Mekinist (Trametinib)

MEK Inhibitor for BRAF V600-Mutated Melanoma and Non-Small Cell Lung Cancer

Rx – Prescription Only ATC: L01EE01 MEK Inhibitor
Active Ingredient
Trametinib (as dimethyl sulfoxide)
Available Forms
Film-coated tablets, Powder for oral solution
Strengths
0.5 mg, 2 mg tablets; 0.05 mg/ml powder
Common Brands
Mekinist, Spexotras
Medically reviewed | Last reviewed: | Evidence level: 1A
Mekinist (trametinib) is a targeted cancer medicine known as a MEK inhibitor. It is used to treat BRAF V600 mutation-positive melanoma (skin cancer) and non-small cell lung cancer (NSCLC). Trametinib works by blocking specific proteins (MEK1 and MEK2) in the cancer cell signalling pathway that drives tumour growth. It is most commonly used in combination with dabrafenib, a BRAF inhibitor, and is available as film-coated tablets and a powder for oral solution. Mekinist is manufactured by Novartis and requires a prescription.
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Quick Facts About Mekinist

Active Ingredient
Trametinib
(as dimethyl sulfoxide)
Drug Class
MEK Inhibitor
Kinase Inhibitor
ATC Code
L01EE01
Antineoplastic Agent
Common Uses
Melanoma & NSCLC
BRAF V600 mutation-positive
Available Forms
Tablets & Powder
0.5 mg, 2 mg; 0.05 mg/ml
Prescription Status
Rx Only
Prescription required

Key Takeaways About Mekinist

  • Targeted cancer therapy: Mekinist specifically blocks MEK1 and MEK2 proteins in the RAS/RAF/MEK/ERK signalling pathway, which is overactive in BRAF V600-mutated cancers
  • BRAF testing is mandatory: A validated test must confirm the presence of a BRAF V600 mutation before treatment can begin, as Mekinist is only effective in tumours with this specific mutation
  • Often combined with dabrafenib: The combination of trametinib plus dabrafenib provides superior outcomes compared to either drug alone, including higher response rates and longer survival
  • Take on an empty stomach: Mekinist should be taken at least 1 hour before or 2 hours after food, as food reduces its absorption by approximately 24%
  • Regular monitoring required: Heart function, liver function, eye health, and skin should be monitored regularly during treatment due to the risk of serious adverse effects

What Is Mekinist and What Is It Used For?

Mekinist (trametinib) is a targeted cancer medicine that blocks the MEK1 and MEK2 proteins in the RAS/RAF/MEK/ERK cell signalling pathway. It is used to treat BRAF V600 mutation-positive unresectable or metastatic melanoma and, in combination with dabrafenib, for adjuvant melanoma treatment and BRAF V600 mutation-positive non-small cell lung cancer (NSCLC).

Trametinib belongs to a class of medicines known as MEK inhibitors (mitogen-activated protein kinase kinase inhibitors). The RAS/RAF/MEK/ERK pathway is one of the most important signalling cascades in human cells, controlling cell growth, division, and survival. In normal cells, this pathway is tightly regulated. However, in cancers that carry BRAF V600 mutations, the BRAF protein becomes permanently active, sending continuous growth signals through MEK1 and MEK2 to ERK1 and ERK2, driving uncontrolled tumour cell proliferation.

Trametinib is a reversible, highly selective allosteric inhibitor of MEK1 and MEK2. Unlike ATP-competitive inhibitors, trametinib binds to MEK at a site distinct from the ATP-binding site, preventing the activation and kinase activity of MEK without competing with ATP. This mechanism blocks the downstream phosphorylation of ERK1 and ERK2, effectively shutting down the aberrant signalling that drives cancer cell growth and survival in BRAF V600-mutated tumours.

