Cabozantinib (Cometriq ®, Cabometyx ®)
Cabozantinib is a targeted therapy drug used to treat medullary thyroid cancer and kidney cancer that has spread.
Cabozantinib is a targeted therapy drug used to treat medullary thyroid cancer and kidney cancer that has spread.
It is best to read this information with our general information about the type of cancer you have. During treatment, you will see a cancer doctor or nurse. This is who we mean when we mention a doctor or nurse in this information.
Cabozantinib is a type of targeted therapy drug called a tyrosine kinase inhibitor. It works by blocking (inhibiting) the signals inside cancer cells that make them grow and divide. This may help to stop or slow down the growth of the cancer. It can also stop new blood vessels growing in the area of the cancer. Cancer cells need to make new blood vessels so they can grow and spread.
When cabozantinib is usedBack to top
Medullary thyroid cancer
Cabozantinib (Cometriq ®) capsules may be used to treat medullary thyroid cancer that cannot be removed with an operation, or that has spread to other parts of the body.
Kidney (renal) cancer
Cabozantinib (Cabometyx ®) tablets can be used to treat kidney cancer that has spread to other parts of the body. You have it after other targeted treatments such as pazopanib or sunitinib have been used.
Cabozantinib may only be available in some situations. Your cancer doctor can tell you if it is appropriate for you. Some people may have it as part of a clinical trial. If a drug is not available on the NHS, there may be different ways you can get it. Your cancer doctor can give you advice. We have further information on what to do if a treatment is not available.
You take cabozantinib as capsules or tablets once a day at the same time each day. Take them with a glass of water, one hour before you eat or two hours after you eat. Don’t chew or crush the tablets or open the capsules before you take them as this may increase side effects. Avoid eating grapefruit and drinking grapefruit juice during your treatment as it may increase side effects.
Always take cabozantinib exactly as your nurse or pharmacist explained. This is important to make sure it works as well as possible for you. Your doctor will talk to you about how long to take cabozantinib for.
If you forget to take your cabozantinib and it is more than 12 hours until the next dose, take it as soon as you remember. If it is less than 12 hours until the next dose, do not take the missed dose – take your usual dose at the usual time the next day. You should never take a double dose.
There are some important things to remember when taking your tablets or capsules:
- Keep them in the original packaging and at room temperature, away from heat and direct sunlight.
- Keep them in a safe place, out of the reach of children.
- If your doctor decides to stop the treatment, return any remaining drugs to the pharmacist. Don’t flush them down the toilet or throw them away.
Possible side effects of cabozantinibBack to top
We explain the most common side effects of cabozantinib here. We also include less common side effects. You may get some of the side effects we mention, but you are unlikely to get all of them.
Always tell your doctor, nurse or pharmacist about any side effects you have. Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This is important to make sure it works as well as possible for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
More information about this drug
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for this drug. The leaflet lists all known side effects.
Common side effects of cabozantinibBack to top
You may have frequent or loose bowel movements. This can usually be easily controlled by taking anti-diarrhoea drugs. Your doctor can prescribe these for you. You should tell your doctor if the diarrhoea is severe or continues. It is important to drink plenty of fluids if you have diarrhoea – around two litres (three and a half pints) a day.
Feeling tired is a common side effect. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
Loss of appetite
You may lose your appetite during treatment and may lose weight. Try to eat small meals regularly. If your appetite doesn’t improve after a few days, let your doctor or nurse know. They can arrange for you to see a dietician who can give you advice. You may be given food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can also buy them from chemists.
Your doctor can prescribe anti-sickness (anti-emetic) drugs to help prevent, or control sickness. If you still feel sick, tell your doctor as they can prescribe other anti-sickness drugs that may work better for you.
You may get pain or discomfort in your tummy (abdomen) or have indigestion. Your doctor can prescribe drugs to help improve these symptoms. Tell them if the pain doesn’t improve or gets worse.
Rarely, cabozantinib can cause a hole (perforation) in the bowel. Tell your doctor straight away if you have sudden or severe pain in your tummy, signs of bleeding from the back passage, black stools, vomit up blood, or have vomit that looks like coffee grounds.
Soreness and redness on the palms of hands and soles of feet
This is called palmar-plantar, or hand-foot syndrome. It gets better when treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool and avoid tight-fitting socks, shoes and gloves. Tell your nurse about any changes in your hands or feet.
High blood pressure
Cabozantinib can increase your blood pressure. A nurse will check your blood pressure regularly during treatment. If you have headaches, nosebleeds or feel dizzy, let your doctor know. Your doctor can usually prescribe tablets to control high blood pressure. Some people may need to reduce their dose of cabozantinib or stop taking it. Less often, cabozantinib may lower your blood pressure.
You may get constipated. Drinking plenty of fluids, eating more fibre and doing some gentle exercise can help. You may also need to take medicines (laxatives). Talk to your doctor or nurse for more advice.
Effects on the mouth
You may notice food tastes different while you are taking cabozantinib. Your nurse can give advice on coping with this. Some people may get a sore mouth or mouth ulcers. Drink plenty of fluids, and clean your teeth regularly and gently with a soft toothbrush. Tell your doctor or nurse if you have any mouth problems. They can prescribe mouthwashes and medicines to treat mouth infections and relieve soreness.
