Cabotib 40mg tablet is an antineoplastic drug with an active ingredient called Cabozantinib. It belongs to the medication class known as tyrosine kinase inhibitors. In adults, it is used to treat advanced kidney cancer and locally advanced or metastatic differentiated thyroid cancer. It is also used in treating liver cancer when Sorafenib (anticancer medicine) is no longer working. Usually, this medicine is given in combination with Nivolumab for advanced kidney cancer. It is not recommended for those younger than 18 years.  

Do not consume Cabotib 40mg tablet if you are allergic to Cabozantinib and its other ingredients. Inform your physician if you have liver disease, inflammatory bowel disease, high blood pressure, heart disease, or diarrhoea. Notify your doctor about the history of blood clots in the leg or significant bleeding, aneurysm (inflammation of blood vessels), or tears in the blood vessel wall. Inform your physician if you are pregnant or planning to get pregnant. Use effective contraception during and even after the treatment or four months. Discuss more fertility concerns with your doctor. 

Before starting with Cabotib 40mg tablet, notify your doctor if you have a thyroid problem; thyroid functions must be monitored before starting the medicine. Do not forget to inform your physician if you recently had any surgery, including dental surgery, within the last month. Avoid taking grapefruit or grapefruit juice during the treatment as they may increase the level of medicine in the blood. This medicine contains lactose; if you are intolerant to any sugar, inform your doctor before taking the medicine.

• Advanced renal cell carcinoma
• Liver Cancer
• Differentiated thyroid cancer

Cabozantinib acts against a protein called receptor tyrosine kinases and interferes with cell signalling, ultimately stopping the growth and spread of cancer cells. Cabotib 40mg is indicated alone or in combination with Nivolumab.

Inform your doctor about any prescribed medications, over-the-counter medicines, nutritional or vitamin supplements, and herbal products you take or have taken before the treatment. Certain medications such as antibiotics, St, John's Wort, Aliskiren and other medicine may interact with Cabotib 40mg tablet and can cause undesirable side effects. 

• Keep out of sight and reach of pets and children
• Store protected from light at a temperature not exceeding 30°C.

Take Cabotib 40mg tablet as advised by your physician. Usually, this medicine will be given once a day. Do not crush, chew, or open the medicine. Your physician will decide the correct dosage and duration based on age, body weight, and disease condition. Only stop taking this medicine if your doctor advises you to stop.

Side effects are unwanted symptoms caused by medicines. Even though all drugs cause side effects, not everyone gets them.

Serious

• Gastrointestinal perforation
• Severe or uncontrollable bleeding
• Shortness of breath
• Nonhealing wound
• Pain in the mouth, jaw/teeth, hand, feet,
• Loss of consciousness,
• Drowsy
• Swelling or sores in the mouth
• Blood vomiting
• Black stools
• Blood in urine
• Headache
• Coughing blood

Common

• Dehydration
• Difficulty swallowing
• Ringing in the ears
• Blood clots in the veins
• Fluctuation in the blood sugar levels
• The lower level of albumin
• Electrolyte imbalance
• Increased levels of liver enzymes
• Elevated cholesterol levels in the blood
• Hair loss
• Changes in hair color
• Muscle spasm
• Skin thickening
• Dry skin
• Itching
• Protein in urine

Oral contraception may be ineffective while under the treatment of Cabotib 40mg tablet. Discuss effective contraception methods with your doctor, along with fertility concerns. Inform your doctor if you have a thyroid problem; thyroid function should be monitored regularly before taking this medicine. Notify your doctor if your face gets colder or tired more commonly or if your voice deepens while taking this medicine. Do not stop the medicine until your doctor advises. Notify your doctor if you experience any serious side effects. You are doctor may change your dose or stop the treatment. Your doctor will inform you if you need any dose adjustments. This medicine is not recommended for children or adolescents.

1. Ipsen Pharma, Electronic Medicines Compendium (EMC), [Revised on July 2022] [Accessed on 25th April 2023], Cabometyx 20 mg Film-coated Tablets - Summary of Product Characteristics (SmPC) - (emc) (medicines.org.uk)
2. Exelixis, Inc., [Revised on Oct 2020] [Accessed on 25th April 2023], https://www.cometriq.com/downloads/Cometriq_Full_Prescribing_Information.pdf
3. Gregory A. Brent and Ronald J. Koenig, Thyroid and Antithyroid Drugs, Goodman & Gilman’s Pharmacological Basis of Therapeutics, 2018, 787-801.