Care During Chemotherapy and Beyond
Generic name: Cabozantinib
COMETRIQ™ is the trade name for the generic chemotherapy drug cabozantinib. In some
cases, health care professionals may use the generic name cabozantinib when referring
to the trade name COMETRIQ™.
Drug type: COMETRIQ™ is a targeted therapy. It is an oral receptor
tyrosine kinase inhibitor - (For more detail, see "How this drug works," below.)
What This Drug Is Used For:
- For the treatment of metastatic medullary thyroid cancer (MTC).
Note: If a drug has been approved for one use, physicians may elect to use this
same drug for other problems if they believe it may be helpful.
How This Drug Is Given:
- COMETRIQ™ is a pill, taken by mouth.
- Take COMETRIQ™ on an empty stomach. Do not eat for at least 2 hours before
and at least 1 hour after taking COMETRIQ™.
- You should not drink grapefruit juice or eat grapefruit during
treatment with COMETRIQ™. It may change the amount of COMETRIQ™ in your blood.
- Take COMETRIQ™ exactly as prescribed.
- Swallow COMETRIQ™ capsules whole with at least 8 ounces of water. Do not crush,
dissolve or open capsules.
- Do not change your dose or stop COMETRIQ™ unless your health care provider tells
- If you miss a dose and your next dose is due in:
- Less than 12 hours, take your next dose at the normal time. Do not make up the
- 12 hours or more, take the missed dose as soon as you remember. Take your next
dose at the normal time.
- Do not take more than 1 dose of COMETRIQ™ at one time. Call your health care provider
right away if you take too much.
- The amount of COMETRIQ™ that you will receive depends on many factors, your general
health or other health problems, and the type of cancer or condition being treated.
Current recommendation is for one tablet twice daily, higher doses do not give a
better response and may cause increased toxicity. Your doctor will determine your
dose and schedule.
Important things to remember about the side effects of COMETRIQ™:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients
These side effects are less common side effects (occurring in about 10-29%) of patients
These are rare but serious complications of COMETRIQ™:
- Perforation (holes) in the GI (gastrointestinal) tract
- Very bad bleeding (hemorrhage)
- Impaired wound healing, fistulas
- Blood clots
- Jaw pain and infection of jaw bone
Contact your health care provider right away if you have any new or worsening symptoms.
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your health
care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Seek emergency help immediately and notify your health care provider, if you
experience the following symptoms:
- Chest pain, shortness of breath
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4° F (38° C or higher, chills)
- Unusual bleeding , ( example: coughing up large amount of blood)
- Black or tarry stools, or blood in your stools
- Severe headache, light headedness or other neurological symptoms (numbness, tingling,
difficulty speaking, Change in thinking clearly and with logic)
Always inform your health care provider if you experience any unusual symptoms.
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Diarrhea (4-6 episodes in a 24-hour period).
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst,
dry mouth, dark and decrease amount of urine, or dizziness.
- Skin or the whites of your eyes turn yellow
- Urine turns dark or brown (tea color)
- Decreased appetite
- Pain on the right side of your stomach
- Bleed or bruise more easily than normal
- Cough with or without mucus
- Mouth sores
- Pain or burning with urination
- Extreme fatigue (unable to carry on self-care activities)
- Jaw pain, tooth or gum infections
Always inform your health care provider if you experience any unusual symptoms.
- Before starting COMETRIQ™ treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.).
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking COMETRIQ™.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (COMETRIQ™ may be hazardous to
the fetus. Women who are pregnant or become pregnant must be advised of the potential
hazard to the fetus.)
- For both men and women: Do not conceive a child (get pregnant) while taking COMETRIQ™.
Barrier methods of contraception, such as condoms, are recommended during treatment
and for 4 months after treatment is complete. Discuss with your doctor when you
may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- You should not drink grapefruit juice or eat grapefruit during your treatment with
COMETRIQ™. It may make the amount of COMETRIQ™ in your blood increase to a harmful
- If you have an elective surgery or dental procedure, they need to notify their medical
team in advance. COMETRIQ™ may need to get discontinued temporarily to allow for
a safe surgery/procedure and appropriate wound healing and recovery.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Monitor your blood pressure and notify your physician if blood pressure is elevated
or if you develop severe headache, light headedness or other neurological symptoms
(numbness, tingling, difficulty speaking).
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
- Eat foods that may help reduce diarrhea (see managing
side effects - diarrhea ).
- Prevention of hand-foot syndrome. Modification of normal activities of daily living
to reduce friction and heat exposure to hands and feet, for about a week after treatment.
- Keep palms of hands and soles of feet moist using emollients.
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- Maintain physical activity as tolerated.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that are
effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking
COMETRIQ™, to monitor side effects and check your response to therapy. Periodic
blood work will be obtained to monitor your complete blood count (CBC) as well as
the function of other organs (such as your kidneys and liver) will also be ordered
by your doctor.
How This Drug Works:
Targeted therapy is the result of about 100 years of research dedicated to understanding
the differences between cancer cells and normal cells. To date, cancer treatment
has focused primarily on killing rapidly dividing cells because one feature of cancer
cells is that they divide rapidly. Unfortunately, some of our normal cells divide
rapidly too, causing multiple side effects.
Targeted therapy is about identifying other features of cancer cells. Scientists
look for specific differences in the cancer cells and the normal cells. This information
is used to create a targeted therapy to attack the cancer cells without damaging
the normal cells, thus leading to fewer side effects. Each type of targeted therapy
works a little bit differently but all interfere with the ability of the cancer
cell to grow, divide, repair and/or communicate with other cells.
There are different types of targeted therapies, defined in three broad categories.
Some targeted therapies focus on the internal components and function of the cancer
cell. The targeted therapies use small molecules that can get into the cell and
disrupt the function of the cells, causing the cancer cells to die. There are several
types of targeted therapy that focus on the inner parts of the cells. Other targeted
therapies target receptors that are on the outside of the cell. Therapies that target
receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target
the blood vessels that supply oxygen to the cells, ultimately causing the cells
COMETRIQ™ is a targeted therapy that targets and binds to the tyrosine kinase receptors
and inhibits the activity of multiple tyrosine kinases, including RET, MET, and
VEGF on the surface of the cell. By binding to these receptors, COMETRIQ™ blocks
important pathways that promote cell division.
Research continues to identify which cancers may be best treated with targeted therapies
and to identify additional targets for more types of cancer.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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