Cabometyx (cabozantinib)

What is Cabometyx?

Cabometyx is a brand-name prescription drug. It’s FDA-approved for use in adults with:

• Renal cell cancer (RCC). This is a type of advanced kidney cancer.
• Hepatocellular carcinoma. This is a type of liver cancer. Cabometyx is used for this condition in adults who’ve previously taken sorafenib (Nexavar).

Cabometyx contains the drug cabozantinib, which belongs to a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs block the tyrosine kinase enzyme to keep cancer cells from growing.

Cabometyx comes as a tablet that’s taken by mouth once a day. You should take it at least 1 hour before or 2 hours after eating.

FDA approval

The Food and Drug Administration (FDA) first approved Cabometyx in 2016 to treat RCC in adults. In 2019, the FDA approved Cabometyx to treat hepatocellular carcinoma in adults.

Effectiveness

To learn about the effectiveness of Cabometyx, see the “Cabometyx uses” section below.

Cabometyx generic

Cabometyx is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Cabometyx contains the active drug ingredient cabozantinib.

Cabometyx side effects

Cabometyx can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Cabometyx. These lists don’t include all possible side effects.

For more information on the possible side effects of Cabometyx, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Cabometyx, you can do so through MedWatch.

Mild side effects

Mild side effects of Cabometyx can include:*

• diarrhea
• fatigue (lack of energy)
• decreased appetite
• nausea and vomiting
• slow healing of wounds
• weight loss
• changes in the way things taste
• hoarse voice
• constipation
• stomatitis (sores inside the mouth)
• abdominal (belly) pain
• rash
• shortness of breath
• cough

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Cabometyx. To learn about other mild side effects, talk with your doctor or pharmacist, or see Cabometyx’s package instructions.

Serious side effects

Serious side effects from Cabometyx aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Gastrointestinal perforation (a hole in the stomach, large intestine, or small intestine). Symptoms can include:
  • pain or tenderness in your abdomen (belly)
  • nausea and vomiting
  • chills
  • fever
• Protein in the urine. Symptoms can include:
  • swelling of the arms, feet, hands, or legs
  • urinating more often than usual
  • nausea or vomiting
• Jaw damage (weakened bone). Symptoms can include:
  • jaw pain
  • toothache
  • tooth or gum infection
  • sores on the gums
• Reversible posterior leukoencephalopathy syndrome (a condition that causes swelling in your brain). Symptoms can include:
  • headache
  • seizures
  • trouble concentrating
  • vision changes
  • confusion

Other serious side effects are explained below in “Side effect details.” These include:

• allergic reaction
• blood clots
• hypertension (high blood pressure)
• hemorrhage (severe bleeding)
• hand-foot syndrome

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Cabometyx. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Cabometyx. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Diarrhea

One of the most common side effects of Cabometyx is diarrhea, which may be severe. In clinical studies, diarrhea occurred in 54% to 74% of people who took Cabometyx. (This percentage varied depending on the condition being treated.)

In comparison, diarrhea occurred in:

• 28% of people who took everolimus (Afinitor)
• 19% of people who took a placebo (a treatment with no active drug)

Severe diarrhea that required a hospital stay occurred in 10% to 11% of people who took Cabometyx. (This percentage varied depending on the condition being treated.) In comparison, severe diarrhea that required a hospital stay occurred in:

• 2% of people who took everolimus
• 11% of people who took sunitinib malate (Sutent)
• 2% of people who took a placebo

Talk with your doctor if you experience diarrhea while taking this medication.

Blood clots

In some cases, taking Cabometyx may cause blood clots. In clinical studies, 7% of people who took Cabometyx had blood clots in a deep vein. Of those who had blood clots in a deep vein, 4% had blood clots in the lungs. Blood clots in the arteries occurred in 2% of people who took Cabometyx. The percentage of people who experienced blood clots while taking other drugs in these studies isn’t known.

In some cases, people taking Cabometyx in clinical trials experienced blood clots that resulted in death. However, it’s not known how often this occurred.

