CABOMETYX Hispanic female patient portrayal

Patient
portrayal

BE Prepared

Learn how to take your CABOMETYX for certain people with papillary and follicular thyroid cancer (2 types of differentiated thyroid cancer)

Taking CABOMETYX

CABOMETYX is a once-daily tablet. Take as prescribed by your doctor.

DO:

CABOMETYX Water and Tablet icon
  • Swallow your CABOMETYX tablets whole
  • Take your CABOMETYX dose at the same time every day, or as prescribed
  • Take CABOMETYX at least 1 hour before or at least 2 hours after eating

DO NOT:

CABOMETYX No Food or Grapefruit icon
  • Take CABOMETYX with food
  • Crush the tablet
  • Drink grapefruit juice, eat grapefruit, or take supplements that contain grapefruit or St. John's wort during treatment with CABOMETYX

If you missed a dose

If your next dose is in:

Less than 12 hours

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  • Do not try to make up the missed dose
  • Take the next dose when you usually take it

12 hours or more

CABOMETYX 12 HOURS OR MORE icon
  • Talk to your doctor or nurse if you miss a dose

Tips to help you remember to take CABOMETYX

It is important to take your medicine as directed by your doctor. Here are some tips you may find helpful.

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Keep a calendar in an easy-to-see place and mark it each time you take your medicine

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Use a weekly pillbox

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Set an alarm on your clock, computer, or phone, and take your medicine when the alarm alerts you

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Take your CABOMETYX right before or after a daily routine like brushing your teeth or feeding your pet

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Keep your CABOMETYX in an easy-to-see spot so it acts as a visual reminder

(Remember to keep your medicine out of reach of children)

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Ask a family member or friend to call or stop by to help remind you

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Talk with your doctor, nurse, or pharmacist. They may be able to offer suggestions to help

Hear Advice on How to Remember to Take Your Medicine

Hear from actual patients, Deanna and Rosa, about how they stay on track taking CABOMETYX.



Managing certain side effects

What can you do to help manage certain side effects?

Your healthcare team has options to help manage certain side effects.

WHAT YOUR HEALTHCARE TEAM MAY DO TO HELP MANAGE CERTAIN SIDE EFFECTS

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Your dose may be adjusted based on how your body responds to the medicine

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Your dose may be temporarily or permanently lowered or stopped
 

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Dose adjustments are not setbacks, since they may help you stay on treatment, if appropriate

Your doctor or nurse may also recommend lifestyle changes and other medicines to help with certain side effects.

Please note that not all side effects can be managed, and some may lead to permanent discontinuation of the medicine.

 

Your healthcare team is your best resource

Your doctor, nurse, or member of your healthcare team can help you manage certain side effects.  How you feel is important to them and they want to offer additional support if you need it.

No concern is too small to bring to their attention. They are available to help you.

If you have any concerns or are not feeling well, reach out to them right away.

See How Open Communication Can Help

Open communication with your healthcare team is important, explain Deanna and Rosa. These actual patients discuss why people should talk about how they’re feeling throughout treatment with CABOMETYX.

These videos feature real patients and healthcare providers to show their individual treatment experiences with CABOMETYX. Some participants were paid for their time and expenses in sharing their story. Individual results may vary. The information in this video is not intended as medical advice. Your healthcare team is your best resource for information about your treatment. If you have any questions about your condition or treatment, contact your healthcare team.

We have an approach called AIM to help you share information with your healthcare team.

A icon

ACKNOWLEDGE
if you are feeling different; this may be a symptom of a side effect

I icon

INFORM
your healthcare team right away

M icon

MANAGE
side effects by working with your healthcare team

The sooner you share information, the sooner your healthcare team can help you manage certain side effects. 
Your healthcare provider may change your dose, temporarily stop, or permanently stop treatment with CABOMETYX if you have certain side effects. Please note that not all side effects can be managed, and some may lead to permanent discontinuation of the medicine.

Understanding side effects CABOMETYX may cause

Taking CABOMETYX may cause side effects, including serious side effects. You can read more about the side effects associated with CABOMETYX here

Side effects can happen at any time, including within the first few weeks of starting treatment with CABOMETYX.

Below are select side effects associated with CABOMETYX

Tell your doctor or nurse right away if you have a side effect that bothers you or does not go away. Below are some select side effects that may occur while taking CABOMETYX:

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Tips to help manage certain side effects of CABOMETYX

These tips are not a substitute for medical advice by your healthcare team.

