Cabometyx

The recommended dose of Cabometyx (Cabozantinib) is 60 mg taken by mouth, once daily. Cabometyx (Cabozantinib) needs to be taken on an empty stomach. Take it one hour before eating or two hours after eating. Swallow the tablets whole. Do not chew or crush the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Cabometyx (Cabozantinib) exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Cabometyx (Cabozantinib) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

20 mg
Each yellow, film-coated, round tablet with no score, debossed with "XL" on one side and "20 " on the other side of the tablet, contains 20 mg of Cabometyx (Cabozantinib) as Cabometyx (Cabozantinib) (S)-maleate. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, hypromellose 2910, iron oxide yellow, lactose anhydrous, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

40 mg
Each yellow, film-coated, triangle tablet with no score, debossed with "XL" on one side and "40" on the other side of the tablet, contains 40 mg of Cabometyx (Cabozantinib) as Cabometyx (Cabozantinib) (S)-maleate. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, hypromellose 2910, iron oxide yellow, lactose anhydrous, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

60 mg
Each yellow, film-coated, oval tablet with no score, debossed with "XL" on one side and "60" on the other side of the tablet, contains 60 mg of Cabometyx (Cabozantinib) as Cabometyx (Cabozantinib) (S)-maleate. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, hypromellose 2910, iron oxide yellow, lactose anhydrous, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

Do not take Cabometyx (Cabozantinib) if you are allergic to Cabometyx (Cabozantinib) or any ingredients of the medication.

There may be an interaction between Cabometyx (Cabozantinib) and any of the following:

• abacavir
• Abiraterone
• Aliskiren
• antiarrhythmics (e.g., Amiodarone, Disopyramide, dofetilide, Dronedarone, procainamide, quinidine, Sotalol)
• Apalutamide
• Apixaban
• Aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• birth control
• bisphosphonates (e.g., Alendronate, etidronate, Risedronate)
• Bosentan
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Cholestyramine
• Cobicistat
• Colchicine
• conivaptan
• Deferasirox
• Digoxin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Enzalutamide
• fexofenadine
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• lamivudine
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• Modafinil
• other protein kinase inhibitors (e.g., Crizotinib, Dabrafenib, Dasatinib, Idelalisib, imatinib, Nilotinib, Palbociclib)
• rifabutin
• rifampin
• St. John's wort
• Sarilumab
• Saxagliptin
• seizure medications (e.g., Carbamazepine, Phenytoin, Phenobarbital, primidone)
• Sitagliptin
• siltuximab
• Stiripentol
• tenofovir
• Tocilizumab
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Cabometyx (Cabozantinib). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Cabometyx (Cabozantinib).

Abnormal heart rhythms: Cabometyx (Cabozantinib) may cause a heart rhythm problem called QT prolongation. If you have a history of QT prolongation, slow or irregular heartbeat, irregular heart rhythm, heart failure, Heart Attack, heart disease, taking other medications known to cause QT prolongation, or a family history of sudden cardiac death at less than 50 years of age, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, or how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib). Your doctor will perform tests at regular intervals to monitor for any changes in your heart rhythm.

Birth control: If you or your partner is of childbearing age, it is important that you use effective birth control, to avoid possible harm to the baby. Birth control should be used while taking Cabometyx (Cabozantinib) and for at least 4 months after the last dose. If you become pregnant while taking Cabometyx (Cabozantinib), contact your doctor immediately.

Bleeding: Cabometyx (Cabozantinib) may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. If you have a history of severe bleeding, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Blood Clots: Cabometyx (Cabozantinib) may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.

If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, Stroke, or clots in the deep veins of your leg or lungs. Discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.

Decreased heart rate: Cabometyx (Cabozantinib) can cause decreased heart rate. If you have a low heart rate or experience symptoms of a low heart rate, such as fatigue, dizziness, or confusion contact your doctor.

Drowsiness/reduced alertness: Cabometyx (Cabozantinib) may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how Cabometyx (Cabozantinib) affects you.

Fluid and electrolyte balance: Cabometyx (Cabozantinib) may cause the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking Cabometyx (Cabozantinib). If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood while you are taking Cabometyx (Cabozantinib).

Gastrointestinal perforation and fistula: Cabometyx (Cabozantinib) has been reported to cause perforations (holes) and fistulas (abnormal connections) in the stomach or intestines. People who have medical conditions affecting the stomach or bowel, such as Crohn's Disease or Diverticulitis, or previous stomach surgeries may be more likely to experience a tear in the lining of the stomach, which can cause serious bleeding. This can occur without abdominal pain.

If you notice bloody or black and tarry stools, or vomit blood or material that looks like coffee grounds, seek medical help immediately.

Grapefruit juice: Grapefruit and grapefruit juice affect how Cabometyx (Cabozantinib) is removed from the body. Consuming grapefruit products can cause too much of the medication to build up in the body and cause possibly harmful side effects. Do not drink grapefruit juice or eat grapefruit at any time while taking Cabometyx (Cabozantinib) for treatment.

High blood pressure: Cabometyx (Cabozantinib) can cause blood pressure to increase; possibly to a life-threatening level. If you have high blood pressure, it should be well controlled before starting to take Cabometyx (Cabozantinib). If your blood pressure is not controlled while taking Cabometyx (Cabozantinib), your doctor may have you stop taking Cabometyx (Cabozantinib). If you have high blood pressure, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Infection: As well as killing cancer cells, Cabometyx (Cabozantinib) can reduce the number of cells that fight infection in the body (white blood cells).

If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness.

Liver function: Liver disease or reduced liver function may cause Cabometyx (Cabozantinib) to build up in the body, causing side effects. Cabometyx (Cabozantinib) may also reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Cabometyx (Cabozantinib).

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Reversible Posterior Leukoencephalopathy Syndrome (RPLS): This is a rare disease of the brain that may occur when using medications like Cabometyx (Cabozantinib). If you experience signs and symptoms of RPLS, such as headache, seizures, change in awareness, or consciousness or vision changes, contact your doctor immediately.

Surgery: Cabometyx (Cabozantinib) can cause wounds to take longer to heal. If you have surgery scheduled, including dental surgery, it may be necessary to stop taking Cabometyx (Cabozantinib) for 28 days before the surgery. Make sure all members of your health care team are aware that you are taking Cabometyx (Cabozantinib) and talk to your doctor about whether you should stop Cabometyx (Cabozantinib) before surgery.

Thyroid disease: Cabometyx (Cabozantinib) may cause decreased thyroid gland function. If you have problems with your thyroid gland, cabozantinb may make these problems worse. If you experience symptoms of underactive thyroid, such as unexpectedly feeling cold, Depression, constipation, or fatigue, let your doctor know. If you have a history of thyroid disease, discuss with your doctor how Cabometyx (Cabozantinib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cabometyx (Cabozantinib), and whether any special monitoring is needed.

Pregnancy: The use of Cabometyx (Cabozantinib) may cause harm to the developing baby if it is taken by the mother during pregnancy. Cabometyx (Cabozantinib) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Cabometyx (Cabozantinib), contact your doctor immediately.

Breast-feeding: It is not known if Cabometyx (Cabozantinib) passes into breast milk. If you are a breast-feeding mother and are taking Cabometyx (Cabozantinib), it may affect your baby. Breast-feeding should be avoided while taking Cabometyx (Cabozantinib) and for 4 months after the last dose of medication. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Cabometyx (Cabozantinib) have not been established for children.