Mekinist is approved for the following indications. In unresectable or metastatic melanoma, trametinib can be used as monotherapy or in combination with dabrafenib (a BRAF inhibitor) for adult patients whose tumours carry a BRAF V600 mutation. Clinical trials have demonstrated that the combination of trametinib plus dabrafenib produces significantly higher response rates, longer progression-free survival, and longer overall survival compared to either drug used alone. In the adjuvant treatment of melanoma, the combination of trametinib and dabrafenib is used after complete surgical resection in patients with Stage III BRAF V600 mutation-positive melanoma, reducing the risk of cancer recurrence. In non-small cell lung cancer (NSCLC), the combination of trametinib and dabrafenib is approved for adult patients with advanced NSCLC carrying a BRAF V600 mutation.

It is critically important that a validated BRAF V600 mutation test confirms the presence of this mutation before treatment with Mekinist is initiated. Approximately 40–50% of cutaneous melanomas harbour BRAF V600 mutations (with V600E being the most common, accounting for approximately 80–90% of BRAF mutations, followed by V600K). In NSCLC, BRAF V600 mutations are found in approximately 1–3% of cases. Trametinib is not effective in tumours without this mutation and should not be used in patients who have progressed on prior BRAF inhibitor therapy when used as monotherapy.

Good to know:

The combination of a MEK inhibitor (such as trametinib) with a BRAF inhibitor (such as dabrafenib) represents one of the most significant advances in melanoma treatment in recent decades. By targeting the same signalling pathway at two different points, this dual blockade approach achieves higher response rates and delays the development of drug resistance compared to single-agent therapy. The COMBI clinical trial programme demonstrated that this combination improved median overall survival to over 25 months in patients with metastatic BRAF V600-mutated melanoma.

What Should You Know Before Taking Mekinist?

Before starting Mekinist, your doctor must confirm a BRAF V600 mutation through validated testing. Inform your doctor about all your medical conditions, especially heart, liver, kidney, lung, and eye problems. Several serious adverse reactions are possible, including heart failure, retinal vein occlusion, and interstitial lung disease.

Contraindications

You should not take Mekinist if you are allergic to trametinib or any of the other ingredients in this medicine. If you have previously experienced an allergic reaction to trametinib, characterised by symptoms such as skin rash, swelling of the face or throat, or difficulty breathing, you must not take this medicine again. Inform your doctor about any known drug allergies before starting treatment.

Warnings and Precautions

Talk to your doctor before taking Mekinist if you have or have had any of the following conditions:

  • Heart problems – including heart failure, problems with the way your heart pumps blood, or a history of decreased left ventricular ejection fraction (LVEF). Trametinib can reduce LVEF and cause heart failure. Your heart function will be assessed before and during treatment.
  • Liver problems – Mekinist can cause liver enzyme elevations. Your liver function will be monitored through regular blood tests.
  • Kidney problems – kidney function should be monitored during treatment, as some patients may develop renal impairment.
  • Lung or breathing problems – including interstitial lung disease or pneumonitis. Mekinist can cause inflammation of the lungs, which may be serious. Report any new or worsening breathing symptoms immediately.
  • Eye problems – including retinal vein occlusion (RVO), retinal pigment epithelial detachment (RPED), or other visual disturbances. Regular eye examinations may be recommended.
  • Bleeding disorders – Mekinist can increase the risk of bleeding, including serious bleeding events. Tell your doctor if you are taking anticoagulants or have a bleeding disorder.
  • Skin problems – new primary cutaneous malignancies, including cutaneous squamous cell carcinoma and new primary melanoma, have been observed during treatment, particularly with the dabrafenib combination. Regular skin examinations are recommended.
  • Gastrointestinal conditions – gastrointestinal perforation and colitis have been reported. Seek immediate medical attention if you develop severe abdominal pain.
  • Muscle problems – rhabdomyolysis (serious breakdown of muscle tissue) has been reported. Report unexplained muscle pain, tenderness, or weakness to your doctor.
  • Inflammatory conditions – sarcoidosis and haemophagocytic lymphohistiocytosis (HLH) have been reported in patients receiving trametinib in combination with dabrafenib.
  • High tumour burden – tumour lysis syndrome (TLS) has been reported rarely. Your doctor may monitor you for signs of TLS if you have a high tumour burden.

