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# Tabretap (Capmatinib) ## Overview Capmatinib is a tyrosine kinase inhibitor (TKI) that selectively targets the mesenchymal-epithelial transition (MET) receptor. It is an oral antineoplastic agent specifically indicated for tumors harboring MET exon 14 skipping alterations. ## Primary Indications Treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have a mutation leading to MET exon 14 skipping. ## Adult Dosing The recommended dosage is 400 mg orally twice daily. Medication should be taken without regard to food. Tablets must be swallowed whole and not crushed or chewed. If a dose is missed, skip the dose and resume the next dose at the scheduled time. ## Pediatric Dosing Safety and efficacy have not been established in patients younger than 18 years. ## Dose Adjustments **Hepatic Impairment:** Avoid use in patients with severe hepatic impairment. No adjustment is required for mild or moderate impairment. **Renal Impairment:** No dose adjustment is required for mild or moderate impairment. The effect of severe renal impairment is unknown. **Toxicity:** If dose reduction is required due to adverse reactions, reduce to 300 mg twice daily, then 200 mg twice daily. Discontinue permanently if unable to tolerate 200 mg twice daily. ## Contraindications There are no formal contraindications; however, use caution in patients with pre-existing interstitial lung disease (ILD) or pneumonitis. ## Adverse Effects Common: Peripheral edema, nausea, fatigue, vomiting, dyspnea, and decreased appetite. Serious: Interstitial lung disease/pneumonitis (potentially fatal), hepatotoxicity, and photosensitivity. ## Key Drug Interactions * **Strong CYP3A inhibitors:** May increase plasma concentrations of capmatinib; monitor for increased toxicity. * **Strong CYP3A inducers:** May decrease plasma concentrations of capmatinib; avoid concomitant use. * **MATE1/MATE2-K substrates:** Capmatinib may increase concentrations of co-administered substrates (e.g., metformin). Monitor for increased toxicity. ## Monitoring * Baseline and periodic monitoring of liver function tests (ALT, AST, bilirubin). * Baseline and periodic monitoring of serum creatinine. * Monitor for new or worsening pulmonary symptoms (cough, dyspnea, fever) suggestive of pneumonitis. ## Clinical Pearls * **Photosensitivity:** Advise patients to limit direct sun exposure and use sun-protective measures (broad-spectrum sunscreen, protective clothing) during treatment. * **Pneumonitis:** Permanently discontinue the drug if ILD/pneumonitis is suspected. * **Administration:** If the patient cannot swallow the tablet, contact the pharmacist; however, crushing is not recommended due to stability and absorption profile. *** **Educational Disclaimer:** This information is provided for educational purposes only. Clinical guidelines and prescribing information can change frequently. Always verify the most current prescribing information via the manufacturer’s package insert or a clinical decision support system (e.g., Lexicomp, UpToDate) before prescribing or administering medication.