Blood clots in a deep vein can affect the abdomen (belly), arms, brain, lower leg, or pelvis (area above your groin and below your belly button). Blood clots in the lungs can occur when a clot in a deep vein breaks into smaller pieces and becomes stuck in the lungs. Blood clots in the arteries can affect the arms, feet, or legs. Symptoms of a blood clot can include:

• trouble breathing
• chest pain
• swelling of your arm or leg

Talk with your doctor right away if you experience these symptoms while taking Cabometyx.

High blood pressure

Cabometyx may cause hypertension (high blood pressure). In clinical studies, high blood pressure was reported in 28% to 39% of people who took Cabometyx. (This percentage varied depending on the condition being treated.)

In comparison, high blood pressure occurred in:

• 8% of people who took everolimus
• 6% of people who took a placebo

In one clinical study, 28% of people who took Cabometyx had to be hospitalized because of high blood pressure. In comparison, 21% of people who took sunitinib had to be hospitalized because of high blood pressure.

In severe cases, some people taking Cabometyx may have a hypertensive crisis. A hypertensive crisis occurs when blood pressure increases very quickly to a measurement above 180/120 millimeters of mercury (mm Hg). The percentage of people who experienced a hypertensive crisis while taking Cabometyx in clinical studies isn’t known.

Symptoms of high blood pressure

You may not have any symptoms of high blood pressure, but in severe cases you might. Symptoms of severe high blood pressure can include:

• chest pain
• confusion
• headache
• nausea or vomiting
• trouble breathing
• urinating less than usual
• weakness in the arms, face, or legs
• vision changes (such as blurry vision or loss of vision)

Talk with your doctor about your risk for developing high blood pressure. They may want to check your blood pressure at each appointment.

Also talk with your doctor before you start taking Cabometyx if you have blood pressure issues. Your doctor may decide to prescribe you a different drug to treat your cancer.

Severe bleeding

For some people, Cabometyx may cause a hemorrhage (severe bleeding). In clinical studies, severe bleeding occurred in 5% of people who took Cabometyx. The percentage of people who experienced severe bleeding while taking other drugs in these studies isn’t known.

In rare cases, people taking Cabometyx in clinical trials experienced severe bleeding that resulted in death. However, it’s not known how often this occurred.

Symptoms of severe bleeding can include:

• coughing up blood or vomiting up blood
• blood in the stool or black stool
• vomit that looks like coffee grounds

Talk with your doctor right away if you experience any of these symptoms.

Hand-foot syndrome

Cabometyx may cause palmar-plantar erythrodysesthesia (hand-foot syndrome). In clinical studies, hand-foot syndrome occurred in 42% to 46% of people who took Cabometyx. (This percentage varied depending on the condition being treated.) In comparison, hand-foot syndrome occurred in 5% of people who took a placebo and 6% of those who took everolimus.

Symptoms of hand-foot syndrome can include a painful rash, redness, and blisters on the palms of your hands or on the bottom of your feet.

Talk with your doctor right away if you think you have hand-foot syndrome.

Eye problems

Eye problems aren’t a side effect of Cabometyx. However, eye problems can be a symptom of a severe reaction to Cabometyx called reversible posterior leukoencephalopathy syndrome (a condition that causes swelling in your brain).

Other symptoms of this reaction can include:

• headache
• trouble concentrating
• confusion

Talk with your doctor right away if you experience any changes in vision while taking Cabometyx.

Cabometyx dosage

The Cabometyx dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Cabometyx to treat
• your age
• the form of Cabometyx you take
• other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Cabometyx comes as a tablet that’s taken by mouth. It’s available in three strengths: 20 mg, 40 mg, and 60 mg.

Dosage for kidney cancer

When used to treat renal cell cancer (RCC), the recommended dosage of Cabometyx is 60 mg once a day. (RCC is a type of advanced kidney cancer.) Cabometyx shouldn’t be taken with food.

Your doctor may prescribe you a different dosage depending on several factors, including whether you have liver disease. If you have questions about the dosage that’s right for you, talk with your doctor.

Dosage for liver cancer

When used to treat hepatocellular carcinoma, the recommended dosage of Cabometyx is 60 mg once a day. (Hepatocellular carcinoma is a type of liver cancer.) Cabometyx shouldn’t be taken with food.

