CABDUAL 40 Tablet 30's
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Introduction About CABDUAL 40 TABLET
CABDUAL 40 TABLET contains Cabozantinib, which belongs to the group of medicines called Anticancer drugs. It is used in adults to manage advanced kidney cancer. It can also be used in the management of liver cancer and advanced thyroid cancer when management with other conventional cancer medicines (such as sorafenib) and radiotherapy is not responding appropriately.
Take CABDUAL 40 TABLET on an empty stomach. You should not eat anything for at least 2 hours before and for 1 hour after taking the medicine. Before taking CABDUAL 40 TABLET, inform your doctor if you have any liver, kidney, or heart problems.
You must also inform your doctor if you have high blood pressure, thyroid problems, inflammatory bowel diseases, abnormal bulging or tears in blood vessels, a recent history of blood clot formation, a stroke, or a heart attack, as a precaution.
During management with CABDUAL 40 TABLET, it is important for you to practice good oral hygiene. You must also inform your dentist about this medicine if you need to visit the dentist regularly.
Avoid eating grapefruit or drinking grapefruit juice while taking CABDUAL 40 TABLET, as it may increase the risk of side effects. CABDUAL 40 TABLET is not recommended for use by pregnant or breastfeeding women.
Men and women taking CABDUAL 40 TABLET must use a suitable contraceptive method to avoid pregnancy while undergoing therapy with CABDUAL 40 TABLET. Men may also seek advice on sperm preservation, if necessary, prior to therapy with this medicine.
The most common side effects of taking CABDUAL 40 TABLET are nausea, vomiting, stomach upset, skin rashes, blisters, and pain in the hands or soles of the feet, weight loss, altered taste sensation, tiredness, weakness, sore mouth, throat, and tongue, fistulas, and piles. Contact your doctor if any of these side effects worsen.
Uses Of CABDUAL 40 TABLET
It is used by adults to manage:
- advanced kidney cancer
- liver cancer
- advanced thyroid cancer
How CABDUAL 40 TABLET Works
CABDUAL 40 TABLET is an anti-cancer medicine. It works by blocking the actions of certain proteins (such as receptor tyrosine kinases) in the body that trigger cancer formation. As a result, it manages abnormal cell division within the body and slows down the growth of cancer cells in the body.
How to use CABDUAL 40 TABLET
Take CABDUAL 40 TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. CABDUAL 40 TABLET should not be taken with food. You should not eat anything for at least 2 hours before and for 1 hour after taking the medicine.
Try to take CABDUAL 40 TABLET at the same time each day. Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and health condition. Do not stop taking CABDUAL 40 TABLET unless advised by your doctor.
Side Effects Of CABDUAL 40 TABLET
Common
- nausea, vomiting
- stomach upset, diarrhea, constipation, indigestion, and stomach pain
- skin rashes, abscess with pus, blisters, and pain in the hands or soles of the feet
- loss of appetite, weight loss, altered taste sensation, acid reflux
- tiredness, weakness, headache, and dizziness
- high blood pressure
- anaemia due to low levels of red blood cells
- low blood platelet and white blood cell counts
- pain, redness, and swelling in the mouth or throat; difficulty speaking; hoarse voice; cough; difficulty swallowing; sore tongue
- shortness of breath
- low thyroid functions cause weight gain, tiredness, constipation, and cold and dry skin
- painful or swollen arms and legs
- dehydration
- ringing in the ears (tinnitus)
- blood clot formation
- increased or decreased blood sugar levels
- low calcium, sodium, and phosphate levels in the blood; high blood potassium levels
- high bilirubin levels in the blood
- high blood cholesterol and triglyceride levels
- numbness, tingling, burning sensation, or pain in the limbs
- fistula (a painful tear or abnormal connection of the tissues in your body), piles
- dry mouth and pain in the mouth
- dry skin and severe itching of the skin; acne
- hair loss and thinning; hair colour change
- joint pain, muscle spasms
- protein in urine
- respiratory tract infections, increased thyroid activity, and lung infections when used in combination with nivolumab
Uncommon
- stroke, fits
- problems in bile flow
Rare
Stop taking CABDUAL 40 TABLET and contact your doctor immediately if you experience any of the following side effects, such as:
- excessive tiredness, chills, and a deep voice
- signs of GI bleeding (such as stomach pain, nausea, vomiting, constipation, fever, blood vomits, black stools, bloody urine, headache, coughing up blood)
- shortness of breath and swollen hands and feet
- a wound that does not heal
- posterior reversible encephalopathy syndrome (signs include fits, headaches, confusion, or finding it difficult to concentrate)
- drowsiness, confusion, and loss of consciousness due to liver problems
- signs of jawbone damage (such as pain in the mouth, teeth, or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or loosening of a tooth)
How To Manage Side Effects
Constipation
Try to eat more high-fiber foods, such as fresh fruit, vegetables, and cereals, and drink plenty of water. Try doing exercise regularly (going for a daily walk or run). If this does not help, inform your doctor about receiving alternate managements for constipation.
