The use of Cobimetinib should strictly follow the indications and combination therapy regimen. It is mainly suitable for BRAFV600 mutation positive unresectable or metastatic melanoma and needs to be used in combination with Vimafenib. The specific dosage and administration method need to be adjusted according to the patient's situation.

1. Conventional usage and dosage

(1) Standard dose: 60mg each time (3 20mg tablets), taken orally once a day, continuously taken for 21 days and stopped for 7 days, forming a 28 day cycle.

(2) Combination therapy: It needs to be used in combination with Vimafenib. The dose of Vimafenib is 960 milligrams twice a day, and the two drugs need to be used simultaneously.

(3) Duration of treatment: Treatment should continue until disease progression or intolerable toxic reactions occur.

2 Precautions for administration

(1) Medication time: It is recommended to take it at a fixed time every day, either with food or on an empty stomach.

(2) Whole tablet ingestion: Do not crush, chew or divide the tablet, use sufficient water to administer.

(3) Omission treatment: If the missed dose exceeds 12 hours, the dose should be skipped and cannot be supplemented or doubled.

3 Principles of Dose Adjustment

(1) Reduction plan: Reduce to 40mg once daily for the first time and 20mg once daily for the second time.

(2) Toxicity management: In case of grade 3 or above adverse reactions, medication should be temporarily suspended and resumed according to the reduction plan after recovery.

(3) Permanent discontinuation of medication: Discontinue treatment when unable to tolerate a dose of 20 milligrams or when specific ocular toxicity occurs.

4. Medication for special populations

(1) Liver dysfunction: Mild damage does not require adjustment, moderate to severe damage requires careful use and close monitoring.

(2) Renal insufficiency: Mild to moderate damage does not require adjustment, and there is no data support for end-stage renal disease patients.

(3) Elderly patients: Those aged 65 and above do not need to adjust the dosage, but it is necessary to strengthen the monitoring of adverse reactions.