Please note not all side effects can be managed, and some may lead to permanent discontinuation of medicine.

These tips are based on information from a variety of organizations that provide information and support to people affected by cancer.

None of the products referenced in these tips are owned by Exelixis, Inc. or its affiliates. These tips are not endorsing those products and the manufacturers of those products have not endorsed these tips. Other similar products may be used.

    Diarrhea, if it is not managed, can be very serious.

    If you have any signs and symptoms and/or your stools are happening more often than normal, contact your healthcare team.

    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if you: 

    • Have any increase in bowel movements (4 - 6 additional episodes per day)
    • Have blood around the anal area or in your stool
    • Lose 5 or more pounds after the diarrhea starts
    • Have pain in your belly or cramps that start and last for 2 or more days
    • Don’t urinate for 12 or more hours
    • Get a puffy or swollen belly

    TIPS TO HELP WITH DIARRHEA

    DO:

    • Drink plenty of clear liquids
    • Eat small, light meals many times a day (such as bananas, rice, applesauce, dry toast, or mashed potatoes)
    • Keep track of how often you have diarrhea, the amount of fluid you drink, and your weight

    AVOID:

    • Caffeinated drinks (such as coffee and soft drinks) or dairy products (such as milk)
    • Spicy, greasy, fatty, or high-fiber foods (such as fast food, raw vegetables, and nuts)
    CABOMETYX Tablet icon

    Loperamide (anti-diarrheal) tablets are included in the Patient Care Kit, which you may have received from your doctor or, if eligible,* you can order here.

    Talk with your doctor about taking loperamide to make sure it’s safe for you.

    *

    Terms and Conditions apply.

    CABOMETYX Digestive track icon

    Certain medicines used to treat cancer may cause mouth problems such as:

    • Canker sores
    • Gum or mouth pain
    • Infections in your mouth or gums
    • Burning sensation of the tongue
    • Red, swollen, or bleeding gums
    • Change in how things taste
    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if you notice anything unusual.

    • Check your mouth 2 times a day
      • Look for small cuts, ulcers, sores, redness, swelling, or blood

    TIPS for oral care

    DO:

    • Discuss plans for dental procedures with your healthcare team
    • See your dentist regularly and tell them about the treatments you are taking
    • Brush teeth regularly after each meal (use a soft toothbrush and children’s toothpaste)
    • Floss your teeth at least once a day
    • Keep your lips moisturized with a lip balm
    • Rinse your mouth regularly with salt and baking soda mixture if you experience sores or dryness. Add 1 teaspoon of salt and 1 teaspoon of baking soda to 1 quart of warm water; stir or shake well. Sip the solution, swish it around and gently gargle, and then spit it out. Do not swallow

    AVOID:

    • Using mouthwash made with alcohol

     

    If you experience mouth pain

    DO:

    • Suck on ice chips or ice pops
    • Drink through a straw
    • Talk to your oncology doctor about over-the-counter medicines that can be used for the pain
    • Eat soft foods that can be swallowed easily

    AVOID:

    • Hard, crusty, salty, sticky, sugary, or spicy foods
    • Fruits or juices that are acidic, such as tomatoes, oranges, grapefruits, limes, and lemons
    CABOMETYX Mouth icon

    You may feel nauseous (queasy) or vomit (throw up).

    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if you: 

    • Vomit more than 3 times an hour for more than 3 hours
    • See blood in your vomit
    • Your vomit looks like coffee grounds
    • Cannot tolerate more than 4 cups of liquid or ice chips in a day
    • Haven’t been able to eat for more than 2 days
    • Are weak, dizzy, or confused
    • Lose 2 or more pounds in 2 days
    • Have dark-yellow urine

    TIPS FOR MANAGING NAUSEA AND VOMITING

    DO:

    • Drink plenty of clear liquids (such as ginger ale, apple juice, or broth)
    • Eat bland foods—with little to no taste (such as dry toast and crackers). Suck on lemon or mint candy to make a bad taste go away
    • Raise the head of your bed for sleeping

    AVOID:

    • Heavy, fatty, greasy foods
    • Strong odors
    • Lying flat for at least 1 hour after eating
    • Eating for 2 to 3 hours before you go to bed

     

    For vomiting (throwing up what’s in your stomach)

    DO:

    • Keep track of how often you are vomiting, the amount of fluid you drink, and your weight
    • After vomiting stops, slowly sip a small amount of cool liquid and suck on some ice chips or frozen juice chips

    Your doctor may also prescribe a medicine for nausea and vomiting.