Effects on the thyroid gland
Cabozantinib can sometimes make the thyroid gland less active. Your doctor will check how your thyroid is working with regular blood tests. If this happens, it can be treated with medication and goes back to normal after the treatment is finished.
You may notice some voice changes or hoarseness. Talk to your doctor if you are worried about this.
Breathlessness and a cough
You may feel more out of breath than normal or develop a cough. Let your doctor know if you notice this.
Your skin may become dry and itchy. You may also notice a rash. Tell your doctor or nurse if you have any of these symptoms. They can prescribe creams and drugs to help.
Joint and muscle pain
You may have pain and stiffness in your joints, and sometimes in your muscles. Tell your doctor or nurse if this happens. They can prescribe painkillers and give you advice.
Build-up of fluid
Your ankles and legs may swell because of fluid building up. If fluid collects in the lining of the lungs (pleural effusion), this may make you breathless. Tell your doctor or nurse if you notice this. They can prescribe medicines to help.
Effects on the hair
Your hair may lose its colour and may become thinner while you are taking cabozantinib. Changes to your hair are usually temporary and get better if you stop treatment. But for some people, hair changes can be permanent.
Risk of infection
If you have a low number of white blood cells, you are more likely to get an infection. If this happens during your treatment your doctor or nurse will advise you how to reduce your risk of infection.
Contact the hospital straight away if:
- your temperature goes over 37.5°C (99.5° F) or over 38°C (100.4° F), depending on the advice given by your healthcare team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – these can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine often.
Anaemia (low number of red blood cells)
Cabozantinib can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
Cabozantinib can sometimes cause bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Tell your doctor if you are taking any medicines that may affect bleeding. These include:
- blood-thinning tablets such as warfarin
- injections such as heparin, or vitamin E.
Contact your doctor straight away if you have any unusual bleeding including vomiting or coughing up blood, unexpected vaginal bleeding or blood in your stools (bowel movements).
Wounds often take longer to heal while you are having treatment with cabozantinib. If you need an operation, your doctor will tell you to stop taking cabozantinib at least four weeks before you have it.
Feeling dry (dehydration)
Cabozantinib may make you feel dry (dehydrated). It can also affect the levels of minerals and salts in your body. Your doctor will take regular blood tests to check these. It is important to drink plenty of fluids while having treatment with cabozantinib – around two litres (three and a half pints) a day. Let your doctor or nurse know if you have any signs of dehydration, such as feeling dizzy or tired, passing small amounts of urine, or having a dry mouth and eyes.
Changes in hearing
Cabozantinib can affect your hearing. You may get ringing in your ears (tinnitus). Tinnitus usually gets better after treatment ends. Tell your doctor if you notice any changes in your hearing.
Numb or tingling hands or feet (peripheral neuropathy)
This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks. The symptoms usually improve slowly after treatment finishes. Talk to your doctor if you are worried about this.
Increased risk of blood clots
Cancer increases the chances of a blood clot (thrombosis),Treatment with cabozantinib can add to this. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Less common side effectsBack to top
Jaw problems (osteonecrosis)
Rarely, cabozantinib may cause a condition called osteonecrosis of the jaw. This is when healthy bone tissue in the jaw becomes damaged and dies. Some dental treatments, such as having a tooth removed, can increase the risk. Before you start taking cabozantinib, you will be advised to have a full dental check-up. Your doctor will advise you to stop taking cabozantinib for a short time before dental treatments like this. Always tell your dentist that you are taking cabozantinib.
Sometimes cabozantinib can affect the heart. If you have chest pain or chest tightness, or if your heartbeat becomes less regular or too fast or too slow, contact a doctor straight away.
Cabozantinib may cause a pocket of infection (pus) to collect in the tummy. An abscess can cause pain or swelling. Tell your doctor or nurse if you notice this, have a fever or feel unwell.
Changes in mood
Sometimes cabozantinib can cause mood changes such as depression or anxiety. If you feel depressed or anxious, or have other changes to your mood, tell your doctor.
Effects on the nervous system
Cabozantinib can affect the nervous system. You may feel confused, dizzy or unsteady. Tell your doctor or nurse straight away if you notice this.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Don't drive if you have dizziness, blurred vision, excessive tiredness or if you feel sleepy. Talk to your doctor for advice if you are not sure whether you are safe to drive.
It can be harmful to take some medicines when you are taking cabozantinib. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your doctor will advise you not to become pregnant or father a child during treatment or for at least four months after. Cabozantinib may harm a developing baby. Because cabozantinib may make oral contraceptives less effective, your doctor will suggest you also use a barrier method.
Doctors don’t yet know how cabozantinib may affect your fertility. If you are worried about this, talk to your doctor before your treatment starts.
Women are advised not to breastfeed during treatment and for at least four months afterwards. This is in case there is any of the drug in their breast milk.
Medical or dental treatment
If you need to go into hospital for any reason, always tell the doctors and nurses that you are taking cabozantinib. Tell them the name of your cancer doctor so they can ask for advice. Always tell your dentist if you are having cabozantinib.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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