Drug Overview: Capmatinib is a kinase inhibitor drug approved by the FDA (food and drug administration) for the treatment of non-small cell lung cancer (NSCLC) in adults that has metastasized (spread) to different body parts. It is available commercially under the brand name "Tabrecta" in the form of oral tablets. Capmatinib is available in oral tablet form at 150 mg and 200 mg. Capmatinib works by inhibiting the enzyme tyrosine kinase by restricting the proto-oncogene c-MET (Mesenchymal epithelial transition) or HGFR (Hepatocyte growth factor receptor).
How Does the Capmatinib Drug Work?
Capmatinib inhibits the enzyme tyrosine kinase by restricting the proto-oncogene c-MET (Mesenchymal epithelial transition) or HGFR (Hepatocyte growth factor receptor). The overexpression and mutation of c-MET, a tyrosine kinase receptor, can lead to the growth, proliferation, and spread of tumor cells in different body parts. Capmatinib inhibits the phosphorylation process by specifically binding to the c-MET (Mesenchymal epithelial transition) proto-oncogene, thus causing the disturbance in the signal transduction pathway resulting in the death of the tumor cells overexpressing the c-MET.
Uses of Capmatinib Drug:
-
Capmatinib is available in tablet form and is taken orally with or without a meal.
-
The doctor prescribed the initial dose of 400 mg twice daily (two 200 mg tablets consumed at once) for 28 days to manage non-small cell lung cancer (NSCLC) in adults.
-
The doctor can adjust or modify the dose to 300 mg, followed by 200 mg twice daily, based on the patient's tolerability of the drug.
-
It is recommended to taper the drug from 400 mg to 300 mg twice daily (two 150 mg tablets consumed at once) initially, followed by a second dose tapering to 200 mg tablet (one 200 mg tablet consumed at once) twice daily for 28 days.
Doses:
The drug Capmatinib is available in the form of oral tablets in two doses that are 200 mg and 150 mg tablets, that can be taken with or without food.
Warnings:
-
Risk of Pneumonitis or Interstitial Lung Diseases: There is an increased risk of lung tissue inflammation in patients under Capmatinib. Pneumonitis (lung tissue inflammation) symptoms like cough, difficulty breathing, and fever are observed in a few patients under the drug Capmatinib.
-
Risk of Hepatotoxicity: Capmatinib causes an increase in the enzyme alanine aminotransferase or bilirubin in a few patients, according to clinical research. It is advised to use the drug cautiously in patients with liver disease.
-
Risk of Photosensitivity Reactions: According to animal studies, Capmatinib increases the risk of ultraviolet light sensitivity reactions. It is advised for the patients to avoid much ultraviolet light exposure or to use sun shield lotions while under treatment with the drug Capmatinib.
-
Risk of Fetal Toxicity: According to the research, Capmatinib can harm the fetus when given to pregnant women. It is recommended for women to take contraceptive measures while on the drug Capmatinib and till one week after the completion of the drug schedule.
-
Risk in Lactating mothers: Breastfeeding mothers are advised not to breastfeed while under treatment with Capmatinib until one week after the completion of the last drug scheduled.
For Patients:
What Is Non-small Cell Lung Cancer?
Non-small cell lung cancer is the most prevalent type of lung cancer affecting the tissues of the lungs. Non-small cell lung cancers have three variants that are:
-
Adenocarcinoma: It generally involves the outer layer of the lungs and is more commonly seen in people who are chronic smokers. In a few instances, it can also be seen in non-smokers.
-
Squamous Cell Carcinoma: It usually involves the central part of the lungs. It is most commonly found in chronic smokers.
-
Large Cell Carcinoma: It can involve any part of the lungs and is very aggressive as it spreads and grows quickly.
Learn More About Capmatinib:
When and Why to Take Capmatinib Medication?
