cabozantinib (tablet)
cabozantinib (tablet)
Pronunciation:
ka boe ZAN ti nib
Other Name(s):
Appearance:
This handout gives general information about this cancer medication.
You will learn:
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who to contact for help
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what the medication is
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how it is given
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what to expect while on medication
This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
My cancer health care provider is: _____________________________________________
During the day I should contact: _______________________________________________
Evenings, weekends and holidays: _____________________________________________
This page gives general information about this cancer medication.
You will learn:
-
who to contact for help
-
what the medication is
-
how it is given
-
what to expect while on this medication
This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
For treating certain types of kidney, liver or thyroid cancers
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Tell your health care team if you have or had significant medical condition(s), espeically if you have / had:
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high blood pressure
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heart problems (including irregular heartbeat)
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thyroid, liver or kidney problems
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diarrhea or inflammatory bowel disease (for example Crohn’s disease or ulcerative colitis, diverticulitis, or appendicitis)
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any bleeding problems, blood clots, or problems with wound healing
- any allergies
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Tell your health care team if you have had any recent surgery or plan to have any surgery, including dental surgery.
- Cabozantinib tablets contains a small amount of lactose. If you cannot have lactose, talk to your healthcare team.
Remember To:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.
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This medication is usually taken once a day by mouth on an empty stomach, at least 1 hour before or at least 2 hours after food.
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Do not crush or chew the tablets.
- Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects.
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If you miss a dose and your next dose is in:
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less than 12 hours, take your next dose at its scheduled time. Do not make up the missed dose.
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12 hours or more, take the missed dose as soon as you remember. Take your next dose at the normal time.
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Do not take 2 doses at the same time or extra doses.
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If you vomit (throw up) after taking your medication, talk to your health care team about what to do.
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If you take too much of your medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
To Prevent or Treat Nausea and Vomiting
You may be given medications to prevent or stop nausea (feeling like throwing up) and vomiting (throwing up) before they start. These are called anti-nausea medications.
- Medications to prevent nausea and vomiting before they start include ondansetron (Zofran®), granisetron (Kytril®), aprepitant (Emend®), or others.
If you already have nausea and/or vomiting, some anti-nausea medications can stop them from getting worse. You may be given these medications to have at home in case you start to feel nausea or if you vomit.
- Medications to stop nausea and vomiting include prochlorperazine (Stemetil®), metoclopramide (Maxeran®), or others.
To Treat Diarrhea
Diarrhea is when you have loose bowel movements (watery poo) or you need to go poo (have bowel movements) more often than usual. Diarrhea may start a few days after your treatment.
You may be given a medication called loperamide (Imodium®) to help treat your diarrhea. Take this medication only if you need it. Keep your loperamide with you all the time. When diarrhea starts, take the loperamide right away.
If you start to have diarrhea:
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Take 2 tablets (4mg) of loperamide right away.
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Take 1 tablet (2mg) after each episode of diarrhea up to a maximum of 8 tablets (16 mg) per day.
- DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures. Your health care team may ask you to stop cabozantinib treatment for 28 days or more before any scheduled surgery. While taking cabozantinib, wounds may take longer to heal than normal or may not fully heal.
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DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects.
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DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic medications, without checking with your health care team.
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DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs, or natural health products without checking with your health care team.
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DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel drowsy or dizzy.
- DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures. Your health care team may ask you to stop cabozantinib treatment for 28 days or more before any scheduled surgery. While taking cabozantinib, wounds may take longer to heal than normal or may not fully heal.
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DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects.
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DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic medications, without checking with your health care team.
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DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs, or natural health products without checking with your health care team.
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DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel drowsy or dizzy.
Yes, this medication can interact with other medications, vitamins, foods and natural health products. Interactions can make this medication not work as well or cause severe side effects.
Tell your health care team about all of your:
- prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
- natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
Check with your health care team before starting or stopping any of them.
- Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®.
- Over-the-counter products such as dimenhydrinate (Gravol®)
- Natural health products such as St. John’s Wort
- Supplements such as vitamin C
- Grapefruit juice
- Alcoholic drinks
- Tobacco
- All other drugs, such as marijuana or cannabis (medical or recreational)
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
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You have a fever if your temperature taken in your mouth (oral temperature) is:
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38.3°C (100.9°F) or higher at any time
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OR
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38.0°C (100.4°F) or higher for at least one hour.
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If you do have a fever:
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Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
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Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
- Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
Talk to your health care team about:
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How this medication may affect your sexual health.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
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If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 4 months after your last dose. Talk to your health care team about which birth control options are best for you.
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Do not breastfeed while on this medication and until at least 4 months after your last treatment dose.
Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:
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Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
The following table lists side effects that you may have when getting cabozantinib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Diarrhea (May be severe) What to look for?
What to do? If you have diarrhea:
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Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day). |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
If you have nausea or vomiting:
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Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe. |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Low appetite, weight loss What to look for?
What to do?
Ask your health care team for the Loss of Appetite pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Rash on your hands and feet (hand-foot syndrome) What to look for?
What to do? To help prevent Hand-foot syndrome:
Ask your health care team for the Hand-foot syndrome pamphlet for more information. To prevent and treat dry skin:
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Talk to your health care team if it does not improve or if it is severe. |
High blood pressure (May be severe) What to look for?
What to do?
If you have a severe headache get emergency help right away as it may be a sign your blood pressure is too high. |
Talk to your health care team if it does not improve or if it is severe. |
Liver problems (May be severe) Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency medical help right away. |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Taste changes What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Too much or too little salt in your body What to look for?
What to do? Get emergency medical help right away for severe symptoms.
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Get emergency medical help right away for severe symptoms. |
Mouth sores What to look for?
To help prevent mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow. |
Changes in thyroid activity Thyroid changes may happen weeks to months after you receive your treatment. Your health care team may check your thyroid activity regularly with a blood test. What to look for?
What to do? Your health care team may give you prescription medication to treat underactive thyroid. If you have weight changes along with any of the other symptoms listed, talk to your health care team as soon as possible. |
Contact your health care team as soon as possible (office hours). |
Speech problems (hoarseness) What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe. |
Talk to your health care team if it does not improve or if it is severe. |
Cough and feeling short of breath What to look for?
What to do?
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Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away. |
Anemia (low red blood cells) What to look for?
What to do? If your health care team has told you that you have anemia (low red blood cells):
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Talk to your health care team if it does not improve or if it is severe. |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Heartburn; stomach upset; bloating What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Proteins in Urine (pee) Your health care team may do urine tests to check for proteins in your pee. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe.
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Talk to your health care team if it does not improve or if it is severe. |
Dizziness What to look for?
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Talk to your health care team if it does not improve or if it is severe. |
Bleeding; Low platelets in the blood When platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. |
Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe, you MUST get emergency medical help right away. |
Other rare, but serious side effects are possible with this treatment.
If you have any of the following, talk to your cancer health care team or get emergency medical help right away:
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pain, swelling and hardening of the vein in an arm or leg
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weakness on one side of your body
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sudden severe pain in your chest or upper back, that moves up your neck or down your back, when you didn’t hurt yourself
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irregular heartbeat
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wounds that do not heal well
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severe belly pain
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unexpected changes in your bowel movements (poo) or digestion, trouble swallowing
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unusual pulsating or throbbing feeling in your chest or belly
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yellowing of your skin or eyes
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teeth, mouth or jaw pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth and the feeling of numbness or heaviness in the jaw
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fainting (passing out), severe headache, seizures, confusion, mood or personality changes, changes in your vision.
For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.
December 2024 Updated drug information sheet
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.