Drug Interactions

Trametinib is not expected to have significant pharmacokinetic interactions with other medicines because it is not primarily metabolised by cytochrome P450 enzymes. However, certain interactions should be considered, particularly when Mekinist is used in combination with dabrafenib.

Drug Interactions with Mekinist (Trametinib)
Drug Severity Effect Recommendation
Dabrafenib Major (intended combination) Dual pathway blockade of RAS/RAF/MEK/ERK; dabrafenib increases trametinib exposure by approximately 23% Used together per protocol; monitor for increased toxicity including fever, skin reactions, and cardiac effects
Warfarin Moderate Potential for altered anticoagulant effect; trametinib may affect warfarin metabolism or displacement Monitor INR closely when starting or stopping Mekinist; dose adjustment of warfarin may be needed
CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir) Moderate When used with dabrafenib combination: CYP3A4 inhibitors increase dabrafenib levels, potentially increasing toxicity of the combination regimen Use with caution in combination therapy; monitor for increased side effects
CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenytoin) Moderate When used with dabrafenib combination: CYP3A4 inducers decrease dabrafenib levels, potentially reducing efficacy of the combination regimen Avoid concomitant use of strong CYP3A4 inducers with the dabrafenib combination; consider alternative medicines
Hormonal contraceptives Moderate When used with dabrafenib combination: dabrafenib is a CYP3A4 inducer that may reduce the effectiveness of hormonal contraceptives Use an alternative non-hormonal method of contraception during treatment and for at least 16 weeks after stopping

Pregnancy and Breastfeeding

Mekinist is not recommended during pregnancy. Animal studies have shown that trametinib can cause harm to the developing foetus, including foetal toxicity and teratogenic effects. If you are pregnant, think you may be pregnant, or are planning to become pregnant, you must inform your doctor before starting treatment. A pregnancy test should be performed before initiating Mekinist therapy.

Women of childbearing potential must use highly effective contraception during treatment with Mekinist and for at least 16 weeks after the last dose. If Mekinist is used in combination with dabrafenib, hormonal contraceptives may not be reliable because dabrafenib is a CYP3A4 inducer that can reduce the effectiveness of hormonal contraception. Therefore, an alternative non-hormonal method of contraception should be used.

It is not known whether trametinib is excreted in human breast milk. A risk to breastfed infants cannot be excluded. Breastfeeding should be discontinued during treatment with Mekinist and for at least 16 weeks after the last dose.

Trametinib may impair fertility in both men and women. In animal studies, adverse effects on male and female reproductive organs were observed. Male patients should be counselled about the potential risk to fertility before starting treatment. Men with female partners of childbearing potential should use effective contraception during treatment and for at least 16 weeks after the last dose.

BRAF V600 Mutation Testing Requirement:

Treatment with Mekinist must only be initiated after a validated test has confirmed the presence of a BRAF V600 mutation in the tumour. Using Mekinist in patients without this mutation will not provide clinical benefit and may expose the patient to unnecessary side effects. Your oncologist will arrange the appropriate molecular testing before treatment begins.

What Is the Correct Dosage of Mekinist?

The recommended dose of Mekinist for adults is 2 mg taken once daily, either as monotherapy or in combination with dabrafenib 150 mg twice daily. Mekinist must be taken on an empty stomach, at least 1 hour before or 2 hours after food, at the same time each day.

Always take Mekinist exactly as your doctor has told you. Do not change your dose or stop taking Mekinist without consulting your oncologist first. Treatment with Mekinist should be continued until disease progression or unacceptable toxicity occurs, or for up to 12 months in the adjuvant melanoma setting.

Adults

Monotherapy (Melanoma)

Recommended dose: 2 mg once daily

Continue treatment until disease progression or unacceptable toxicity. Dose reductions may be required for management of adverse reactions.

Combination with Dabrafenib (Melanoma and NSCLC)

Trametinib dose: 2 mg once daily

Dabrafenib dose: 150 mg twice daily (approximately 12 hours apart)

When used in combination, take trametinib at the same time as one of the dabrafenib doses. If disease progression occurs on the combination, do not continue trametinib as monotherapy.

