selumetinib at a glance
Medicine class
Selective MEK1 and MEK2 inhibitor
Main role
Symptomatic, inoperable plexiform neurofibromas associated with NF1
Granule administration
Open the capsule and sprinkle all granules onto a small amount of suitable soft food
Specialist oversight
Treatment is started and monitored by a clinician experienced in NF1-related tumours
What is selumetinib used for?
The granule product is licensed as monotherapy for:
Symptomatic plexiform neurofibromas that cannot be completely removed by surgery in people with neurofibromatosis type 1, for children aged 1 to under 7 years and older patients with swallowing difficulties.
How does selumetinib work?
Selumetinib selectively inhibits MEK1 and MEK2, enzymes in the RAF–MEK–ERK signalling pathway. This pathway can be overactive in NF1-associated tumours; inhibiting it reduces signals that support tumour-cell growth and survival.
selumetinib preparations and strengths
Capsule
Route: Oral
Strengths: 5 mg
How to take selumetinib
Follow the specialist prescription and illustrated pack leaflet carefully.
Open each capsule and sprinkle all its contents onto a small amount of smooth yoghurt, fruit sauce, fruit purée or jam.
Do not mix the granules with liquids, vegetable purée, grapefruit or products containing Seville orange.
Swallow the food mixture without chewing within 30 minutes. Do not store it for later.
Do not swallow or chew the capsule shell, and do not crush or chew the granules.
Keep the bottle tightly closed in its original container. Do not swallow or remove the desiccant.
selumetinib side effects
Common or expected effects
- Nausea, vomiting or diarrhoea
- Sore mouth or mouth ulcers
- Acne-like or other rash, dry skin and inflammation around the nails
- Hair thinning or colour changes
- Tiredness, weakness or fever
- Swelling of the hands or feet
- Changes in liver enzymes, muscle enzymes, haemoglobin or other blood-test results
Get urgent medical advice
- New blurred vision, loss of vision, floaters or other visual changes
- Breathlessness or leg, ankle or foot swelling that may indicate reduced heart function
- Severe or persistent diarrhoea or vomiting, particularly if unable to keep fluids down
- Severe or rapidly worsening skin or nail inflammation
selumetinib in pregnancy
Selumetinib is not recommended during pregnancy because human information is lacking and animal studies found harm to developing offspring. Pregnancy testing is recommended before treatment where relevant. Male and female patients of reproductive potential should use effective contraception during treatment and for at least one week afterwards. Hormonal contraception may be less reliable, so use an additional barrier method. Contact the specialist team promptly if pregnancy occurs.
selumetinib while breastfeeding
It is unknown whether selumetinib enters human milk, and a risk to a breastfed child cannot be excluded. Breastfeeding should be stopped during treatment; discuss feeding options with the specialist team.
selumetinib interactions
Give the specialist and pharmacist a complete list of prescribed, non-prescribed and herbal products. Important examples include:
Clarithromycin, oral ketoconazole and other strong CYP3A4 inhibitors
May increase selumetinib exposure and adverse effects, so concurrent use should generally be avoided.
Fluconazole, erythromycin, fluoxetine or omeprazole
May increase selumetinib exposure through CYP3A4 or CYP2C19 inhibition and require specialist review.
Rifampicin, carbamazepine, phenytoin and St John’s wort
May reduce selumetinib exposure and effectiveness, so concurrent use should be avoided.
Common questions about selumetinib
Answers are fully visible for fast scanning and source review.
Is selumetinib a chemotherapy medicine?
It is an antineoplastic targeted treatment called a MEK inhibitor rather than traditional cytotoxic chemotherapy.
Does selumetinib cure neurofibromatosis type 1?
No. It does not correct the genetic cause of NF1; it is used to control symptomatic plexiform neurofibromas that cannot be fully removed surgically.
Can selumetinib granule capsules be swallowed whole?
No. Open these capsules, place the granules on suitable soft food, and discard the empty shells.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.