-
Patients diagnosed with metastatic non-small cell lung carcinoma (NSCLC) with mesenchymal-epithelial transition after thorough clinical and radiographic examination and after running other diagnostic tests are prescribed Capmatinib medication by the doctor. It is prescribed in specific doses of 400 mg twice daily for 28 days with or without food, based on the patient's condition. The drug dose can be tapered by the doctor initially to 300 mg, followed by a 150 mg dosage based on the patient's tolerability.
-
Capmatinib has proven effective in managing non-small cell lung carcinoma (NSCLC) metastasizing in adult patients.
How Effective Is Capmatinib Against Non-small Cell Lung Carcinoma?
The drug Capmatinib has been proven to be effective in adult patients in whom metastasis of small lung carcinoma is seen. Capmatinib works by preventing the mutation and over-expression of the proto-oncogene c-MET (mesenchymal, endothelial transition), a tyrosine kinase receptor, thereby disrupting the signal transduction mechanism in the death of tumor cells. It prevents cancer cell growth, proliferation, and spread to different body parts.
Things to Inform The Doctor Before They Prescribe Capmatinib:
-
Inform the doctor if allergic to any drug.
-
In case of any history of systemic diseases like diabetes, liver disease, or renal disease, inform the doctor about it.
-
Pregnant and breastfeeding mothers should notify the doctor of their health before starting the drug.
-
Women who are planning pregnancy should tell the doctor before taking the drug.
-
Patients under any medication for any condition should notify the doctor of their ongoing and previous medicines.
-
Tell the doctor if undergone any recent or previous surgeries.
Starting Capmatinib Medications:
How to Take Capmatinib?
-
To prevent metastasis of non-small cell lung carcinoma, the drug Capmatinib should be taken at 400 mg twice daily for 28 days with or without food based on the drug schedule as prescribed by the doctor.
-
Drug modification or dose tapering can be done by the doctor based on the patient's symptoms and tolerability of the drug.
-
Take the tablet whole; it is advised not to crush, split, or chew it.
Things to Do After Starting Capmatinib
-
In case of any side effects develop, like shortness of breath or pneumonitis after taking the drug Capmatinib, should be informed by the doctor immediately so that dose modifications and tapering can be done by the doctor based on the symptoms.
-
Improvement in the symptoms should be reported to the doctor during the follow-up visits.
-
Do not stop the drug abruptly in between without informing the doctor.
-
Keep track of the improvement in health conditions.
Look Out for the Side Effects:
Common side effects due to Capmatinib:
-
Nausea and vomiting.
-
Confusion.
-
Tiredness.
-
Weakness or lethargy.
-
Dark color urine.
-
Yellowish discoloration of skin or white part of the eyes.
-
Weight loss due to loss of appetite.
-
Changes in stool color (light-colored).
Serious side effects:
-
Swelling in the abdominal area.
-
Cough.
-
Fever.
-
Shortness of breath.
The severe side effects indicate swelling of the lung tissues (Pneumonitis). The drug Capmatinib also carries many other side effects. Any side effects noticed should be reported to the doctor immediately.
Dietary Alterations:
The drug Capmatinib can be taken with or without food. However, consuming a more fat-containing meal can alter the area under the graph (AUC).
What Should Be Done if Forgot a Dose?
It is advised not to overdose or double the drug dose to compensate for the missed dose. Try to take the dose as soon as remembered. If it's time for the next one, take it as a regular schedule and follow the normal schedule from the next day.
What Should Be Done in Case of Capmatinib Overdose?
In case of a Capmatinib drug overdose, inform the doctor immediately and call the poison control helpline.
How to Store Capmatinib?
Capmatinib should be stored at room temperature between 20 to 25-degree celsius. It should be kept away from moisture.
Avoid Self-Prescription:
The drug Capmatinib should be started under a doctor's supervision. After performing the diagnostic tests, the doctor prescribes the drug dosage and schedule based on the patient's clinical history and symptoms.
Staying On Capmatinib:
-
It is advised to take the drug in actual dosage and frequency as prescribed by the doctor.