Adjuvant Melanoma (Combination with Dabrafenib)

Trametinib dose: 2 mg once daily

Dabrafenib dose: 150 mg twice daily

Duration: Up to 12 months unless disease recurrence or unacceptable toxicity occurs.

Children and Adolescents

Mekinist is not recommended for use in patients under 18 years of age. The safety and efficacy of trametinib in children and adolescents have not been established. There are no data available from paediatric studies to support a dosing recommendation in this age group.

How to Take Mekinist

Mekinist must be taken on an empty stomach. Take the tablet at least 1 hour before or 2 hours after a meal. Food reduces the bioavailability of trametinib by approximately 24%, which may reduce its therapeutic effectiveness. Swallow the tablet whole with a full glass of water. Do not crush, break, or chew the tablets. Take Mekinist at approximately the same time each day to maintain consistent drug levels in your body.

For patients who cannot swallow tablets, Mekinist is also available as a powder for oral solution (Spexotras brand, 0.05 mg/ml after reconstitution). The oral solution should be prepared by a pharmacist and administered according to the instructions provided with the product.

Missed Dose

If you miss a dose of Mekinist and it is less than 12 hours until the time of the next scheduled dose, skip the missed dose and take the next dose at the regular time. If it is more than 12 hours before the next scheduled dose, take the missed dose as soon as you remember and then continue with the regular dosing schedule. Do not take a double dose to make up for a missed one.

Dose Adjustments for Side Effects

Your oncologist may need to reduce your dose, temporarily stop treatment, or permanently discontinue Mekinist based on the severity of side effects. The dose reduction levels are as follows:

Mekinist Dose Reduction Levels
Dose Level Trametinib Dose Notes
Starting dose 2 mg once daily Standard recommended dose
First reduction 1.5 mg once daily For Grade 2 or 3 adverse reactions
Second reduction 1 mg once daily If further reduction needed
Below 1 mg Discontinue Permanently discontinue if dose below 1 mg is required

Overdose

Overdose Warning:

If you take more Mekinist than you should, contact your doctor or emergency services immediately. There is no specific antidote for trametinib overdose. Treatment is supportive and symptomatic. The long elimination half-life of trametinib (3.9–5.7 days) means that symptoms of overdose may persist for an extended period. It is unlikely that haemodialysis would be effective, as trametinib is highly protein-bound (approximately 97.4%).

What Are the Side Effects of Mekinist?

The most common side effects of Mekinist include rash, diarrhoea, fatigue, peripheral oedema, nausea, and hypertension. Serious but less common side effects include heart failure, retinal vein occlusion, interstitial lung disease, and gastrointestinal perforation. Side effect profiles differ between monotherapy and combination therapy with dabrafenib.

Like all medicines, Mekinist can cause side effects, although not everybody gets them. Many side effects are manageable with dose adjustments and supportive care. Your oncologist will monitor you closely for side effects throughout treatment. Always report any new or worsening symptoms promptly.

Seek immediate medical attention if you experience:
  • Shortness of breath, cough, or chest pain (possible pneumonitis or heart failure)
  • Sudden vision changes, blurred vision, or loss of vision (possible retinal vein occlusion)
  • Severe abdominal pain (possible gastrointestinal perforation)
  • Unexplained muscle pain, tenderness, or weakness (possible rhabdomyolysis)
  • High fever (38°C/100.4°F or above), chills, severe shaking (possible febrile reaction)
  • Swelling of the legs or ankles, difficulty breathing when lying down (possible heart failure)
  • Severe skin reaction with widespread rash, blisters, or peeling skin

Mekinist Monotherapy Side Effects

Very Common

May affect more than 1 in 10 people

  • Hypertension (high blood pressure)
  • Haemorrhage (bleeding)
  • Cough
  • Shortness of breath (dyspnoea)
  • Diarrhoea
  • Nausea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Dry mouth
  • Rash, acne-like rash (acneiform dermatitis)
  • Facial redness (erythema)
  • Dry skin, itchy skin (pruritus)
  • Hair loss or thinning (alopecia)
  • Fatigue, weakness (asthenia)
  • Peripheral oedema (swelling of hands and feet)
  • Fever (pyrexia)
  • Abnormal liver function tests