Your doctor may prescribe you a different dosage depending on several factors, including whether you have liver disease. If you have questions about the dosage that’s right for you, talk with your doctor.

What if I miss a dose?

If it’s more than 12 hours until your next dose, take your missed dose as soon as you remember.

If you miss a dose, and your next dose is due in less than 12 hours, skip the missed dose and simply take your next dose at the normal time. Don’t “double up” and take two doses, as this could cause side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Cabometyx is meant to be used as a long-term treatment, as long as it’s working for you and you don’t have bothersome side effects. If you and your doctor determine that Cabometyx is safe and effective for you, you’ll likely take it long term.

Cabometyx uses

The Food and Drug Administration (FDA) approves prescription drugs such as Cabometyx to treat certain conditions. Cabometyx may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Cabometyx for kidney cancer

Cabometyx is FDA-approved for use in adults with renal cell cancer (RCC), a type of advanced kidney cancer. RCC is the most common type of kidney cancer. It may grow as a single tumor in one kidney or as tumors in both kidneys.

For this use, Cabometyx can be used as a first treatment or after you’ve had other treatments for your cancer.

Effectiveness as a first treatment for kidney cancer

In clinical studies, Cabometyx was found to be effective for use in adults first starting treatment for RCC.

One clinical study compared Cabometyx and sunitinib malate (Sutent) as first treatments. The researchers wanted to see which medication was better at improving progression-free survival. (This refers to the length of time someone lives without their disease getting worse.)

Of the people who took Cabometyx, 50% of them experienced progression-free survival for at least 8.6 months. Of the people who took sunitinib malate, 50% of them experienced progression-free survival for at least 5.3 months.

Of the people who took Cabometyx, 20% had their kidney tumor shrink. In comparison, 9% of those who took sunitinib malate had their kidney tumor shrink.

Effectiveness for kidney cancer that’s been treated before

Clinical studies have also shown Cabometyx to be effective for treating kidney cancer in adults who’ve previously taken a different cancer drug.

A clinical study compared Cabometyx and everolimus (Afinitor) in people who’ve already tried at least one other treatment for kidney cancer. The researchers wanted to see which medication was better at improving progression-free survival. (This refers to the length of time someone lives without their disease getting worse.)

Of the people who took Cabometyx, 50% of them experienced progression-free survival for at least 7.4 months. Of the people who took everolimus, 50% of them experienced progression-free survival for at least 3.8 months.

Of those who took Cabometyx, 17% had their kidney tumor shrink. In comparison, 3% of people who took everolimus had their kidney tumor shrink.

Of the people who took Cabometyx, 50% of them were still alive 21.4 months after starting treatment. In comparison, 50% of people who took everolimus were still alive 16.5 months after starting treatment.

Cabometyx for liver cancer

Cabometyx is FDA-approved to treat hepatocellular carcinoma in adults who’ve previously taken sorafenib (Nexavar). Hepatocellular carcinoma is the most common type of liver cancer in adults. It may grow as a single tumor or as many small tumors throughout the liver.

Effectiveness for liver cancer

Clinical studies have found Cabometyx to be effective for treating liver cancer in adults who’ve previously been treated with a different drug.

One clinical study compared Cabometyx with a placebo in people who had previously taken sorafenib (Nexavar). The researchers wanted to see if Cabometyx helped people live longer. They also wanted to see if Cabometyx improved progression-free survival. (This refers to the length of time someone lives without their disease getting worse.)

In the study, 50% of people taking Cabometyx were still alive 10.2 months after starting treatment. In comparison, 50% of people taking a placebo were still alive 8 months after starting treatment.

Of the people who took Cabometyx, 50% of them experienced progression-free survival for at least 5.2 months. In comparison, 50% of people who took a placebo experienced progression-free survival for at least 1.9 months.

Of the people taking Cabometyx, 4% had their liver tumor shrink. In comparison, 0.4% of people taking a placebo had their liver tumor shrink.

Off-label use for Cabometyx

In addition to the uses listed above, Cabometyx may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below is an example of off-label use for Cabometyx.

