What is this medication for?

Cabozantinib is used to treat kidney, liver and thyroid cancers that have spread to other parts of the body.

Cabozantinib comes in two brands: Cabometyx® and Cometriq®. Do not switch between brands as they are not interchangeable.

How should I take/use this medication?

• Take Cabozantinib once a day

• Cabozantinib should be taken on an empty stomach (one hour before or two hours after a meal)

• Do not break or crush the tablet. Swallow the tablet whole.

  • Inform your doctor or pharmacist if you have difficulty swallowing

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. However, if it is less than 12 hours to your next dose, skip the missed dose and take your next dose at the usual time. Do not take two doses at the same time.

What precautions should I take?

Inform your healthcare professional if:

• You are allergic to this medication

• You or your partner becomes pregnant or is planning for pregnancy

  • You should use effective birth control during and for four months after stopping treatment

• You are breastfeeding

  • Do not breastfeed during and for four months after stopping treatment

• You have any other medical conditions such as heart problems or high blood pressure

• You are taking or intend to take any other medications, including supplements, traditional medications and herbal remedies

• You have any recent or upcoming surgery

• You have any dental problems

  • Practice good oral hygiene while you are taking Cabozantinib

  • Be sure to let your dentist know you are taking Cabozantinib so that appropriate precautions can be taken

What are some common side-effects of this medication?

• Nausea, decreased appetite

  • Take small, frequent meals throughout the day

• Diarrhea

  • Drink plenty of clear fluids to replace those lost (two litres everyday)

• Palms of the hands or soles of the feet may become numb, sore, red or dry

  • Moisturize these areas daily

  • Avoid wearing tight-fitting shoes

• Feeling tired and lack of energy

  • Do not drive or operate machinery when you feel tired

• Mouth sores

  • Rinse your mouth after meals using an alcohol-free mouthwash or salt water

  • Brush your teeth with a soft toothbrush

• Increased blood pressure

  • Monitor your blood pressure regularly and record it down. Inform your doctor if you notice an increasing trend.

What are some rare but serious side-effects that I need to seek medical advice immediately?

• Symptoms of a drug allergy including one or more of the following:

  • Swollen face/eyes/lips/tongue

  • Difficulty in breathing

  • Itchy skin rashes over your whole body

• Very bad stomach pain

• Signs of infection - fever of 38° C and above, chills, cough, sore throat, pain or burning feeling on passing urine

• Unusual bleeding, bruising, black sticky stools or blood in the urine

• Unusual weakness, tiredness or light-headedness

• Signs of blood clot e.g. warmth, pain or redness with swelling on arm or leg

• Chest pain or shortness of breath

• Very bad diarrhea

• Painful blisters and peeling of hands or feet

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take this medication?

Avoid taking grapefruit or grapefruit juice when you are taking this medication as it may interact with your medication and increase the risk of side-effects.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away this medication safely?