Severe rash & other skin reactions. Patients w/ additional risk factors for bleeding eg, brain metastases; who have progressed on prior BRAF inhibitor. Perform prompt ophth exam in patients reporting new or worsening visual disturbances; withhold treatment until visual symptoms improve to grade ≤1 if serious retinopathy is diagnosed. Evaluate left ventricular ejection fraction prior to, after 1st mth & at least every 3 mth or as clinically indicated until treatment discontinuation. Monitor liver value abnormalities prior to & mthly during treatment or as clinically indicated. Interrupt treatment if rhabdomyolysis is diagnosed & monitor creatine phosphokinase (CPK) levels; measure serum CPK & creatinine levels prior to & mthly during treatment. Avoid sun exposure. Concomitant use w/ medications increasing risk of bleeding eg, antiplatelet or anticoagulants; CYP3A inducers & inhibitors. May affect ability to drive & use machines. Hepatic & severe renal impairment. Women of childbearing potential should use effective contraception during & at least 3 mth after last dose. Not recommended during pregnancy. Lactation. Childn & adolescents <18 yr.
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