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Cabometyx

Cabometyx

(cabozantinib)

Cabometyx (Cabozantinib) belongs to the group of cancer-fighting medications known as antineoplastics and more specifically to a class of medications called tyrosine kinase inhibitors. Cabometyx (Cabozantinib) works by blocking signals that allow cancer cells to grow and divide and it also helps to block the growth of new blood vessels in the area of the tumour.

Available form

Dosage

Tablet

20MG

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Cabometyx information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

The recommended dose of Cabometyx (Cabozantinib) is 60 mg taken by mouth, once daily. Cabometyx (Cabozantinib) needs to be taken on an empty stomach. Take it one hour before eating or two hours after eating. Swallow the tablets whole. Do not chew or crush the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Cabometyx (Cabozantinib) exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Cabometyx (Cabozantinib) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Cabometyx (Cabozantinib). If you are concerned about side effects, discuss the risks and benefits of Cabometyx (Cabozantinib) with your doctor.

The following side effects have been reported by at least 1% of people taking Cabometyx (Cabozantinib). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

changed sense of taste
Constipation
cough
decreased appetite
Diarrhea
dizziness
Dry Mouth
dry skin
fatigue
hair loss
hand-foot skin reaction (e.g., redness, blisters, and pain on the palms of hands or soles of feet)
headache
heartburn
hoarseness
mouth sores or mouth pain
muscle spasms
nausea
pain in arms, legs, and joints
signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heartbeat, lack of coordination, thirst, confusion)
stomach pain
trouble sleeping
vomiting
weakness
weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

dehydration (e.g., headache, thirst, loss of appetite, tiredness, weakness, dark or decreased urine)
difficulty speaking
fainting
fluid build-up in the abdomen (e.g., rapid weight gain, abdominal pain, shortness of breath)
jaw pain
high blood pressure (e.g., headache, vision changes, nausea, vomiting)
rash or skin redness
shortness of breath
signs of Anemia (e.g., fatigue, pale skin, shortness of breath, loss of energy, weakness)
signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (chest pain, coughing up blood, shortness of breath)
signs of decreased Thyroid function (e.g., constipation, dry skin, tiredness, weight gain, sensitive to the cold)
signs of fluid build-up around the lungs (e.g., chest pain, cough, hiccups, rapid breathing)
signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
signs of low electrolyte levels (e.g., muscle spasms or weakness, tingling or numbness, tiredness, twitching, or memory loss)
sudden, severe pain in the back, chest, or abdomen
swelling in the hands, feet, or face
symptoms of a fistula (e.g., anal bleeding, pain with bowel movements, Fever, chills, foul smelling discharge from the anus)
symptoms of irregular heartbeat (e.g., chest pain; dizziness; rapid, pounding heartbeat; shortness of breath)
wounds that do not heal

Stop taking the medication and seek immediate medical attention if any of the following occur:

Aneurysm (weakened blood vessel; cough, coughing up blood, sharp unexpected pain, hoarseness, unusual sensation in chest or abdomen)
decreased brain function due to liver problems (e.g., change in alertness, confusion, mood or personality changes, changes in sleep, loss of consciousness)
seizures
signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)
signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
signs of reversible posterior leukoencephalopathy syndrome (e.g., headache, seizures, weakness, confusion, high blood pressure, vision changes, difficulty thinking clearly)
symptoms of severely increased blood pressure (e.g., chest pain, blurred vision, dizziness, excessive tiredness, headache, stronger or faster heartbeat)
symptoms of blood clot in the lungs (difficulty breathing, sharp chest pain that is worse when breathing in, coughing, coughing up blood, sweating, or passing out)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Cabometyx (Cabozantinib).

There may be an interaction between Cabometyx (Cabozantinib) and any of the following:

abacavir
Abiraterone
Aliskiren
antiarrhythmics (e.g., Amiodarone, Disopyramide, dofetilide, Dronedarone, procainamide, quinidine, Sotalol)
Apalutamide
Apixaban
Aprepitant
"azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
birth control
bisphosphonates (e.g., Alendronate, etidronate, Risedronate)
Bosentan
calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
Cholestyramine
Cobicistat
Colchicine
conivaptan
Deferasirox
Digoxin
diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
Enzalutamide
fexofenadine
grapefruit juice
HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
lamivudine
macrolide antibiotics (e.g., clarithromycin, erythromycin)
mifepristone
Modafinil
other protein kinase inhibitors (e.g., Crizotinib, Dabrafenib, Dasatinib, Idelalisib, imatinib, Nilotinib, Palbociclib)
rifabutin
rifampin
St. John's wort
Sarilumab
Saxagliptin
seizure medications (e.g., Carbamazepine, Phenytoin, Phenobarbital, primidone)
Sitagliptin
siltuximab
Stiripentol
tenofovir
Tocilizumab
Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Cabometyx (Cabozantinib). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Cabometyx (Cabozantinib).