Cabometyx for non-small cell lung cancer

Cabometyx is sometimes used off-label to treat non-small cell lung cancer (NSCLC). A clinical study has shown Cabometyx to be effective for treating NSCLC in adults who’ve had at least two previous treatments for their cancer.

Another clinical study showed Cabometyx to be effective for use in people who have NSCLC with certain genetic mutations.

More research is needed to determine Cabometyx’s role in treating NSCLC.

Cabometyx and children

Cabometyx isn’t approved for use in children. It’s not known if the drug is safe or effective for children.

Common questions about Cabometyx

Here are answers to some frequently asked questions about Cabometyx.

What is the life expectancy of someone taking Cabometyx?

Life expectancy with Cabometyx can depend on many factors, including which type of cancer you’re using it to treat.

In clinical studies, life expectancy rates differed between people with kidney and liver cancers.

In clinical studies, 50% of people taking Cabometyx for renal cell cancer (RCC), a type of kidney cancer, were still alive 21.4 months after starting treatment. In comparison, 50% of people who took everolimus for RCC were still alive 16.5 months after starting treatment.

In clinical studies, 50% of people taking Cabometyx for hepatocellular carcinoma (a type of liver cancer) were still alive 10.2 months after starting treatment. In comparison, 50% of those taking a placebo for hepatocellular carcinoma were still alive 8 months after starting treatment.

In the studies, people taking Cabometyx for either type of cancer generally lived longer than people taking other cancer drugs.

It’s important to note that everyone’s situation is unique, and your results from Cabometyx may not match those seen in clinical trials. If you have questions about life expectancy while you’re taking Cabometyx, talk with your doctor.

When should I contact my doctor if I have diarrhea?

Talk with your doctor right away if you experience diarrhea while taking Cabometyx. Severe diarrhea that’s not treated properly can lead to dehydration (when your body loses more fluid than it takes in).

Diarrhea is a common side effect of Cabometyx and may be severe. In clinical studies, diarrhea occurred in 63% of people who took Cabometyx. Severe diarrhea that required a hospital stay occurred in 11% of people who took Cabometyx.

For more information, see the “Diarrhea” section under “Side effect details.”

Can I have surgery while I’m taking Cabometyx?

If you’re going to have a planned surgery during your Cabometyx treatment, you’ll need to stop taking the drug for a while. This is because Cabometyx can cause surgical cuts to heal slowly.

Talk with your doctor if you plan to have surgery before or during your Cabometyx treatment. They will likely have you stop taking Cabometyx for several weeks before and after the surgery to allow your wounds to heal.

Is Cabometyx a chemotherapy drug?

No, Cabometyx isn’t a chemotherapy drug. Chemotherapy drugs work to kill cells that are growing quickly. Cancer cells tend to grow more quickly than normal cells. However, chemotherapy drugs can’t tell the difference between healthy cells and cancer cells. This means that healthy cells can be damaged by chemotherapy, which can lead to side effects from the drug.

Cabometyx is a targeted therapy for cancer. Targeted therapies are better at telling the difference between cancer cells and healthy cells. Therefore, they have less of an effect on healthy cells. Cabometyx belongs to a class of targeted cancer drugs called tyrosine kinase inhibitors (TKIs). TKIs block the tyrosine kinase enzyme to keep cancer cells from growing.

Will Cabometyx cure my cancer?

No, Cabometyx doesn’t cure cancer. It’s approved to treat renal cell cancer (a type of kidney cancer) and hepatocellular carcinoma (a type of liver cancer). There is currently no cure for these types of cancer.

To learn about the effectiveness of Cabometyx, see the “Cabometyx uses” section above. Talk with your doctor if you have questions about how this drug works to treat your cancer.

Alternatives to Cabometyx

Other drugs are available that can treat your kidney cancer or liver cancer. Some may be a better fit for you than others. If you’re interested in finding an alternative to Cabometyx, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for kidney cancer

Examples of other drugs that may be used to treat kidney cancer include:

• avelumab (Bavencio)
• axitinib (Inlyta)
• bevacizumab (Avastin)
• everolimus (Afinitor)
• interferon-alfa
• interleukin-2
• ipilimumab (Yervoy)
• lenvatinib (Lenvima)
• nivolumab (Opdivo)
• pazopanib (Votrient)
• pembrolizumab (Keytruda)
• sorafenib (Nexavar)
• sunitinib (Sutent)
• temsirolimus (Torisel)

Talk to your doctor about the best treatment options to fit your needs.