Common

May affect up to 1 in 10 people

  • Folliculitis (skin infection around hair follicles)
  • Nail problems (paronychia, nail disorder)
  • Cellulitis
  • Pustular rash
  • Allergic reactions (hypersensitivity)
  • Dehydration
  • Blurred vision
  • Periorbital oedema (swelling around the eyes)
  • Left ventricular dysfunction (decreased heart pumping)
  • Bradycardia (slow heart rate)
  • Pneumonitis (lung inflammation)
  • Stomatitis (mouth ulcers)
  • Cracked or fissured skin
  • Palmar-plantar erythrodysaesthesia (hand-foot syndrome)
  • Facial swelling
  • Peripheral neuropathy (numbness or tingling)
  • Anaemia

Uncommon

May affect up to 1 in 100 people

  • Chorioretinopathy (fluid under the retina)
  • Papilloedema (swelling of the optic disc)
  • Retinal detachment
  • Retinal vein occlusion (RVO)
  • Heart failure
  • Gastrointestinal perforation
  • Colitis (inflammation of the colon)
  • Rhabdomyolysis (severe muscle breakdown)
  • Atrioventricular block (AV block)

Rare / Not Known

May affect up to 1 in 1,000 people or frequency cannot be estimated

  • Myocarditis (inflammation of the heart muscle)
  • Exfoliative dermatitis (severe skin peeling)
  • Tumour lysis syndrome

Additional Side Effects When Combined with Dabrafenib

When Mekinist is used in combination with dabrafenib, additional side effects may occur that are not typically seen with Mekinist monotherapy. These are primarily related to the effects of dabrafenib and the enhanced activity of the combination. The most notable additional effects include:

  • Fever (very common): Pyrexia is one of the most frequent side effects of the combination, often requiring temporary treatment interruption. Fever may be accompanied by chills, rigors, hypotension, and dehydration.
  • New primary skin cancers: Cutaneous squamous cell carcinoma, keratoacanthoma, and new primary melanoma have been observed. Regular dermatological examinations are essential.
  • Increased photosensitivity: Enhanced sun sensitivity requiring sun protection measures.
  • Pancreatitis: Inflammation of the pancreas has been reported with the combination.
  • Renal failure: Cases of acute kidney injury have been reported, often associated with fever and dehydration.
  • Hyperglycaemia: Elevated blood sugar levels, particularly in patients with pre-existing diabetes.
  • Haemophagocytic lymphohistiocytosis (HLH): A rare but serious condition involving excessive immune activation.
  • Sarcoidosis: Inflammatory granulomatous disease has been reported.

If you experience any side effects not listed here, or if any side effect becomes severe, contact your doctor or pharmacist. Reporting suspected side effects helps ensure ongoing monitoring of the medicine's benefit-risk balance.

How Should You Store Mekinist?

Store Mekinist tablets in the original packaging, protected from light and moisture. Keep the desiccant in the bottle. Before opening, no special temperature storage is required. After opening the bottle, store below 30°C and use within 30 days. Keep out of the reach and sight of children.

Proper storage of Mekinist is important to ensure the medicine remains effective throughout its shelf life. The film-coated tablets are supplied in a bottle with a child-resistant closure containing a desiccant. Follow these storage guidelines carefully:

  • Before opening the bottle: No special temperature storage conditions are required. Store in the original bottle to protect from light and moisture. Do not remove the desiccant from the bottle.
  • After opening the bottle: Store below 30°C. Use all tablets within 30 days of first opening the bottle. The desiccant must remain in the bottle throughout use to protect the tablets from moisture.
  • Keep out of reach of children: Store the medicine in a safe place where children cannot access it. Mekinist is a cancer medicine and poses a risk if accidentally ingested by a child.
  • Do not use after the expiry date: The expiry date is printed on the bottle label and outer carton. The expiry date refers to the last day of the stated month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help protect the environment from pharmaceutical contamination.

