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Cabozantinib (thyroid cancer)

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Why is this medication prescribed?

Cabozantinib is prescribed for the treatment of advanced medullary thyroid cancer (MTC) that cannot be surgically removed or has spread to other parts of the body. MTC is a type of thyroid cancer that originates from the thyroid gland’s parafollicular cells, also known as C cells. Cabozantinib works by inhibiting certain proteins involved in the growth and spread of cancer cells, thereby slowing down or halting the progression of the disease. It may also help shrink tumors and alleviate symptoms associated with advanced MTC.

How should this medicine be used?

Cabozantinib is typically taken orally, in the form of capsules. The specific dosage and administration schedule should be determined by a healthcare provider based on factors such as the patient’s overall health, the stage of cancer, and other medications they may be taking.

Here are general guidelines for how Cabozantinib is typically used:

  • Dosage: The recommended dosage of Cabozantinib can vary depending on individual factors. It’s essential to follow the exact dosage prescribed by the healthcare provider.
  • Timing: Cabozantinib is usually taken once daily, with or without food. However, it’s typically recommended to take it on an empty stomach, at least one hour before or two hours after eating.
  • Administration: The capsules should be swallowed whole with a glass of water. It’s crucial not to crush, chew, or open the capsules.
  • Monitoring: Patients should attend regular follow-up appointments with their healthcare provider to monitor their progress, manage any side effects, and adjust the treatment plan as needed.
  • Duration: Treatment with Cabozantinib may continue for as long as it remains effective and well-tolerated by the patient. It’s important not to stop taking the medication without consulting a doctor, even if the symptoms improve, as discontinuing it prematurely could affect its efficacy.
  • Side effects management: Patients should be aware of potential side effects associated with Cabozantinib and report any adverse reactions to their healthcare provider promptly.

As with any medication, it’s essential to follow the instructions provided by the prescribing healthcare provider carefully. They can provide personalized guidance based on the individual’s specific medical history and condition.

Other uses for this medicine

Some of these potential uses may include:

  • Renal Cell Carcinoma (Kidney Cancer): Cabozantinib has been approved for the treatment of advanced renal cell carcinoma (RCC), a type of kidney cancer, in certain situations.
  • Hepatocellular Carcinoma (Liver Cancer): Cabozantinib has been studied for its potential efficacy in the treatment of advanced hepatocellular carcinoma, which is the most common type of liver cancer.
  • Other Cancer Types: Cabozantinib is being investigated in clinical trials for its effectiveness in various other cancer types, including prostate cancer, lung cancer, and ovarian cancer.

What special precautions should I follow?

As for special precautions to follow when taking Cabozantinib for thyroid cancer or any other indication, here are some important considerations:

  • Regular Monitoring: Patients should undergo regular monitoring, including blood tests and imaging studies, to assess the response to treatment and monitor for any potential side effects.
  • Risk of Hypertension: Cabozantinib can cause high blood pressure (hypertension). Blood pressure should be monitored regularly during treatment, and hypertension should be managed appropriately with medications if necessary.
  • Potential for Cardiovascular Events: Cabozantinib may increase the risk of cardiovascular events such as heart attacks or blood clots. Patients with a history of cardiovascular disease should be closely monitored during treatment.
  • Risk of Hemorrhage: Cabozantinib can increase the risk of bleeding, including gastrointestinal bleeding and hemorrhage. Patients with a history of bleeding disorders or those taking anticoagulant medications should be monitored closely.
  • Wound Healing: Cabozantinib may impair wound healing. Patients undergoing surgery should inform their healthcare provider about their Cabozantinib treatment, and the medication may need to be temporarily discontinued before and after surgical procedures.
  • Thyroid Function: Since Cabozantinib is used to treat thyroid cancer, it’s important to monitor thyroid function regularly during treatment.
  • Pregnancy and Breastfeeding: Cabozantinib can harm an unborn baby, so it should not be used during pregnancy. Women of childbearing potential should use effective contraception during treatment and for some time after discontinuing Cabozantinib. It’s not known if Cabozantinib passes into breast milk, so breastfeeding is not recommended during treatment.

These are just some of the precautions to consider when using Cabozantinib. It’s essential to discuss any specific concerns or questions with a healthcare provider before starting treatment.

What special dietary instructions should I follow?

  • Take on an Empty Stomach: Cabozantinib is typically taken on an empty stomach, at least one hour before or two hours after eating. Follow your doctor’s instructions regarding the timing of doses.
  • Avoid Grapefruit: Grapefruit and grapefruit juice may interact with Cabozantinib, leading to increased levels of the medication in the blood. Avoid consuming grapefruit or grapefruit products during treatment.

