Cabozantinib (Cabometyx)

What Is Cabozantinib?

Cabozantinib (pronounced [ka boe ZAN ti nib]) is also known by the brand names Cabometyx (tablets) and Cometriq (capsules). Cabozantinib is an oral targeted anticancer therapy called a tyrosine kinase inhibitor (TKI). It works by blocking multiple signals (kinases) that cancers use to grow, spread, and form new blood vessels, which can help slow cancer growth.

What Is Targeted Therapy (TKI)?

Targeted therapies are cancer treatments that block specific proteins (“targets”) involved in cancer growth and spread. Cabozantinib is a TKI, meaning it blocks certain kinases that can drive tumor growth and blood vessel formation. This is different from traditional chemotherapy, which typically affects many rapidly dividing cells.

Safe Handling Precautions

Cabozantinib is considered a hazardous medication, so handle it carefully:

• Do not crush, chew, or open tablets/capsules.
• Keep it away from children and pets, and follow your pharmacy’s instructions for safe disposal.
• If a tablet/capsule is broken, avoid direct contact with the contents.
• If you (or a caregiver) must handle the medication, wear gloves and wash hands afterward.

How Is Cabozantinib Used?

Cabozantinib is FDA-approved for certain cancers, including renal cell carcinoma (RCC), hepatocellular carcinoma (HCC) (after prior treatment), and certain thyroid cancers. Your oncology team will determine whether Cabometyx or Cometriq is appropriate based on your cancer type and treatment plan.

Available Formulations

Cabozantinib comes in two different products:

• Cabometyx (tablets): 20 mg, 40 mg, and 60 mg strengths.
• Cometriq (capsules): 20 mg and 80 mg strengths.

Even though both contain cabozantinib, Cabometyx tablets and Cometriq capsules are not interchangeable. Always take the exact product and strength prescribed by your provider.

Directions for Use

Take cabozantinib on an empty stomach at least 1 hour before or 2 hours after eating (if taken too close to a meal, it may not be absorbed to its full extent). Swallow the tablet/capsule whole. Do not crush, chew, or open it. Take with a full glass of water unless your provider instructs otherwise.

Missed Dose

If a dose is missed, take the dose as soon as possible, but if it is within 12 hours of the next dose, then skip the dose and continue with the next scheduled dose.

Storage

Store tablets and capsules in a cool, dry place at room temperature and ensure the bottle is tightly closed.

What To Avoid While Taking Cabozantinib

While on the cabozantinib therapy, you must follow some precautions. Always tell your physician about any medication you are already taking. Do not take any drug or medicine (even herbals or over-the-counter medications) without prior consent from your physician or pharmacist, as they may have some significant interactions with cabozantinib.

Avoid grapefruit, grapefruit juice, and any foods or supplements containing grapefruit or grapefruit juice throughout therapy, as they may also interact with this medication.

Pregnancy and Cabometyx

Pregnancy status should be checked before starting cabozantinib in people who can become pregnant. Use effective contraception during treatment, and do not breastfeed during treatment and for 4 months after the last dose.

Side Effects

As with any medication, cabozantinib can cause side effects. Tell your healthcare team about any new or worsening symptoms.

Most common side effects (single-agent Cabometyx) may include:

• Diarrhea
• Tiredness (fatigue)
• Hand-foot skin reaction (PPE) (redness, pain, peeling on palms/soles)
• Decreased appetite and weight loss
• High blood pressure (hypertension)
• Nausea/vomiting
• Constipation
  

Potential serious side effects (seek urgent care for concerning symptoms):

• Severe bleeding (hemorrhage): coughing/vomiting blood, black/tarry stools, unusual bleeding
• GI perforation or fistula: severe or persistent abdominal pain
• Blood clots/stroke/heart attack: chest pain, shortness of breath, one-sided weakness, sudden vision/speech changes
• Severe or uncontrolled high blood pressure: severe headache, dizziness, vision changes
• Slow wound healing: inform your provider if you have surgery planned or wounds that won’t heal
• Osteonecrosis of the jaw (rare): jaw pain, mouth sores, slow healing after dental work

Precautions

Cabozantinib may not be appropriate for everyone. Your prescriber will decide if it’s safe for you. Tell your healthcare team if any of the following apply:

• Allergy: Do not take cabozantinib if you have had an allergic reaction to cabozantinib or any ingredient in the product.
• Severe kidney problems: Cabozantinib may not be recommended in severe kidney impairment — your provider may choose a different treatment or monitor you more closely.
• Risk of blood clots or serious heart/brain events: Cabozantinib can increase the risk of blood clots, heart attack, or stroke. Get urgent medical care for chest pain, sudden shortness of breath, one-sided weakness, or leg swelling.
• High blood pressure: Cabozantinib can raise blood pressure. Your blood pressure should be checked regularly. If it becomes severely high or hard to control, your provider may adjust your blood pressure medicines, hold, or reduce cabozantinib.
• GI perforation/fistula or severe diarrhea risk: Call your provider right away for severe stomach/abdominal pain, persistent diarrhea, black/tarry stools, vomiting blood, or signs of dehydration.
• Bleeding risk: Seek urgent care for unusual bruising/bleeding, coughing up blood, vomiting blood, or bloody/black stools.
• Jaw bone problems (ONJ)/dental procedures: Maintain good oral hygiene and tell your provider before invasive dental work. Your provider may recommend holding cabozantinib before certain dental procedures.
• Planned surgery or poor wound healing: Tell your provider about any scheduled surgery. Cabozantinib is often held before and after surgery to reduce bleeding and wound-healing complications.

FAQs

Is cabozantinib a chemo agent?

Cabozantinib is an oral targeted therapy (tyrosine kinase inhibitor) used to treat certain cancers. It is not traditional chemotherapy, but it is an anticancer medication and may be discussed alongside chemotherapy in cancer treatment plans.

What is the best time to take cabozantinib?

Take cabozantinib on an empty stomach at least 1 hour before or 2 hours after eating.

Is cabozantinib available as a generic?

Currently, it is not available as a generic. It is only available as the brands Cabometyx (tablets) or Cometriq (capsules).

Can you touch cabozantinib?

It’s best to handle it as little as possible. Do not crush or open it. If you (or a caregiver) must handle the medication, wear gloves, and avoid touching broken tablets/capsules. Wash hands after handling.