Abnormal heart rhythms: Cabometyx (Cabozantinib) may cause a heart rhythm problem called QT prolongation. If you have a history of QT prolongation, slow or irregular heartbeat, irregular heart rhythm, heart failure, Heart Attack, heart disease, taking other medications known to cause QT prolongation, or a family history of sudden cardiac death at less than 50 years of age, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, or how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib). Your doctor will perform tests at regular intervals to monitor for any changes in your heart rhythm.

Birth control: If you or your partner is of childbearing age, it is important that you use effective birth control, to avoid possible harm to the baby. Birth control should be used while taking Cabometyx (Cabozantinib) and for at least 4 months after the last dose. If you become pregnant while taking Cabometyx (Cabozantinib), contact your doctor immediately.

Bleeding: Cabometyx (Cabozantinib) may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. If you have a history of severe bleeding, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Blood Clots: Cabometyx (Cabozantinib) may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.

If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, Stroke, or clots in the deep veins of your leg or lungs. Discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.

Decreased heart rate: Cabometyx (Cabozantinib) can cause decreased heart rate. If you have a low heart rate or experience symptoms of a low heart rate, such as fatigue, dizziness, or confusion contact your doctor.

Drowsiness/reduced alertness: Cabometyx (Cabozantinib) may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how Cabometyx (Cabozantinib) affects you.

Fluid and electrolyte balance: Cabometyx (Cabozantinib) may cause the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking Cabometyx (Cabozantinib). If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood while you are taking Cabometyx (Cabozantinib).

Gastrointestinal perforation and fistula: Cabometyx (Cabozantinib) has been reported to cause perforations (holes) and fistulas (abnormal connections) in the stomach or intestines. People who have medical conditions affecting the stomach or bowel, such as Crohn's Disease or Diverticulitis, or previous stomach surgeries may be more likely to experience a tear in the lining of the stomach, which can cause serious bleeding. This can occur without abdominal pain.

If you notice bloody or black and tarry stools, or vomit blood or material that looks like coffee grounds, seek medical help immediately.

Grapefruit juice: Grapefruit and grapefruit juice affect how Cabometyx (Cabozantinib) is removed from the body. Consuming grapefruit products can cause too much of the medication to build up in the body and cause possibly harmful side effects. Do not drink grapefruit juice or eat grapefruit at any time while taking Cabometyx (Cabozantinib) for treatment.

High blood pressure: Cabometyx (Cabozantinib) can cause blood pressure to increase; possibly to a life-threatening level. If you have high blood pressure, it should be well controlled before starting to take Cabometyx (Cabozantinib). If your blood pressure is not controlled while taking Cabometyx (Cabozantinib), your doctor may have you stop taking Cabometyx (Cabozantinib). If you have high blood pressure, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Infection: As well as killing cancer cells, Cabometyx (Cabozantinib) can reduce the number of cells that fight infection in the body (white blood cells).

If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness.

Liver function: Liver disease or reduced liver function may cause Cabometyx (Cabozantinib) to build up in the body, causing side effects. Cabometyx (Cabozantinib) may also reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Cabometyx (Cabozantinib).

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Reversible Posterior Leukoencephalopathy Syndrome (RPLS): This is a rare disease of the brain that may occur when using medications like Cabometyx (Cabozantinib). If you experience signs and symptoms of RPLS, such as headache, seizures, change in awareness, or consciousness or vision changes, contact your doctor immediately.

Surgery: Cabometyx (Cabozantinib) can cause wounds to take longer to heal. If you have surgery scheduled, including dental surgery, it may be necessary to stop taking Cabometyx (Cabozantinib) for 28 days before the surgery. Make sure all members of your health care team are aware that you are taking Cabometyx (Cabozantinib) and talk to your doctor about whether you should stop Cabometyx (Cabozantinib) before surgery.

Thyroid disease: Cabometyx (Cabozantinib) may cause decreased thyroid gland function. If you have problems with your thyroid gland, cabozantinb may make these problems worse. If you experience symptoms of underactive thyroid, such as unexpectedly feeling cold, Depression, constipation, or fatigue, let your doctor know. If you have a history of thyroid disease, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Pregnancy: The use of Cabometyx (Cabozantinib) may cause harm to the developing baby if it is taken by the mother during pregnancy. Cabometyx (Cabozantinib) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Cabometyx (Cabozantinib), contact your doctor immediately.

Breast-feeding: It is not known if Cabometyx (Cabozantinib) passes into breast milk. If you are a breast-feeding mother and are taking Cabometyx (Cabozantinib), it may affect your baby. Breast-feeding should be avoided while taking Cabometyx (Cabozantinib) and for 4 months after the last dose of medication. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Cabometyx (Cabozantinib) have not been established for children.

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