Alternatives for liver cancer

Examples of other drugs that may be used to treat liver cancer include:

• lenvatinib (Lenvima)
• nivolumab (Opdivo)
• pembrolizumab (Keytruda)
• ramucirumab (Cyramza)
• regorafenib (Stivarga)
• sorafenib (Nexavar)

Talk with your doctor about the best treatment to fit your needs.

Cabometyx vs. Cometriq

Cabometyx is FDA-approved for use in adults with:

• renal cell cancer (RCC), a type of advanced kidney cancer
• hepatocellular carcinoma, a type of liver cancer, in those who’ve previously taken sorafenib (Nexavar)

Cometriq is approved for use in adults with metastatic medullary thyroid cancer, a rare type of thyroid cancer that’s spread to other parts of the body.

Cabometyx and Cometriq both contain the drug cabozantinib. Cabometyx comes as a tablet, and Cometriq comes as a capsule. Although Cabometyx and Cometriq contain the same active drug, they have different approved uses and shouldn’t be substituted for each other.

Both Cabometyx and Cometriq are taken by mouth once a day. Both should be taken at least 1 hour before or 2 hours after eating.

Cabometyx vs. Sutent

You may wonder how Cabometyx compares with other medications that are prescribed for similar uses. Here we look at how Cabometyx and Sutent are alike and different.

Ingredients

Cabometyx contains the drug cabozantinib. Sutent contains the drug sunitinib. Both Cabometyx and Sutent belong to a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs block the tyrosine kinase enzyme to keep cancer cells from growing.

Uses

Cabometyx is FDA-approved for use in adults with:

• renal cell cancer (RCC), a type of advanced kidney cancer
• hepatocellular carcinoma, a type of liver cancer, in those who’ve previously taken sorafenib (Nexavar)

Sutent is FDA-approved for use in adults with:

• gastrointestinal stromal tumor (GIST), a type of abdominal (belly) cancer, in those whose tumors have grown or who’ve previously taken imatinib (Gleevec)
• RCC, as a first treatment
• RCC, in people who’ve had surgery to remove a kidney and are at risk of RCC tumors returning
• advanced or metastatic pancreatic neuroendocrine tumors (pNET), a type of cancer that starts in the pancreas and may spread to other parts of the body

Drug forms and administration

Cabometyx comes as a tablet that’s taken by mouth once a day. You should take it at least 1 hour before or 2 hours after eating. Sutent comes as a capsule that’s taken by mouth once a day. You can take it with or without food.

Side effects and risks

Cabometyx and Sutent have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Cabometyx, with Sutent, or with both Cabometyx and Sutent (when taken individually).

• Can occur with Cabometyx:
  • weight loss
  • hoarse voice
  • slow healing of wounds
  • abdominal (belly) pain
• Can occur with Sutent:
  • indigestion (upset stomach)
  • skin discoloration
• Can occur with both Cabometyx and Sutent:
  • diarrhea
  • fatigue (lack of energy)
  • decreased appetite
  • nausea and vomiting
  • stomatitis (sores inside the mouth)
  • changes in the way things taste

Serious side effects

These lists contain examples of serious side effects that can occur with Cabometyx, with Sutent, or with both drugs (when taken individually).

• Can occur with Cabometyx:
  • reversible posterior leukoencephalopathy syndrome (a condition that causes swelling in your brain)
• Can occur with Sutent:
  • changes in skin or hair color
  • heart problems, including heart failure, heart attack, and abnormal changes to heart rhythm
  • liver damage
  • hypoglycemia (low blood sugar)
  • severe skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
  • thyroid problems
  • tumor lysis syndrome (cancer cells release harmful chemicals into your blood)
• Can occur with both Cabometyx and Sutent
  • allergic reaction
  • blood clots
  • hand-foot syndrome
  • hypertension (high blood pressure)
  • jaw damage (weakened bone)
  • protein in the urine
  • hemorrhage (severe bleeding)
  • gastrointestinal perforation (a hole in the stomach, large intestine, or small intestine)

Effectiveness

Cabometyx and Sutent have different FDA-approved uses, but they’re both used to treat renal cell cancer (RCC), a type of advanced kidney cancer.

