Cabozantinib – oral

As an antineoplastic drug, cabozantinib is prescribed to patients whose medullary thyroid cancer has spread to another part of their body and when other drugs have failed to work.

Overview

Cabozantinib is a useful drug designed to treat certain types of cancer. An antineoplastic drug and a tyrosine kinase inhibitor, it is designed to stop cancer cells from growing.

Cabozantinib is prescribed to patients who suffer from a medullary thyroid cancer that has spread to other parts of the body already. For example, it is used to treat patients who are suffering from advanced kidney cancer once other medication options have been tried and exhausted.

This medication is only available with a prescription from a physician and it comes in both tablet and capsule format. In the US, its brand is Cometriq, which means you may see it referred to in this way on packaging, in pharmacies and stores.

Condition(s) treated

  • Cancer

Type of medicine

  • Antineoplastic
  • Tyrosine kinase inhibitors

Side effects

As with any drug, taking cabozantinib can result in certain unpleasant side effects, as well as relief from the symptoms for which it is designed to treat you.

Serious side effects

The first category of side effect that can result from taking cabozantinib are those that are serious and that require immediate medical attention. In the event that you experience any of these side effects, you should consult your physician right away. If they are not available, you should attend the nearest emergency room and you or someone who is with you should explain that you are taking oral cabozantinib.

These side effects include a number of symptoms that are rare, but are also still serious. These include mental problems, such as confusion, as well as a large range of vision-related problems, such as a disturbed perception of colour, double vision, observing halos or large amounts of extra brightness around sources of light, inability to see at night, tunnel vision and more. Seizures are also included in this category.

Furthermore, there are some side effects of taking this drug that are still serious, but are simply less common, rather than rare. These include a wide range of problems related to bleeding, including blood in the stools or urine, heavier periods, bleeding gums, coughing up of blood, nosebleeds or episodes of bleeding with long durations.

In addition, some miscellaneous symptoms can be classified as serious, but less common. These include a feeling of heaviness in the jaw, heartburn, nausea or indigestion, swelling, pain or numbness around the jaw and mouth regions, cramps in the stomach, difficulty breathing and more.

Finally, there are some serious side effects which are more common, and hence you are more likely to experience these when taking oral cabozantinib. These include, for example, a number of eyesight-related issues, such as blurred vision, as well as problems relating to your throat, chest and mouth area, like problems swallowing or breathing, dehydration, pain in the chest and a heartbeat that is particularly slow or fast, and more.

In addition, some miscellaneous more common - and still serious - side effects of this medication include headaches, sensations of tingling and burning, dizziness, a feeling of nervousness, slurring of speech, a pounding in the ears, scaling or swelling of the skin, skin ulcers, loss of co-ordination and more.

Less serious side effects

In addition to the serious side effects mentioned above, there are also some symptoms you may experience as a result of taking this medicine that do not require treatment from your doctor.

All of the side effects in this category are considered to be more common, meaning it's more likely you'll experience them.

Side effects in this category include a number of digestion, eating and stomach-related problems. These can include acid on the stomach, altered perception of taste, a drop in weight levels or appetite and more. In addition, there are lots of problems related to your hair which sit in this category. These include changes in the hue of your hair, thinning of the hair or hair loss.

Some of the side effects in this category include a number of potentially embarrassing problems. These include swelling around the anus, bleeding following a bowel movement or difficulty going to the toilet, belching, diarrhea and more. While you do not need to see a physician unless the problems persist or are causing you major issues, it is important to monitor these side effects and speak to a medical professional if they get worse. Remember, no medical professional will judge you, and they are there to help.

Finally, there are a range of miscellaneous problems that can be caused as a result of taking oral cabozantinib. These include a feeling of fear, difficulty moving around, excessive dryness of the skin, a hoarse voice, a loss of strength, muscle spasms or pain, and more.

In the event that you experience these side effects, you do not ordinarily need to go to your physician. These side effects are often just your body's way of dealing with taking the medication, and often go away of their own accord. You only need to pay a visit to the physician's office if you are particularly concerned about the side effects, if they don't go away, or if they are causing you excessive trouble.

Remember, all of the lists presented here are non-exhaustive. As a result, you should always read the document provided to you inside your medication's packaging.

If you have any questions about possible side effects, you should speak to your physician or other healthcare professional. They will be able to put your mind at ease and provide you with some practical tips on how to go about managing the side effects you're experiencing.

It is important to remember that you will not necessarily experience the same side effects that other patients do. The experience of side effects can vary from one person to the next, so you should not expect to have - or not have - any particular effects.

Dosage

This medication, as with a lot of cancer medications, is very strong. As a result, you should always follow the instructions of your physician before taking it. That way, you will not expose yourself to any unnecessary risks.

In addition to following the instructions of a medical professional regarding how much of this medication you should take, you should also always follow other instructions relevant to this medicine as well. This includes information like the frequency of intervals left in between taking the medicine, the amount of capsules or tablets that need to be taken each time, the format in which they should be taken, and so on.

While you should always follow your physician's instructions, there is some general dosage information in existence to act as a guide only.

Ordinarily, adult patients who are suffering from thyroid cancer and take this medication as capsules will be expected to take 140 milligrams (mg) per day. Usually, the configuration of capsules to be taken will be one 80 mg capsule, followed by three 20 mg capsules, all combined into one dose. Children who are prescribed this medicine will have their dose determined by a physician.

For adult patients who are taking this medicine in tablet form to treat advanced kidney cancer, the standard dosage tends to be 60 mg, taken once per day. Again, children who get given this medication will have their dosage determined by a physician.

