A kinase is an enzyme that promotes cell growth. There are many types of kinases, which control different phases of cell growth. By blocking a particular enzyme from working, this medication can slow the growth of cancer cells.

Cabozantinib is a type of targeted therapy called a tyrosine kinase inhibitor that blocks a few targets including VEGF, MET, RET, and ROS. This means it works by targeting receptors present on the cancer cells. By blocking these targets on cancer cells, tumor growth and angiogenesis (the development of a blood supply to the tumor) are blocked.

How to Take Cabozantinib

Cabozantinib comes in both capsule and tablet form, both in several dosage strengths. You should never substitute capsules for tablets or tablets for capsules. It is taken once a day on an empty stomach. Do not eat for 2 hours before, or 1 hour after the dose. Swallow the capsules or tablets whole with a full glass (at least 8 ounces) of water; do not open, break or chew the capsules or tablets. Do not take a missed dose within 12 hours of the next dose. Do not take 2 doses at once to make up for a missed dose.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. Your dose may be altered if you are taking any of these medications. These include: grapefruit, grapefruit juice, ketoconazole, posaconazole, voriconazole rifampin, phenytoin, phenobarbital, St. John’s wort, and carbamazepine. Be sure to tell your healthcare provider about all medications and supplements you take.

Storage and Handling

Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist). This medication should not be stored in a pillbox. Keep containers out of reach of children and pets.

If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.

Possible side effects

There are a number of things you can do to manage the side effects of cabozantinib. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Diarrhea

Diarrhea can be a serious side effect that can lead to dehydration and other gastrointestinal side effects. Notify your healthcare provider immediately if you are experiencing an increase in the frequency of bowel movements or if your bowel movements become loose.

Fatigue

Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.

Nausea and/or Vomiting

Talk to your oncology care team so they can prescribe medications to help you manage nausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try saltines, or ginger ale to lessen symptoms.