-
In case of any missed dose, inform the doctor immediately.
-
In case there is a worsening of the symptoms, tell the doctor.
-
If there is an improvement in the health conditions, update the doctor during the follow-up visits.
For Doctors:
Indications:
The Drug Capmatinib is indicated in adult patients with metastatic (spread to different body parts) non-small cell lung carcinoma.
Pharmacology:
Mechanism of Action:
The drug Capmatinib is a tyrosine kinase enzyme inhibitor, and it acts by restricting the overexpression of the proto-oncogene c-MET (mesenchymal, endothelial transition). This tyrosine kinase enzyme disrupts the signal transduction resulting in the death of the tumor cells. It thereby causes restriction of growth, proliferation, and mutation of the tumor cells.
Pharmacodynamics:
The overexpression of c-MET, a tyrosine kinase receptor enzyme involved in the progression and mutation of the cancer cells in non-small cell lung carcinoma. The drug Capmatinib inhibits this overactivity of c- MET (mesenchymal, endothelial transition), thereby inhibiting the mutation and overgrowth of the tumor cells.
Chemical Taxonomy:
Ingredients:
Active Ingredient: The only active ingredient is Capmatinib, available in tablet form.
Inactive Ingredients:
-
Silicon dioxide.
-
Crospovidone.
-
Magnesium stearate.
-
Mannitol.
-
Microcrystalline cellulose.
-
Sodium lauryl sulfate.
-
Ferric oxide.
-
Polyethylene glycol.
-
Titanium dioxide.
-
Povidone.
Absorption:
- The plasma concentration of Capmatinib is achieved in 2 hours following the intake of oral tablets.
- The drug Capmatinib has an oral bioavailability of more than seventy percent.
Distribution:
The distribution volume of the drug Capmatinib achieves its steady state at 164 L.
Metabolism:
The drug Capmatinib undergoes metabolism by CYP3A4 and aldehyde oxidase.
Elimination:
- The drug is eliminated through feces (around 42 percent) and urine (approximately 22 percent).
- The half-life for the elimination of Capmatinib is around 6.5 hours.
Toxicity:
The side effects of an overdose of Capmatinib are not much known; however, the chances of fetal toxicity are seen according to other clinical research.
Warning and Precautions:
-
Capmatinib has shown severe adverse effects in patients with interstitial lung disease, so it should be used cautiously in such patients.
-
An increase in alanine aminotransferase enzyme and bilirubin is seen in patients with liver disease, so caution should be taken in patients with liver disease by continuous monitoring of the liver profile of the patient when under the drug Capmatinib.
-
Capmatinib is toxic to the fetus, so it should be avoided in pregnant and breastfeeding mothers.
Doses and Forms:
The drug Capmatinib is available in the form of oral tablets in the dosage of 200 mg and 150 mg.
Administration of the Drug:
-
Capmatinib is prescribed by the doctor at the dose of 400 mg twice daily for 28 days with or without food to treat non-small cell lung cancer in adult patients.
-
The doctor modified or tapered the drug dosage to 300 or 150 mg based on the patient's symptoms and tolerability.
Contraindications:
The drug Capmatinib is contraindicated in patients allergic to the drug.
Drug Interactions:
-
The metabolism of the drug Albendazole, Acyclovir, and Agomelatine is decreased when given in combination with Capmatinib.
-
When given in combination with Abametapir, the serum concentration of Capmatinib increases.
Other Specifications:
Capmatinib in Pregnant and Lactating Females:
Capmatinib is not indicated in lactating and pregnant women as it carries a risk of embryo-fetal toxicity, according to animal studies. However, there is much research needed in the field.
Capmatinib in Patients with Lungs Disease:
According to the research, Capmatinib carries a risk of fatal pneumonitis or interstitial lung disease. Patients on Capmatinib should be kept on regular monitoring for any adverse pulmonary symptoms.
Capmatinib in Pediatric Patients:
The risk of using Capmatinib in the pediatric population is yet unknown.