What should I do if I forget a dose?

If you forget to take a dose of Cabozantinib, take it as soon as you remember, unless it’s almost time for your next scheduled dose. In that case, 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’re unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Cabozantinib, like any medication, can cause side effects, some of which may be common, while others are less common but more serious. Here are some potential side effects associated with Cabozantinib when used for thyroid cancer:

  • Hypertension (High Blood Pressure): Elevated blood pressure is a common side effect of Cabozantinib. It’s essential to monitor blood pressure regularly during treatment and manage hypertension with medications if necessary.
  • Diarrhea: Diarrhea is another common side effect of Cabozantinib. It’s important to stay hydrated and inform your doctor if diarrhea is severe or persistent.
  • Fatigue: Feeling tired or fatigued is a common side effect of Cabozantinib. Getting adequate rest and discussing strategies for managing fatigue with your healthcare provider can be helpful.
  • Decreased Appetite: Some people may experience a decreased appetite while taking Cabozantinib. Eating small, frequent meals and choosing nutrient-rich foods can help maintain adequate nutrition.
  • Nausea and Vomiting: Nausea and vomiting are potential side effects of Cabozantinib. Anti-nausea medications may be prescribed to help manage these symptoms.
  • Palmar-Plantar Erythrodysesthesia (Hand-Foot Syndrome): This condition can cause redness, swelling, pain, and peeling of the skin on the palms of the hands and the soles of the feet. Proper skin care and avoiding activities that may exacerbate symptoms can help.
  • Proteinuria (Increased Protein in Urine): Cabozantinib may cause proteinuria, which is the presence of excess protein in the urine. Regular monitoring of kidney function is essential during treatment.
  • Hair Color Changes: Some people may experience changes in hair color while taking Cabozantinib.
  • Thyroid Dysfunction: Cabozantinib can affect thyroid function, leading to symptoms such as hypothyroidism or hyperthyroidism. Regular monitoring of thyroid hormone levels is necessary during treatment.
  • Bleeding: Cabozantinib may increase the risk of bleeding, including gastrointestinal bleeding and hemorrhage. Inform your doctor if you experience any signs of bleeding, such as easy bruising or bleeding gums.
  • Cardiovascular Events: In some cases, Cabozantinib may increase the risk of cardiovascular events such as heart attack or blood clots. Seek medical attention immediately if you experience symptoms such as chest pain or shortness of breath.

It’s essential to report any side effects or symptoms experienced during Cabozantinib treatment to your healthcare provider promptly. They can provide guidance on managing side effects and may adjust your treatment plan if necessary.

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

Storage and disposal of Cabozantinib:


  • Room Temperature: Store Cabozantinib capsules at room temperature between 68°F to 77°F (20°C to 25°C).
  • Protect from Light: Keep the medication container tightly closed and protect it from light.
  • Dry Place: Store Cabozantinib away from moisture and heat, such as in the bathroom or kitchen.
  • Keep Out of Reach: Store Cabozantinib out of reach of children and pets.


  • Dispose Properly: Unused or expired Cabozantinib should be disposed of properly to prevent accidental ingestion. Follow any specific disposal instructions provided by your healthcare provider or pharmacist.
  • Take-back Programs: Some pharmacies or community organizations may offer drug take-back programs to safely dispose of unused medications. Check with your local pharmacy or health department for information on available options.
  • Do Not Flush: Do not flush Cabozantinib down the toilet unless instructed to do so by specific medication disposal guidelines.

In case of emergency/overdose

  • Seek Medical Attention: In case of an overdose or emergency, such as accidentally taking too much Cabozantinib, seek immediate medical attention by calling emergency services or contacting your local poison control center.
  • Symptom Management: Treatment for Cabozantinib overdose may involve supportive care to manage symptoms such as elevated blood pressure, gastrointestinal issues, or other adverse effects. Medical professionals will provide appropriate treatment based on the individual’s condition.

What other information should I know?

  • Follow-up Care: Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to Cabozantinib treatment, manage side effects, and adjust your treatment plan as needed.
  • Regular Monitoring: Cabozantinib treatment may require regular monitoring of blood pressure, thyroid function, kidney function, and other parameters to ensure safety and efficacy.
  • Patient Education: Stay informed about Cabozantinib treatment, including its potential side effects, interactions with other medications, and instructions for use. Ask your healthcare provider any questions you may have about your treatment regimen.
  • Medication Interactions: Inform your healthcare provider about all medications, supplements, or herbal products you are taking, as they may interact with Cabozantinib and affect its effectiveness or safety.

By following these guidelines for storage, disposal, and emergency management, you can help ensure the safe and effective use of Cabozantinib for thyroid cancer treatment.

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