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Cabozantinib is used to treat:

-Advanced renal cell carcinoma.

-Liver cancer.

-Certain types of thyroid cancer.

Dose and Schedule

Taking Cabozantinib as instructed is essential for effective treatment. Please keep the following key points in mind:

  • Your dose may vary, but the usual dosages are:
    • Renal Cell Carcinoma: 40–60 mg, taken by mouth once a day at a scheduled time.
    • Liver Cancer: 60 mg, taken by mouth once a day at a scheduled time.
    • Metastatic Thyroid Carcinoma: 140 mg, taken by mouth once a day at a scheduled time.
    • Differentiated Thyroid Carcinoma: 40–60 mg, taken by mouth once a day at a scheduled time.
  • Take Cabozantinib on an empty stomach, at least 1 hour before or 2 hours after a meal.
  • Do not switch Cabozantinib tablets for capsules.
  • Swallow tablets whole—do not crush, cut, or dissolve them. If swallowing is difficult, consult your doctor for alternative options.

Missed Dose

  • If it has been more than 12 hours since your scheduled dose, skip the missed dose and take the next one at the regular time.
  • Do not double your dose. Record missed doses and inform your doctor.
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Drug and Food Interactions

  • Inform your doctor about all prescription medications, over-the-counter medicines, vitamins, and herbal products you are taking.
  • Avoid consuming grapefruit or grapefruit juice, as they may interact with Cabozantinib.
  • Always consult your doctor or pharmacist before starting new medications, supplements, or receiving vaccines.
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Storage and Handling

  • Store Cabozantinib at room temperature (below 25°C) in a dry, light-protected location.
  • Keep out of reach of children and pets.
  • Leave the medication in its original packaging until ready to use.
  • Handle the tablets with care, as they are toxic. Family members or caregivers should wear gloves when handling Cabozantinib.
  • Administer the medication immediately by mouth with water.

Disposal

  • Do not throw unused Cabozantinib in the trash or flush it. Return unused medication to your healthcare provider for proper disposal.

Travel Precautions

  • Place Cabozantinib packaging in a sealed plastic bag. Ask your pharmacist about additional travel precautions.
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Side Effects

Common Side Effects

The following side effects may occur in some patients, but you may not experience any of them:

Blood Count Changes

  • Decreased white blood cells (WBCs): Increases the risk of infection.
  • Low haemoglobin: May cause fatigue or tiredness.
  • Low platelet count: Increases the risk of bleeding.

Liver and Kidney Function

  • Changes in liver or kidney function.

Electrolyte and Lab Value Changes

  • High glucose, triglyceride, or lactate dehydrogenase levels.
  • Low levels of sodium, phosphate, albumin, calcium, or magnesium.
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Management Tips

Protect Yourself from Infections

  • Wash hands frequently.
  • Avoid crowds and people with fevers or infections.
  • Maintain good personal hygiene.

When to Contact Us

  • Fever (over 38°C).
  • Chills, sore throat, or burning during urination.
  • Unusual tiredness or persistent sores.

For Low Haemoglobin

  • Get 7–8 hours of sleep nightly.
  • Balance activity with rest and stay active as much as possible.
  • Call us immediately if you experience shortness of breath, dizziness, or palpitations.

For Low Platelets

  • Avoid activities that may cause bruises, cuts, or burns.
  • Brush teeth gently and use a soft toothbrush.
  • Contact us if you experience prolonged or severe bleeding.

Liver or Kidney Issues

  • Call if you notice yellowing of the skin, dark urine, or reduced urination.

Electrolyte Imbalance Symptoms

  • Chest discomfort, headaches, dizziness, or unusual swelling.
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Managing Other Side Effects

Fatigue

  • Rest as needed but remain active.
  • Plan activities for when you feel more energetic.

Diarrhoea

  • Drink 8–10 glasses of water daily.
  • Eat small, bland, low-fibre meals.
  • Avoid high-fibre, spicy, fried, or greasy foods.
  • Use over-the-counter remedies like Loperamide (Imodium) if necessary.

Mouth Sores

  • Rinse your mouth with a mixture of salt and bicarbonate of soda in warm water.
  • Use products like Nystacid (for white sores) or Andolex C (for red sores).

Decreased Appetite or Weight Loss

  • Eat small, frequent meals.
  • Keep nutritious snacks nearby.
  • Try liquid nutritional supplements.

Nausea or Vomiting

  • Eat slowly and in small portions.
  • Avoid strong odours, spicy, or greasy foods.

Hair Colour Changes or Taste Alterations

  • Use plastic utensils if food tastes metallic.
  • Try mints or chewing gum to mask taste changes.

Pain or Discomfort in Hands/Feet

  • Soak feet in warm water with Epsom salts and exfoliate gently.
  • Moisturise regularly and avoid tight shoes.

Increased Blood Pressure

  • Monitor blood pressure regularly and report significant changes.
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Handling Body Fluids and Waste

  • Use gloves when handling soiled clothing or bedding.
  • Flush toilets twice and clean soiled surfaces immediately.
  • Wash hands thoroughly with soap and water after contact with body waste.
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Pregnancy, Sexual Activity, and Contraception

  • Do not become pregnant or father a child during treatment or for 4 months after the last dose.
  • Do not breastfeed during treatment or for 4 months after the last dose.
  • Inform your doctor immediately if you become pregnant.
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Compiled by : Karin Mouton

Registered Oncology Nurse

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