What Does Mekinist Contain?

Each Mekinist tablet contains the active substance trametinib (as trametinib dimethyl sulfoxide). The 0.5 mg tablets are yellow, oval-shaped, and marked “TT”. The 2 mg tablets are pink, round, and marked “LL”. The tablets contain standard pharmaceutical excipients.

Active Ingredient

The active substance is trametinib. Each 0.5 mg film-coated tablet contains trametinib dimethyl sulfoxide equivalent to 0.5 mg trametinib. Each 2 mg film-coated tablet contains trametinib dimethyl sulfoxide equivalent to 2 mg trametinib. The dimethyl sulfoxide salt form is used to improve the pharmaceutical properties of the drug substance.

Inactive Ingredients (Excipients)

The tablet core contains: mannitol (E421), microcrystalline cellulose (E460), hypromellose (E464), croscarmellose sodium, magnesium stearate (E572), sodium lauryl sulphate, and colloidal silicon dioxide (E551). These excipients serve various functions including as fillers, binders, disintegrants, lubricants, and flow agents.

Film Coating

The film coating contains: hypromellose (E464), titanium dioxide (E171), polyethylene glycol, and polysorbate 80 (E433). The 0.5 mg tablets additionally contain yellow iron oxide (E172), giving them their yellow colour. The 2 mg tablets additionally contain red iron oxide (E172) and yellow iron oxide (E172), giving them their pink colour.

Tablet Appearance

0.5 mg tablets: Yellow, modified oval (biconvex) film-coated tablets, approximately 7.3 mm long and 4.3 mm wide, debossed with “TT” on one side.

2 mg tablets: Pink, round (biconvex) film-coated tablets, approximately 5.6 mm in diameter, debossed with “LL” on one side.

Sodium Content

This medicine contains less than 1 mmol sodium (23 mg) per dose, meaning it is essentially “sodium-free”. This is relevant for patients on a sodium-restricted diet.

Frequently Asked Questions About Mekinist

The BRAF V600 mutation is a change in the BRAF gene that causes the BRAF protein to become permanently active, driving uncontrolled cancer cell growth through the RAS/RAF/MEK/ERK signalling pathway. Approximately 40–50% of cutaneous melanomas carry this mutation (V600E is the most common, followed by V600K). In non-small cell lung cancer, BRAF V600 mutations are found in approximately 1–3% of cases. Testing is mandatory before starting Mekinist because the drug specifically targets the downstream effects of this mutation. In tumours without a BRAF V600 mutation, Mekinist will not provide clinical benefit and may paradoxically activate the MAPK pathway, potentially worsening outcomes.

Mekinist is approved for use both as monotherapy and in combination with dabrafenib for unresectable or metastatic melanoma. However, for adjuvant melanoma and non-small cell lung cancer, it is only approved in combination with dabrafenib. Clinical evidence strongly supports the combination approach in all settings. The COMBI trials demonstrated that trametinib plus dabrafenib achieves significantly higher overall response rates (approximately 67% vs. 51% for dabrafenib alone), longer median progression-free survival (approximately 11 months vs. 8.8 months), and longer median overall survival (approximately 25.1 months vs. 18.7 months) compared to BRAF inhibitor monotherapy. The combination also delays resistance development by blocking the pathway at two points simultaneously.

Fever is a very common side effect, particularly when Mekinist is used in combination with dabrafenib (affecting approximately 50–70% of patients). If you develop a temperature of 38°C (100.4°F) or higher, contact your doctor immediately. They may advise you to temporarily stop both Mekinist and dabrafenib until the fever resolves. Antipyretic medications such as paracetamol (acetaminophen) or ibuprofen may be prescribed. Stay well hydrated, as fever combined with other side effects like diarrhoea can lead to dehydration and kidney problems. Do not restart treatment without your doctor's guidance, as dose adjustments may be necessary. In some cases, corticosteroids may be used for recurrent febrile episodes.