The use of Cabometyx and Sutent in treating RCC has been directly compared in a clinical study.

The researchers wanted to see which medication was better at improving progression-free survival. (This refers to the length of time someone lives without their disease getting worse.)

Of the people who took Cabometyx, 50% of them experienced progression-free survival for at least 8.6 months. Of the people who took Sutent, 50% of them experienced progression-free survival for at least 5.3 months.

Of the people who took Cabometyx, 20% had their kidney tumor shrink. In comparison, 9% of those who took Sutent had their kidney tumor shrink.

Costs

Cabometyx and Sutent are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Cabometyx costs significantly more than Sutent. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Cabometyx vs. Nexavar

Cabometyx and Nexavar are prescribed for similar uses. Below are details of how these medications are alike and different.

Ingredients

Cabometyx contains the drug cabozantinib. Nexavar contains the drug sorafenib. Both Cabometyx and Nexavar belong to a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs block the tyrosine kinase enzyme to keep cancer cells from growing.

Uses

Cabometyx is FDA-approved for use in adults with:

• renal cell cancer (RCC), a type of advanced kidney cancer
• hepatocellular carcinoma, a type of liver cancer, in those who’ve previously taken sorafenib (Nexavar)

Nexavar is FDA-approved for use in adults with:

• RCC
• hepatocellular carcinoma, in those who can’t have their liver tumor removed
• a certain type of differentiated thyroid carcinoma (a form of thyroid cancer)

Drug forms and administration

Cabometyx comes as a tablet that’s taken by mouth once a day. You should take it at least 1 hour before or 2 hours after eating. Nexavar comes as a tablet that’s taken by mouth twice a day. Nexavar should also be taken at least 1 hour before or 2 hours after a meal.

Side effects and risks

Cabometyx and Nexavar have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Cabometyx, with Nexavar, or with both drugs (when taken individually).

• Can occur with Cabometyx:
  • changes in the way things taste
  • hoarse voice
  • slow healing of wounds
  • stomatitis (sores inside the mouth)
• Can occur with Nexavar:
  • alopecia (hair loss)
  • rash
• Can occur with both Cabometyx and Nexavar:
  • diarrhea
  • fatigue (lack of energy)
  • decreased appetite
  • nausea and vomiting
  • weight loss
  • abdominal (belly) pain

Serious side effects

These lists contain examples of serious side effects that can occur with Cabometyx, with Nexavar, or with both drugs (when taken individually).

• Can occur with Cabometyx:
  • blood clots
  • jaw damage (weakened bone)
  • protein in the urine
  • reversible posterior leukoencephalopathy syndrome (a condition that causes swelling in your brain)
• Can occur with Nexavar:
  • heart disease, including heart failure, heart attack, and problems with heart rhythm
  • liver damage
  • severe skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
  • thyroid problems
• Can occur with both Cabometyx and Nexavar:
  • allergic reaction
  • hand-foot syndrome
  • hypertension (high blood pressure)
  • hemorrhage (severe bleeding)
  • gastrointestinal perforation (a hole in the stomach, large intestine, or small intestine)

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Cabometyx and Nexavarto be effective for treating renal cell cancer (RCC) and hepatocellular carcinoma.

An indirect comparison, called a meta-analysis, has been conducted to see if either medication is better at improving progression-free survival in people with advanced RCC. The study found that Cabometyx was better at improving progression-free survival compared to Nexavar.

Costs

Cabometyx and Nexavarare both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Cabometyx costs significantly more than Nexavar. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Cabometyx and alcohol

There is no known interaction between Cabometyx and alcohol. If you drink alcohol, talk with your doctor about how much is safe for you to drink during your Cabometyx treatment.