Diarrhea
Drink lots of fluids, such as water, to keep yourself hydrated. Try to avoid taking any medicine on your own to manage diarrhoea and consult your doctor if the symptom gets worse.
Dizziness Or Drowsiness
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Consult your doctor if your dizziness worsens.
Headache
Rest and relax. Keep yourself hydrated by drinking plenty of fluids, such as water or electrolytes. Applying a pain-relieving balm to your forehead can be beneficial. Consult your doctor if your headache worsens.
Mouth Ulcers
Avoid eating spicy foods. Drink plenty of water. Apply a pain-relieving gel to the affected areas of the mouth if required. Consult your doctor if the symptom does not improve.
Nausea And Vomiting
Stick to simple meals. Avoid eating oil-rich or spicy foods. If your nausea worsens, consult your doctor for advice.
Skin rash Or Itching
Avoid hot showers because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash worsens.
Warning & Precautions
Pregnancy
Monitoring requiredCABDUAL 40 TABLET is not recommended for use in pregnant women unless considered necessary by the physician. Therefore, inform your doctor before taking CABDUAL 40 TABLET if you are pregnant or think you may be pregnant. Women of childbearing potential must use a suitable contraceptive method to avoid pregnancy while undergoing therapy with CABDUAL 40 TABLET and until 4 months after the last dose.
Breastfeeding
ContraindicatedCABDUAL 40 TABLET may pass through the breast milk. Therefore, it is not recommended for use in breastfeeding women during the therapy or until 4 months after the last dose. Consult your doctor for advice before taking it.
Driving and Using Machines
Use with CautionCABDUAL 40 TABLET may cause tiredness and weakness. Therefore, do not drive or operate any heavy tools or machines if your ability is affected by this medicine.
Alcohol
Consult your doctorAvoid consuming alcohol while taking CABDUAL 40 TABLET, as it could make you feel dizzy.
Kidney
Use with CautionCABDUAL 40 TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.
Liver
Use with CautionCABDUAL 40 TABLET should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.
Allergy
ContraindicatedDo not take CABDUAL 40 TABLET if you are allergic to cabozantinib.
Heart Disease
Use with CautionCABDUAL 40 TABLET should be used with caution in patients with hypertension. Therefore, consult your doctor before taking it.
Use In Pediatrics
ContraindicatedCABDUAL 40 TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.
Use In Geriatrics
Use with CautionCABDUAL 40 TABLET should be used with caution in elderly patients (aged 65 years or older). Therefore, consult your doctor before taking it.
