Cabozantinib (thyroid cancer) : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

Cabozantinib (Cometriq) is used to treat a certain type of thyroid cancer that is getting worse and that has spread to other parts of the body. Cabozantinib (Cometriq) is in a class of medications called tyrosine kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.

Cabozantinib is also available as tablets (Cabometyx) to treat advanced renal cell carcinoma (CRC; a type of cancer that begins in the cells of the kidneys) and hepatocellular carcinoma (HCC; a type of liver cancer) in certain patients. who have previously suffered has been treated with another medicine. This monograph only provides information on cabozantinib (Cometriq) capsules for thyroid cancer. If you are using this medicine for advanced CRC or HCC, read the monograph Cabozantinib (liver and kidney cancer).

How should this medicine be used?

Cabozantinib (Cometriq) comes as capsules to take by mouth. It is usually taken once a day on an empty stomach, at least 1 hour before and 2 hours after eating. Take cabozantinib (Cometriq) at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any parts you don’t understand. Take cabozantinib (Cometriq) exactly as directed. Do not take more or less, or take it more often than prescribed by your doctor.

Swallow the capsules whole with a full glass (8 oz., 240 ml) of water. You will not know.

Your doctor may lower your dose of cabozantinib (Cometriq) or stop your treatment permanently or temporarily if you experience serious side effects. Be sure to talk to your doctor about how you feel during your treatment with cabozantinib (Cometriq).

The length of your treatment depends on how well you respond to the medicine and the side effects you experience. Keep taking cabozantinib (Cometriq) even if you feel fine. Do not stop taking cabozantinib (Cometriq) without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking cabozantinib (Cometriq),

  • Tell your doctor and pharmacist if you are allergic to cabozantinib (Cabometyx, Cometriq), any other medications, or any of the ingredients in cabozantinib capsules. Ask your pharmacist or see the Medication Guide for a list of ingredients.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: adefovir (Hepsera); antifungals such as itraconazole (Sporanox), ketoconazole, and voriconazole (Vfend); clarithromycin (Biaxin, in Prevpac); dexamethasone; furosemide (Lasix); certain HIV or AIDS medications, such as abacavir (Ziagen), atazanavir (Reyataz), cidofovir, indinavir (Crixivan), lamivudine (Epivir, in Combivir); nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tenofovir (Viread); certain medications for seizures such as carbamazepine (Equetro, Tegretol, Teril), phenobarbital, and phenytoin (Dilantin, Phenytek); nefazodone; probenecid (Probalan), rifabutin (Mycobutin); rifampicin (Rifactin, Rifadin, in Rifamate, in Rifater); rifapentine (Priftin); telithromycin (Ketek); and warfarin (Coumadin, Jantoven). Many other medications can also interact with cabozantinib (Cometriq), so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you more closely for side effects.
  • Tell your doctor what herbal products you are taking, especially St. John’s wort.
  • Tell your doctor if you have recently had any unusual or severe bleeding, such as coughing up blood, vomiting blood, or bloody or tarry stools. Also tell your doctor if you have an open or healing wound, or if you have or have ever had high blood pressure or liver disease.
  • Tell your doctor if you are pregnant or plan to become pregnant. You will need to take a pregnancy test before starting cabozantinib treatment. You should not become pregnant during your treatment with cabozantinib and for 4 months after your final dose. Talk to your doctor about birth control methods that you can use during your treatment. If you become pregnant while taking cabozantinib (Cometriq), call your doctor immediately. Cabozantinib can harm the fetus.
  • Tell your doctor if you are breastfeeding. Your doctor may tell you not to breastfeed during your treatment and for 4 months after your final dose.
  • You should know that this medicine can decrease fertility in men and women. Talk to your doctor about the risks of taking cabozantinib (Cometriq).
  • If you are having surgery, tell your doctor or dentist that you are taking cabozantinib (Cometriq). Your doctor will likely tell you to stop taking cabozantinib (Cometriq) at least 21 days before your surgery and tell you when to start taking the medicine again after your surgery.
  • You should know that cabozantinib (Cometriq) can cause serious jaw problems. A dentist should examine your teeth before you start taking cabozantinib and regularly during your treatment. Be sure to brush your teeth and clean your mouth properly while taking cabozantinib (Cometriq). Talk to your doctor before undergoing any dental treatment while taking this medicine. Your doctor will likely tell you to stop taking cabozantinib at least 21 days before your dental surgery.
  • You should know that your blood pressure may increase during your treatment with cabozantinib (Cometriq). Your doctor will likely monitor your blood pressure during your treatment.
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What special dietary instructions should I follow?

Do not drink grapefruit juice or eat grapefruit or any food or supplement that contains grapefruit or grapefruit juice while you are taking this medicine.

What should I do if I forget a dose?

Take the missed dose as soon as you remember. However, if your next scheduled dose is less than 12 hours away, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for the one you forgot.

What side effects can this medication cause?

Cabozantinib (Cometriq) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • constipation
  • hemorrhoids
  • nausea
  • vomiting
  • heartburn
  • change in ability to taste food
  • difficulty swallowing
  • redness, swelling, sores, or pain in your mouth or throat
  • loss of appetite
  • weight loss
  • tiredness or weakness
  • pain in joints
  • muscle pain or spasms
  • anxiety
  • numbness, burning, or tingling in the hands, arms, feet, or legs
  • dry skin
  • patchy thickening of the skin
  • hair loss
  • hair color turning lighter or gray
  • voice changes or hoarseness

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

  • coughing up blood or blood clots
  • vomiting material that is bloody or looks like coffee grounds
  • menstrual bleeding that is heavier than usual
  • red or black, tarry stool
  • any unusal or heavy bleeding or bruising
  • diarrhea
  • tender or painful stomach area
  • swelling or pain in the arms or legs
  • shortness of breath
  • lightheadedness or fainting
  • sweating
  • numbness or weakness of the face, arm, or leg on one side of your body
  • dizziness
  • sudden difficulty with balance or coordination
  • swollen or painful gums
  • sudden, severe headache
  • jaw pain
  • toothache
  • seizures
  • sudden trouble walking
  • sudden vision problems
  • confusion
  • sudden difficulty thinking or speaking clearly
  • rash
  • redness, pain, swelling, or blistering on the palms or the soles
  • difficulty eating or drinking due to mouth sores or nausea and vomiting
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Cabozantinib (Cometriq) may cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org

Unnecessary medications must be disposed of in special ways to ensure they cannot be consumed by pets, children, and others. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

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In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or cannot wake up, immediately call 911 for emergency services.

Symptoms of overdose may include the following:

  • memory loss
  • confusion
  • weight loss

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain laboratory tests to check your body’s response to cabozantinib (Cometriq).

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Cometriq®

Disclaimer: DrLinex has made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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