This leaflet provides information on a course of treatment called cabozantinib. The leaflet will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers are given at the end of the leaflet.
What is cabozantinib?
Cabozantinib is a cancer treatment which is given as tablets.
Why am I having cabozantinib?
Cabozantinib has been found to help some patients with your type of cancer.
How often will I see the specialist team?
You will see the specialist team regularly at first and then as advised by your doctor. You will have regular blood tests and we will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you.
Can I bring relatives and friends with me?
Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment.
How should I take the cabozantinib tablets?
Cabozantinib tablets should be taken once a day. Try to take them at approximately the same time every day on an empty stomach. Do not eat 2 hours before or 1 hour after taking the tablets. The tablets should be swallowed whole with a large glass of water. They must not be chewed or crushed.
How many cabozantinib tablets will I need to take?
Your doctor will advise you about the best dose for you. The tablets come in different doses and colours. The amount you need to take will be clearly marked on the packs. It is very common however for the dose to be changed or for you to have a break from treatment.
What should I do if I forget to take my tablets?
If you forget to take your tablets, take them as soon as possible but do not take if less than 12 hours before the next dose. Do not take any additional cabozantinib tablets.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Please ask for the treatment helpline.
How should I store the tablets?
Your tablets should be stored in their original packaging and in a safe place away from children. They should be kept in a cool dry place (below 25oC).
Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
What are the possible side effects?
Side effects are quite common with this drug but they are usually easily treated. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Nausea and vomiting, loss of appetite
Loss of appetite varies from person to person. Some people may have a problem with nausea and vomiting. If you do have these symptoms please tell your doctor, who can give you anti-sickness medication to take at home.
Some people will notice their hair losing colour. A small number of people will notice hair thinning and possibly hair loss. This is only temporary. Your hair will grow back and the colour will change again when your treatment has finished.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
Effects on your bowels
Cabozantinib can cause both constipation or diarrhoea. If you have constipation it may be relieved by drinking plenty of fluids and eating lots of fibre. Your doctor can prescribe medication to relieve constipation.
If you have diarrhoea it is important that you drink plenty of fluids. Medication is available to control diarrhoea. If you have 4 or more bowel movements in 24 hours above what is normal for you, you should stop taking your cabozantinib tablets and contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Soreness to your hands and feet
You may experience mild pain, redness, swelling and possible blisters on your hands or feet. If this occurs we recommend regular use of a non perfumed cream or lotion, such as Aveeno® or an aqueous cream. Please contact Velindre Cancer Centre if your hands or feet become painful.
Myalgia (pain in the muscles)
Some patients may experience myalgia which is muscle pain. This can sometimes be severe but will only last for a few days. If you already have painkillers at home you may find they relieve the pain. If this does not work please contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.
If your mouth becomes very painful or you are finding it difficult to eat and drink, you should stop taking your cabozantinib tablets and contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
High blood pressure
Cabozantinib can cause an increase in blood pressure in some people. Your blood pressure will be checked regularly during your treatment. If you have headaches, nosebleeds or feel dizzy let your doctor know. High blood pressure can usually be controlled with tablets prescribed by your doctor. Rarely patients may have bleeding or haemorrhage, if you cough blood or vomit coffee ground liquid, pass black stools, or notice heavy periods, please contact the chemotherapy pager, the telephone number is at the end of the leaflet.
A small number of patients can develop a small hole in the wall of the bowel (perforation). This is rare, but if you develop any abdominal pain, swelling, pass blood in stool or vomit blood, contact Velindre Cancer Centre for advice.
Tiredness and fatigue
Cabozantinib can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest.
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other side effects and information
Some people may experience problems with headaches. Try taking the painkillers you would normally take for a headache. If you find that painkillers do not help or you have any problems with your vision, experience dizziness or confusion, please tell your doctor or nurse. Rarely patients may have seizures, if this occurs call your GP, if severe you may need to dial 999. You must inform your oncologist this has occurred. You will need to stop taking the treatment.
Very rarely this treatment affects the nerves to your hands and feet. This results in a loss of sensation or altered sensation such as ‘pins and needles’ or ‘tingling’. In most cases the symptoms will resolve within a few months of finishing your treatment.
Wounds may take longer to heal while you are having treatment with cabozantinib. If you are due to have surgery, including simple things like a tooth removal at the dentist, you should let your doctor know. You may need to stop your cabozantinib medication for a period of time before and after the procedure to allow the wounds to heal well.
Cabozantinib may cause heart problems. If you have a heart condition or you take any heart medication please tell your doctor before you start
Cabozantinib may cause muscle spasm. If you do get muscle spasms please let us know.
Cabozantinib may cause abdominal pain or indigestion. Please inform your doctor or nurse if you have abdominal pain or indigestion.
Is it alright to take other medicines with cabozantinib?
If you are taking other medicines, vitamins or herbal remedies please let your doctor, nurse or pharmacist know. There are a small number of medicines that you may have to avoid. These include St. John’s Wort.
Please tell your doctor, nurse or pharmacist if you take warfarin tablets.
Avoid drinking grapefruit juice or eating grapefruits, at the same time as taking cabozantinib.
It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby. Use contraception whilst taking cabozantinib. It is not advisable to breast feed whilst taking cabozantinib and for 4 months afterwards.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
For urgent advice at any time of the day or night please ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicine.
Tenovus freephone 0808 808 1010
Macmillan freephone Helpline 0808 808 0000
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.