Others
Before taking CABDUAL 40 TABLET, inform your doctor if you:
- have or ever had an aneurysm (an abnormal bulging of the arteries)
- have a tear in the walls of blood vessels
- have diarrhoea
- recently suffered significant bleeding
- have recently undergone or are planning for any surgery in the upcoming days (including minor dental surgeries)
- have inflammatory bowel disease (such as Crohn’s disease, ulcerative colitis, diverticulitis, or appendicitis)
- have a previous history of blood clot formation in the legs
- suffered a stroke or heart attack due to blood clots
- have thyroid problems
Interactions
A. Drug-Drug Interactions:
Before taking CABDUAL 40 TABLET, inform your doctor if you are taking any of the following medicines, such as:
- medicines used to manage fungal infections (such as itraconazole, ketoconazole, and posaconazole)
- medicines used to manage bacterial infections (such as erythromycin, clarithromycin, and rifampicin)
- medicines used to manage allergic conditions (such as fexofenadine)
- medicines used to manage chest pain (Ex. ranolazine)
- medicines used to manage epilepsy (such as phenytoin, carbamazepine, and phenobarbital)
- John’s Wort (a herbal preparation used to manage depression)
- medicines used for blood thinning (such as warfarin and dabigatran etexilate)
- medicines used to manage high blood pressure or other heart conditions (such as aliskiren, ambrisentan, digoxin, talinolol, and tolvaptan)
- medicines used to manage diabetes (Ex. saxagliptin and sitagliptin)
- medicines used to manage gout (Ex. colchicine)
- medicines used to manage HIV infection (such as efavirenz, ritonavir, maraviroc, and emtricitabine)
- immunosuppressants (used to manage auto-immune conditions and graft rejections) such as ciclosporin
B. Drug-Food Interactions:
Avoid eating grapefruit or drinking grapefruit juice while taking CABDUAL 40 TABLET, as it may increase the risk of side effects.
Overdosage:
If you or anyone else accidentally took more CABDUAL 40 TABLET, consult your doctor immediately or visit the nearby hospital.
Synopsis
| Drug | : | Cabozantinib |
| Pharmacological Category | : | Tyrosine Kinase Inhibitor |
| Therapeutic Indication | : | Kidney cancer, liver cancer, thyroid cancer |
| Dosage Forms | : | Tablet |
More Information
- Keep CABDUAL 40 TABLET out of reach of children
- Store CABDUAL 40 TABLET at room temperature
FAQs About CABDUAL 40 TABLET
Q: What is CABDUAL 40 TABLET used for?
A: CABDUAL 40 TABLET is used in adults to manage advanced kidney cancer. It can also be used in the management of liver cancer and advanced thyroid cancer when management with other conventional cancer medicines (such as sorafenib) and radiotherapy is not responding appropriately.
Q: How does CABDUAL 40 TABLET work on my body?
A: CABDUAL 40 TABLET is an anti-cancer medicine. It works by blocking the actions of certain proteins (such as receptor tyrosine kinases) in the body that trigger cancer formation. As a result, it manages abnormal cell division within the body and slows down the growth of cancer cells in the body.
Q: Can the use of CABDUAL 40 TABLET cause hair loss?
A: Hair loss is one of the common side effects of taking CABDUAL 40 TABLET. This side effect is usually temporary and disappears once therapy with this medicine stops completely. If it bothers you, consult your doctor for advice.
Q: Can the use of CABDUAL 40 TABLET cause mouth ulcers?
A: Mouth ulcers are one of the common side effects of taking CABDUAL 40 TABLET. Avoid eating spicy foods. Drink plenty of water. Apply a pain-relieving gel to the affected areas of the mouth if required. Consult your doctor if this side effect bothers you.
Q: Can CABDUAL 40 TABLET be used with children?
A: CABDUAL 40 TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.
Q: Is CABDUAL 40 TABLET a chemo drug?
A: Yes. CABDUAL 40 TABLET contains a medicine called Cabozantinib, which is a chemotherapeutic agent. It stops the abnormal growth and multiplication of cancer cells in the body.
Q: What happens if I forget to take a dose of CABDUAL 40 TABLET?
A: If you forgot to take a dose of CABDUAL 40 TABLET, take it as soon as you remember. However, if it is time for the next dose of CABDUAL 40 TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of CABDUAL 40 TABLET to compensate for the missed ones.
Q: Will taking a higher dose of CABDUAL 40 TABLET be more effective?
A: No, taking a higher dose of CABDUAL 40 TABLET will not be effective; rather, it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
Q: What happens if I stop taking CABDUAL 40 TABLET?
