vilanterol which could result in a higher serum level. |
| Viloxazine | Trametinib may decrease the excretion rate of Viloxazine which could result in a higher serum level. |
| Vortioxetine | Trametinib may decrease the excretion rate of Vortioxetine which could result in a higher serum level. |
| Warfarin | Trametinib may decrease the excretion rate of Warfarin which could result in a higher serum level. |
| Zaleplon | Zaleplon may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Zanamivir | Zanamivir may decrease the excretion rate of Trametinib which could result in a higher serum level. |
| Zonisamide | Zonisamide may increase the excretion rate of Trametinib which could result in a lower serum level and potentially a reduction in efficacy. |
Pregnancy and Lactation
AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned.
Pregnancy
Based on its mechanism of action and findings from animal reproduction studies, MEKINIST can cause fetal harm when administered to a pregnant woman. There is insufficient data on pregnant women exposed to MEKINIST to assess the risks. Trametinib was embryotoxic and abortifacient in rabbits at doses greater than or equal to those resulting in exposures approximately 0.3 times the human exposure at the recommended clinical dose. Advise pregnant women of the potential risk to the fetus.
Lactation
No information is available on the clinical use of trametinib during breastfeeding. Because trametinib is 97% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is 3.9 to 4.8 days and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during trametinib therapy and for 4 months after the last dose.
Why is this medication prescribed?
Trametinib is used alone or in combination with dabrafenib (Tafinlar) to treat a certain type of melanoma (a type of skin cancer) that cannot be treated with surgery or that has spread to other parts of the body. It is used in combination with dabrafenib to treat and prevent the return of a certain type of melanoma after surgery to remove it and any affected lymph nodes. Trametinib is also used in combination with dabrafenib to treat a certain type of non-small-cell lung cancer (NSCLC) that has spread to nearby tissues or to other parts of the body. It is used in combination with dabrafenib to treat a certain type of thyroid cancer that has spread to nearby tissues or to other parts of the body, which cannot be treated with other therapies. Trametinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps stop the spread of cancer cells.
How should this medicine be used?
Trametinib comes as a tablet to take by mouth. It is usually taken once a day on an empty stomach, at least 1 hour before or 2 hours after a meal. Take trametinib at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take trametinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Do not stop taking trametinib without talking to your doctor.
Your doctor may adjust your dose of trametinib depending on your response to treatment and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking trametinib,
- tell your doctor and pharmacist if you are allergic to trametinib, any other medications, or any of the ingredients in trametinib tablets. 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.
- tell your doctor if you have or have ever had lung disease or breathing problems; diabetes; bleeding problems or blood clots; colitis (inflammation of the colon); stomach problems; high blood pressure; heart, eye, liver, or kidney disease; or any other medical conditions.
- tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are taking trametinib. You should use birth control to prevent pregnancy during your treatment with trametinib and for 4 months after your final dose. Talk to your doctor about birth control methods that will work for you. If you become pregnant while taking trametinib, call your doctor. Trametinib may harm the fetus.
- tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking trametinib and for 4 months after your final dose.
- you should know that this medication may decrease fertility in women. Talk to your doctor about the risks of taking trametinib.
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, away from moisture and light, and out of the reach of children. Do not place the tablets in other containers, such as daily or weekly pill boxes. Store it in a refrigerator, but do not freeze it. Do not remove the desiccant (small packet included with medication to absorb moisture) from your bottle.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- vision problems
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before and during your treatment to see if it is safe for you to receive trametinib and to check your body’s response to trametinib. Your doctor will also check your skin for any changes before you begin treatment, every 2 months during your treatment, and for up to 6 months after treatment. Your doctor will also check your blood pressure from time to time as needed.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
References