How Cabometyx works

Cabometyx is FDA-approved for use in adults with:

• renal cell cancer (RCC), a type of advanced kidney cancer
• hepatocellular carcinoma, a type of liver cancer, in people who’ve previously taken sorafenib (Nexavar)

About RCC and hepatocellular carcinoma

RCC is the most common type of kidney cancer. RCC may grow as a single tumor in one kidney, or as tumors in both kidneys.

Hepatocellular carcinoma is the most common type of liver cancer in adults. It may grow as a single tumor, or as many small tumors throughout the liver.

Cancer occurs when cells in the body begin to grow, divide, and spread without stopping. Normal human cells will die when the body no longer needs them. However, cancer cells may continue to grow and spread even when these cells aren’t needed.

What Cabometyx does

Cabometyx belongs to a class of drugs called tyrosine kinase inhibitors (TKIs). TKIs work by blocking the tyrosine kinase enzyme. This enzyme helps the cancer cells grow and divide. Blocking this enzyme slows cancer by keeping cancer cells from growing.

How long does it take to work?

Cabometyx starts working right away to slow the growth of tumors. It may take several weeks for your tumors to stop growing or become smaller.

You won’t notice Cabometyx working in your body. However, your doctor will do tests during your treatment to check if Cabometyx is working for you.

Cabometyx interactions

Cabometyx can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Cabometyx and other medications

Below is a list of medications that can interact with Cabometyx. This list doesn’t contain all drugs that may interact with Cabometyx.

Before taking Cabometyx, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Cabometyx and certain medications that affect how your body metabolizes Cabometyx

Cabometyx shouldn’t be taken with certain drugs that affect how your body metabolizes (breaks down) Cabometyx.

Strong CYP3A4 inhibitors

You shouldn’t take Cabometyx with a type of drug called a strong CYP3A4 inhibitor. This type of drug works by inhibiting (blocking) an enzyme in the body called CYP3A4. This is the enzyme your body uses to break down Cabometyx.

Blocking this enzyme can raise the level of Cabometyx in your blood, which can increase your risk for side effects.

The following drugs are examples of strong CYP3A4 inhibitors. Talk with your doctor before taking Cabometyx if you use any of these drugs:

• cobicistat (Tybost)
• indinavir (Crixivan)
• itraconazole (Sporanox, Tolsura)
• ketoconazole
• lopinavir/ritonavir (Kaletra)
• paritaprevir/ritonavir/ombitasvir
• paritaprevir/ritonavir/ombitasvir/dasabuvir (Viekira Pak)
• posaconazole (Noxafil)
• ritonavir (Norvir)
• saquinavir (Invirase)
• tipranavir (Aptivus)
• voriconazole (Vfend)

Strong CYP3A4 inducers

You also shouldn’t take Cabometyx with a type of drug called a strong CYP3A4 inducer. Drugs of this type can increase how quickly the CYP3A4 enzyme breaks down Cabometyx. This can lower the level of Cabometyx in your blood, which may prevent Cabometyx from working effectively. Therefore, you shouldn’t take Cabometyx with this type of drug.

The following drugs are examples of strong CYP3A4 inducers. Talk with your doctor before taking Cabometyx if you use any of these drugs.

• apalutamide (Erleada)
• carbamazepine (Tegretol)
• enzalutamide (Xtandi)
• mitotane (Lysodren)
• phenytoin (Dilantin)
• rifampin (Rifadin)

Cabometyx and herbs and supplements

You should avoid taking St. John’s wort during your Cabometyx treatment. Taking Cabometyx with this herbal supplement may cause Cabometyx to be less effective.

Check with your doctor or pharmacist before using any herbs or supplements while taking Cabometyx.

Cabometyx and foods

You shouldn’t eat grapefruit or drink grapefruit juice during your Cabometyx treatment. Grapefruit or grapefruit juice may increase the level of Cabometyx in your blood. This may raise your risk for side effects.

Talk with your doctor if you have any questions about eating certain foods with Cabometyx.

Cabometyx cost

As with all medications, the cost of Cabometyx can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Cabometyx at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Cabometyx. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Cabometyx.

If you’re not sure if you’ll need to get prior authorization for Cabometyx, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Cabometyx, or if you need help understanding your insurance coverage, help is available.

