Key takeaways
- Koselugo (selumetinib) is given twice per day, 12 hours apart. For both adults and children, the specific dosage prescribed will depend on the person’s height and weight.
- Koselugo comes in two oral forms: capsules to be swallowed whole and granules meant to be sprinkled over soft food.
- If you or your child has trouble swallowing pills, Koselugo granules may be a better option.
The dosage dosage is based on your child’s body surface area (BSA). This is a calculation, expressed in square meters (m2), based on your child’s height and weight.
Koselugo is available in two forms: an oral capsule and oral granules meant to be sprinkled over soft food.
Note: Koselugo granules come in capsules that are meant to be split open to reveal the contents inside. Unlike standard Koselugo capsules, the granule capsules are printed with an image to indicate that they should be opened.
Koselugo capsules comes in two strengths: 10 milligrams (mg) and 25 mg.
Koselugo granules also come in two strengths: 5 mg and 7.5 mg.
The following table highlights the basics of Koselugo’s dosage to treat PN in adults and children ages 1 year and older with neurofibromatosis type 1 (NF1). Doses should be taken 12 hours apart.
Koselugo capsule dosage
| BSA | Koselugo capsule dosage |
|---|---|
| 0.55 to 0.69 m2 | 30 mg daily, as follows: • morning: 20 mg • evening: 10 mg |
| 0.70 to 0.89 m2 | 20 mg twice daily |
| 0.90 to 1.09 m2 | 25 mg twice daily |
| 1.10 to 1.29 m2 | 30 mg twice daily |
| 1.30 to 1.49 m2 | 35 mg twice daily |
| 1.50 to 1.69 m2 | 40 mg twice daily |
| 1.70 to 1.89 m2 | 45 mg twice daily |
| greater than or equal to 1.90 m2 | 50 mg twice daily |
Koselugo granules dosage
| BSA | Koselugo capsule dosage |
|---|---|
| 0.40 to 0.59 m2 | 12.5 mg twice daily |
| 0.60 to 0.69 m2 | 15 mg twice daily |
| 0.70 to 0.89 m2 | 20 mg twice daily |
| 0.90 to 1.09 m2 | 25 mg twice daily |
| 1.10 to 1.29 m2 | 30 mg twice daily |
| 1.30 to 1.49 m2 | 35 mg twice daily |
| 1.50 to 1.69 m2 | 40 mg twice daily |
| 1.70 to 1.89 m2 | 45 mg twice daily |
| greater than or equal to 1.90 m2 | 50 mg twice daily |
Koselugo should be taken approximately 12 hours apart. Keep reading for specific details about how to take Koselugo capsules vs. granules.
Taking Koselugo capsules
Koselugo capsules should be taken:
- with or without food
- swallowed whole with water (not chewed, dissolved, or opened)
What to consider: If you or your child cannot swallow the capsules whole, consider speaking with your doctor about switching to the oral granules.
Taking Koselugo granules
Koselugo granules should be taken:
- sprinkled onto or mixed directly into a small amount (1 to 3 teaspoons) of soft food
- eaten within 30 minutes after mixing with food
Keep in mind: The individual granules should not be chewed or crushed.
What to do if you don’t take the full dose of Koselugo granules
If the full dose of Koselugo granules isn’t consumed within 30 minutes of mixing with food, throw away the remaining mixture and take the next dose at the scheduled time.
If you or your child consistently have dificulty finishing the Koselugo mixture, try the following:
- reducing the amount of food you mix with Koselugo, so it’s easier to eat in one sitting
- mixing with different soft foods to find one that’s easier to eat
- alternating between different safe foods to help prevent developing an aversion to any particular food
If you vomit after taking a dose, do not take an extra dose. Instead, wait to take your next dose at the scheduled time.
Koselugo is usually a long-term treatment. You and your child’s doctor can determine whether it’s safe and effective for your child.
If you agree that it is, your child likely will take it long term. Typically, they’ll continue Koselugo treatment until the disease progresses or Koselugo’s side effects become difficult to tolerate.
If a dose is missed, you can take it as soon as you remember — unless it’s within 6 hours of the next scheduled dose.
If it’s less than 6 hours until the next dose, skip the missed one and return to the normal schedule. Never “double up” on doses to make up for a missed dose.
You should not take more Koselugo than your doctor prescribes, as this can lead to harmful effects.
What to do in case your child takes too much Koselugo
Call your doctor right away if you think you’ve taken too much Koselugo. You can also call 800-222-1222 to reach Poison Help or use its online resource. But if the symptoms seem severe, immediately call 911 (or your local emergency number). Or go to the nearest emergency room.
If you or your child are preparing to start Koselugo, taking a few proactive steps can help you manage the treatment schedule safely and effectively:
- Discuss formulation options: Talk with your doctor about whether oral capsules or oral granules are the best fit for your or your child’s swallowing preferences.
- Plan around meal schedules: For granules, consider establishing a daily routine to ensure each dose is taken around the time of day that your child is hungry.
- Prepare for potential dosage adjustments: Ask your healthcare team how Koselugo’s side effects — like skin rash or diarrhea — are managed and whether temporary dose reductions may be necessary.
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