A: No. Do not stop taking CABDUAL 40 TABLET without consulting your doctor, as it may make your symptoms reappear. Therefore, take CABDUAL 40 TABLET as advised by your doctor for the stipulated duration.
Q: Can CABDUAL 40 TABLET be used during pregnancy?
A: CABDUAL 40 TABLET is not recommended for use in pregnant women unless considered necessary by the physician. Therefore, inform your doctor before taking CABDUAL 40 TABLET if you are pregnant or think you may be pregnant.
Q: Can the use of CABDUAL 40 TABLET make me feel tired?
A: Yes. CABDUAL 40 TABLET may make you feel tired easily. This is because it reduces the levels of red blood cells in your blood and may make you anaemic. Consult your doctor if you experience tiredness after taking CABDUAL 40 TABLET. Tiredness can also occur if you have any pre-existing disease conditions, such as liver or kidney impairment, while taking this medicine.
Q: Can I drive a car after taking CABDUAL 40 TABLET?
A: CABDUAL 40 TABLET may make you feel tired or dizzy. Therefore, do not drive or operate any heavy tools or machines if your abilities are affected by CABDUAL 40 TABLET.
Q: How do I take CABDUAL 40 TABLET?
A: Take CABDUAL 40 TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. CABDUAL 40 TABLET should not be taken with food. You should not eat anything for at least 2 hours before and for 1 hour after taking the medicine.
Q: How do you control nausea caused by CABDUAL 40 TABLET?
A: Generally, anticancer medicines are associated with uncontrollable nausea and vomiting. To avoid this, your doctor would prescribe a suitable medicine to control them, along with CABDUAL 40 TABLET. If not, consult your doctor for a suitable anti-emetic medicine. Do not self-manage nausea.
Q: What are the side effects of taking CABDUAL 40 TABLET?
A: The most common side effects of taking CABDUAL 40 TABLET are nausea, vomiting, stomach upset, skin rashes, blisters, and pain in the hands or soles of the feet, weight loss, altered taste sensation, tiredness, weakness, sore mouth, throat, and tongue, fistulas, and piles. Contact your doctor if any of these side effects worsen.
Q: Who should avoid taking CABDUAL 40 TABLET?
A: CABDUAL 40 TABLET is not recommended for use if you are allergic to Cabozantinib. It is also not recommended for use in pregnant or breastfeeding women or in children (aged below 18 years).
Q: Is CABDUAL 40 TABLET safe to use in kidney disease?
A: CABDUAL 40 TABLET should be used with caution in patients with kidney problems. Your doctor will assess your health condition and suggest a suitable dose for you.
Q: Can the use of CABDUAL 40 TABLET affect the liver?
A: Yes. CABDUAL 40 TABLET may affect the way your liver works. It can elevate the levels of certain liver enzymes in your body. Therefore, it should be used with caution in patients with liver problems. Consult your doctor before taking it.
References
1. Yeong Hak Bang, Choong-kun Lee and Baek-Yeol Ryoo. Real-world efficacy and safety of cabozantinib in Korean patients with advanced hepatocellular carcinoma: a multicenter retrospective analysis. Therapeutic Advances in Medical Oncology. May 2022. [Accessed on 29th March 2023] https://journals.sagepub.com/doi/10.1177/17588359221097934?icid=int.sj-abstract.similar-articles.3
2. Patheon France. CABOMETYX 20 mg, 40 mg, 60 mg film-coated tablets. Cabozantinib. Electronic Medicines Compendium (EMC). [Revised in July 2022]. [Accessed on 29th March 2023] https://www.medicines.org.uk/emc/files/pil.4331.pdf
3. Exelixis, Inc. CABOMETYX® (cabozantinib) tablets, for oral use. U.S. Food and Drug Administration. [Revised in January 2019]. [Accessed on 29th March 2023] https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/208692s003lbl.pdf
Useful Diagnostic Tests
- Thyroglobulin (Tg)
- Anti Thyroglobulin (Atg)
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