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 capsules.
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.
How should I take the cabozantinib capsules?
Cabozantinib capsules 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 capsules. The capsules should be swallowed whole with a glass of water. They must not be chewed or crushed.
How many cabozantinib capsules will I need to take?
It is usual to take several capsules together, each day when you start. It is very common however for the dose to be changed or for you to have a break from treatment. Your doctor will advise you about the best dose for you. . The capsules come in different doses and colour. The amount you need to take will be clearly marked on the packs.
What should I do if I forget to take my capsules?
If you forget to take your capsules, 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 capsules.
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 chemotherapy pager.
How should I store the capsules?
Your capsules 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 capsules 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.
Hair changes
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.
Diarrhoea
You may have diarrhoea with this treatment. If this occurs it is important that you drink plenty of fluids. If you have four or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately. We will need to check your blood tests if you have significant diarrhoea. 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.
Sore mouth
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 capsules 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
Bowel perforation
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.
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 or experience dizziness, please tell your doctor or nurse.
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 whilst taking cabozantinib.
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.
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
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and common side-effects: for more information regarding 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 medicines
Tenovus freephone 0808 808 1010
cancer helpline
7 days a week 8am – 8pm for general queries on cancer
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.