Mekinist is a targeted therapy, meaning it specifically inhibits MEK1 and MEK2 proteins in the RAS/RAF/MEK/ERK signalling pathway. This is fundamentally different from traditional chemotherapy, which kills all rapidly dividing cells indiscriminately, and from immunotherapy (such as checkpoint inhibitors like pembrolizumab or nivolumab), which works by enhancing the immune system's ability to recognise and destroy cancer cells. Targeted therapy with Mekinist typically produces faster tumour responses than immunotherapy but may have a more limited duration without combination therapy. Immunotherapy tends to produce more durable responses in the patients who respond. The choice between targeted therapy and immunotherapy depends on individual patient factors, tumour characteristics, and treatment goals, and is best discussed with your oncologist.

Mekinist may have a minor influence on the ability to drive and use machines. Side effects such as fatigue, dizziness, blurred vision, and other visual disturbances can impair your ability to drive safely or operate machinery. If you experience any of these symptoms, you should not drive until they resolve. Discuss with your doctor whether it is safe for you to drive during treatment. Be particularly cautious during the first weeks of treatment and after any dose changes, when new side effects are most likely to emerge.

Regular and comprehensive monitoring is essential during Mekinist treatment. Heart function should be assessed by echocardiography or MUGA scan before starting treatment, after approximately one month, and then every 2–3 months during treatment to detect any decrease in left ventricular ejection fraction. Blood tests should be performed regularly to monitor liver function (ALT, AST, bilirubin), kidney function (creatinine), blood counts, and blood glucose. Eye examinations are recommended if any visual symptoms occur, as retinal vein occlusion and other serious eye conditions have been reported. Skin examinations should be performed before starting, during, and for 6 months after stopping treatment, as new skin cancers can develop. Blood pressure should be monitored regularly, as hypertension is a very common side effect. Your oncologist will establish a personalised monitoring schedule based on your individual risk factors and treatment response.

References

This article is based on the following international medical guidelines and peer-reviewed sources. All medical claims have evidence level 1A, the highest quality of evidence based on systematic reviews of randomised controlled trials.

  1. European Medicines Agency (EMA). Mekinist (trametinib) – Summary of Product Characteristics. EMA product information database. Accessed January 2026.
  2. U.S. Food and Drug Administration (FDA). Mekinist (trametinib) – Prescribing Information. FDA drug label database. Accessed January 2026.
  3. Robert C, Grob JJ, Stroyakovskiy D, et al. Five-Year Outcomes with Dabrafenib plus Trametinib in Metastatic Melanoma. New England Journal of Medicine. 2019;381(7):626–636. doi:10.1056/NEJMoa1904059
  4. Long GV, Hauschild A, Santinami M, et al. Adjuvant Dabrafenib plus Trametinib in Stage III BRAF-Mutated Melanoma. New England Journal of Medicine. 2017;377(19):1813–1823. doi:10.1056/NEJMoa1708539
  5. Planchard D, Smit EF, Groen HJM, et al. Dabrafenib plus trametinib in patients with previously untreated BRAF V600E-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial. The Lancet Oncology. 2017;18(10):1307–1316. doi:10.1016/S1470-2045(17)30679-4
  6. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Melanoma: Cutaneous. Version 2.2025. NCCN.org.
  7. World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd list. Geneva: WHO; 2023.
  8. Flaherty KT, Infante JR, Daud A, et al. Combined BRAF and MEK inhibition in melanoma with BRAF V600 mutations. New England Journal of Medicine. 2012;367(18):1694–1703. doi:10.1056/NEJMoa1210093

Editorial Team

This article has been written and reviewed by the iMedic Medical Editorial Team, a group of licensed specialist physicians with expertise in oncology, clinical pharmacology, and internal medicine.

Medical Writers

Board-certified physicians specialising in oncology and clinical pharmacology with documented academic and clinical experience in targeted cancer therapy.

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Independent review board ensuring clinical accuracy, adherence to international guidelines (EMA, FDA, NCCN, WHO), and evidence level 1A standards.

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