This medication requires certain dietary procedures to be followed in order to ensure it works correctly and to full effect. Firstly, you should ensure that this medication is taken on an empty stomach, rather than a full one. You should avoid eating for a period of two hours prior to taking the medication, and for the hour after you have taken it.

It is vital that this medication is taken whole, rather than being broken down. For that reason, you are instructed not to chew the tablet or capsule, and you should also not break it down by crushing it or opening it.

This medication needs to be taken with water. You should pour a full glass of water (with a weight of at least eight ounces, or around 226 ml), and then use it to swallow your capsule or tablet in its entirety.

In the event that you miss a dose of this medication, you should decide what to do based on what time it is when you notice that you've missed it. If, when you remember, less than twelve hours have passed since you were supposed to take the dose you missed, you should take the missed dose right away. If the missed dose was twelve hours or more ago, however, you should avoid taking it, skip it and instead wait until your next dose to take the medication again. You should never take a double dose of oral cabozantinib.

Interactions

As with many medications, oral cabozantinib can interact with a wide range of other medicines once it is inside your system.

For this reason, you should always provide an up to date list of drugs you are currently taking to your physician, including all over the counter medications, as well as prescription ones. Your physician may choose to alter the configuration of your current medication based on this, so you should always be honest and accurate with this information.

Some drugs can interact with oral cabozantinib in a serious fashion. These include acenocoumarol, which may increase the risk of bleeding when taken alongside this drug, as well as artemether, bisacodyl, hydroxyzine, levomepromazine, osimertinib and more. In addition, some drugs interact with oral cabozantinib in a moderate way. These include idelalisib, nevirapine, pegaspargase and more.

Some medications that can interact with the drug are available over the counter, such as St John's wort. Once again, this means you should be fully accurate when providing your physician with details of your current drugs.

Remember, this is a non-exhaustive list of potential interactions and you should consult your physician if you need a more complete list.

Warnings

This medication, as with all medications, should come with a leaflet that explains how to take it correctly, what the possible side effects may be and more. Even though not all of the possible warnings may apply to you, you should ensure that you do read it thoroughly, to ensure you don't miss any which do apply to you.

Furthermore, you should always retain this leaflet while taking your course of this medication and for a while afterwards. This is because you may need to refer back to it to find out a piece of crucial information in the future.

In addition to these general warnings, there are some specific warnings regarding oral cabozantinib which you should follow.

  • You should never substitute Cabometyx™ tablets with capsules specifically designated as cabozantinib. In addition, you should also never substitute branded capsules labelled Cometriq® with tablets designated as cabozantinib.
  • You should avoid eating grapefruit or grapefruit products while you are taking oral cabozantinib, and you should also avoid drinking grapefruit juice as well. This is because it can increase the amount of this medicine that accesses your bloodstream.
  • Remember, taking this drug may make you feel dizzy. As a result, you should not drive or carry out any other tasks requiring full alertness until you are sure as to how this medication affects you.

Storage

As with all medication, it's vital that you keep this medication stored somewhere where it cannot cause problems. Because oral cabozantinib is a particularly strong medicine, you should take extra care to ensure it does not fall into the wrong hands or be accessible anywhere where it could cause real harm.

Firstly, you should ensure that your oral cabozantinib is stored out of the reach of all children at all times. Even if you do not have children living in your home, it's vital that you still do this, in case they come to visit at some point in the future and you do not remember to move your oral cabozantinib.

Secondly, while you should never stop taking this medication unless told to by a physician, it's important to ensure that you dispose of any leftover capsules or tablets in an appropriate fashion. If you are unsure as to how you should go about doing this, you should speak to a healthcare professional.

Finally, your medication may be compromised if it is stored in adverse environmental conditions. It should, for example, always be stored in surroundings which are free from the influence of direct light, excessive heat and moisture. Make sure you store your oral cabozantinib in a container that is closed at all times when not in use, and ensure that you never freeze your medication, as this can seriously damage it.

Summary

Oral cabozantinib is designed to treat certain cancers, including medullary thyroid cancer and advanced kidney cancer. This drug, which is only available with a prescription from a physician, comes in tablet and capsule format and has the brand name Cometriq.

There are some side effects that are possible as a result of taking this medication. These include some serious symptoms, which require emergency medical attention from your physician or, if they are unavailable, another medical professional. Side effects in this category include double vision, blood in the stools or urine, coughing up blood and more. Some side effects are less serious, and only require medical attention if they persist or cause excessive problems. These include altered perception of taste, thinning of the hair, diarrhea and more. These lists are non-exhaustive.

Dosages of oral cabozantinib vary from person to person, and are likely to be determined by your doctor. Some standard dosages exist for informational purposes only, but advice from your doctor should always be prioritised. If you miss a dose of this medication, you should only skip a dose if it is more than twelve hours since you were supposed to take it.

There are a number of warnings associated with this medication. For example, you should not consume grapefruit products or grapefruit juice while taking this medication, and you should avoid driving until you are certain as to how this medication affects your alertness levels. This list is non-exhaustive and the full list of warnings will be available either from your physician or on the leaflet which comes with the packaging of your medication. You should retain this leaflet for future reference.

A number of medications interact with this drug, and for this reason you should ensure that your physician has a full and accurate list of the drugs you are currently taking, including any over the counter medications. Your physician may choose to alter the configuration of your current medication based on this information to protect your health and reduce the risk that you will experience problems, so you should always make sure this information is accurate.

Always store your oral cabozantinib in a closed container away from direct light, heat and other adverse environmental conditions. Keep out of the reach of children at all times, and consult your healthcare professional if you are unsure how to dispose of any extra amounts of this medication.