Exelixis, the manufacturer of Cabometyx, offers a program called Exelixis Access Services (EASE). This program offers a copay card that can be used by people with commercial insurance. The copay card may help lower the cost of the drug. EASE also provides assistance for people with or without insurance who can’t afford Cabometyx.

For more information and to find out if you’re eligible for support, call 844-900-3273 or visit the program website.

Generic version

Cabometyx isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

How to take Cabometyx

You should take Cabometyx according to your doctor’s or healthcare provider’s instructions. For more information on how to take Cabometyx, visit the drug’s website.

When to take

Try to take your dose each day at the same time. To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Cabometyx with food

You should take Cabometyx on an empty stomach, at least 1 hour before or 2 hours after eating. Take Cabometyx with a full glass of water (at least 8 ounces).

Can Cabometyx be crushed, split, or chewed?

No, Cabometyx shouldn’t be crushed, split, or chewed. You should swallow Cabometyx tablets whole.

Cabometyx and pregnancy

Cabometyx isn’t safe to take while pregnant. Based on animal studies, it may cause harm to the fetus when taken by a pregnant woman. Talk with your doctor right away if you become pregnant while taking this drug.

Based on animal studies, taking Cabometyx may lead to fertility problems (trouble conceiving a child) for some men and women. However, animal studies don’t always predict what will happen in humans.

If you and your partner are planning a pregnancy, talk with your doctor before starting Cabometyx.

Cabometyx and birth control

Cabometyx isn’t safe to use during pregnancy. If you’re a woman who can become pregnant, you’ll need to use birth control while taking Cabometyx.

You should continue using birth control for 4 months after taking your last Cabometyx dose. If you have questions about your birth control options, talk with your doctor.

The manufacturer of Cabometyx hasn’t given birth control recommendations for men using the drug. If you’re a man using Cabometyx and you’re sexually active with a woman who could become pregnant, talk with your doctor about your birth control needs while using this drug.

Cabometyx and breastfeeding

It’s not known if Cabometyx can pass into breast milk. Side effects could occur in children who are breastfed. Therefore, it’s best not to breastfeed while taking Cabometyx or for 4 months after taking your last dose.

If you’re currently breastfeeding or planning to breastfeed while taking Cabometyx, talk with your doctor about the risks and benefits.

Cabometyx precautions

Before taking Cabometyx, talk with your doctor about your health history. Cabometyx may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Hemorrhage (severe bleeding). You shouldn’t take Cabometyx if you’ve recently had a hemorrhage. If you’ve recently had an issue with severe bleeding, talk with your doctor about whether Cabometyx is safe for you to take.
• High blood pressure. If you have uncontrolled high blood pressure, you shouldn’t take Cabometyx. This is because Cabometyx may raise your blood pressure even more. Your doctor may prescribe you medication to treat your high blood pressure before you take Cabometyx.
• Surgery. Cabometyx can slow your body’s ability to heal wounds. You shouldn’t use Cabometyx for at least 3 weeks before having a planned surgery. You also shouldn’t use Cabometyx for at least 2 weeks following a major surgery. Talk with your doctor if you have questions about having surgery while taking Cabometyx.
• Pregnancy. It’s not safe to use Cabometyx while pregnant. Talk to your doctor right away if you become pregnant while taking this drug. For more information, see the “Cabometyx and pregnancy” section above.
• Breastfeeding. It’s recommended that you don’t breastfeed while using Cabometyx. For more information, see the “Cabometyx and breastfeeding” section above.

Note: For more information about the potential negative effects of Cabometyx, see the “Cabometyx side effects” section above.

Cabometyx overdose

Using more than the recommended dosage of Cabometyx can lead to serious side effects.

Don’t use more Cabometyx than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

• confusion
• increase in blood urea nitrogen (BUN) levels (measured by a test that evaluates kidney function)
• memory loss
• weight loss

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Cabometyx expiration, storage, and disposal

When you get Cabometyx from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Cabometyx tablets should be stored at room temperature between 68°F and 77°F (20°C and 25°C). It should be kept in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Cabometyx and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.