    CABOMETYX Pill icon

    Queasy Drops® are included in the Patient Care Kit, which you may have received from your doctor or, if eligible, you can order here.

    They have ingredients that may help stop nausea and dry mouth. Talk to your doctor before using.

    Queasy Drops is a registered trademark of Three Lollies, LLC.

    Terms and Conditions apply.

    CABOMETYX Upset stomach icon

    Fatigue, or feeling tired, weak, or lacking energy is a common side effect.

    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if you:

    • Are too tired to get out of bed for 24 hours or more
    • Can’t think clearly
    • Can’t sleep at night
    • Feel tired (out of breath or heavy/fast heartbeat) after doing small activities

    TIPS FOR MANAGING fatigue

    DO:

    • Get a good night’s sleep each night (7 to 8 hours)
    • Keep good sleep habits (go to bed at the same time each night and wake up at the same time each day)
    • Sleep in a quiet and dark bedroom with a comfortable temperature
    • Be as active as possible. It’s best to start slowly. Only do more when you are able to. Talk to your doctor for tips
    • Plan ahead. Decide which activities are most important to you and schedule them throughout the day, if possible so you can take breaks
    • Eat a nutritious and well-balanced diet (make sure you have enough calories and protein to give your body the energy it needs)
    • Consider meeting with a registered dietitian who specializes in helping people with cancer

    AVOID:

    • Heavy meals before bedtime
    • Caffeine close to bedtime. If you have caffeine, make sure it is 6 to 8 hours before going to bed. Caffeine can be in liquids (such as soft drinks and coffee), food (such as chocolate), and some medicines
    CABOMETYX Fatigue icon

    HFSR is a side effect that causes symptoms such as pain and swelling in your hands or feet. This can be severe.

    You may also hear your doctor call HFSR palmar-plantar erythrodysesthesia syndrome (PPES).

    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if you notice anything unusual such as:

    • Your skin is red or swollen
    • You feel tingling/burning or your skin is sensitive to touch
    • You have thick calluses or blisters
    • Your skin is cracked, flaking, or peeling
    • Your skin has blisters, ulcers, or sores
    • You have a hard time walking or using your hands (especially if it’s because of pain)
    CABOMETYX Cream icon

    Start using the Udderly Smooth®§ Extra Care Cream included in the Patient Care Kit, which you may have received from your doctor or, if eligible,|| can order here.

    Follow package directions or use as directed by your doctor.

    Talk to your doctor about using drugstore creams such as clobetasol and halobetasol.

    §

    Udderly Smooth is a registered trademark of Redex Industries, Inc.

    ||

    Terms and Conditions apply.

    TIPS FOR MANAGING HAND-FOOT SKIN REACTION (HFSR)

    DO:

    • Use an ice pack if your hands and feet feel hot (cool for 15-20 minutes)
    • Take cool showers or baths
    • Wear loose and comfortable clothing, well-fitting footwear, cotton gloves and socks to help protect your hands and feet
    • Gently pat your skin dry after washing your hands or bathing
    • Use mild, fragrance-free lotions

    AVOID:

    • Heat (hot water, hot showers and baths, direct sunlight, or other heat sources). Heat may make your symptoms worse or more likely to happen
    • Pressure, friction, or rubbing
    • Using hammers, shovels, knives, or other tools
    CABOMETYX Hand and foot icon

    It is important to take your blood pressure before you start taking your medicine and regularly during your treatment.

    Keep a record of your blood pressure measurements so you can tell your doctor if there is a change. Hypertension can be severe.

    CABOMETYX Phone icon

    Remember AIM and call your doctor or nurse right away if:

    • Your blood pressure suddenly goes up
    • Your blood pressure is outside the recommended range (normal blood pressure is 120/80). Talk to your doctor about your blood pressure goals
    • You feel dizzy
    • You have shortness of breath
    • You have any new or worsening symptoms (eg, headaches, chest pains, visual changes)

    TIPS FOR MANAGING HYPERTENSION (HIGH BLOOD PRESSURE)

    DO:

    • Talk to your doctor about how to take your blood pressure regularly
    • Eat healthy (whole grains, fruits, vegetables, and low-fat dairy products such as yogurt)
    • Exercise regularly
      • Walking, jogging, cycling, or swimming are the best types of exercises that can help with blood pressure
      • Talk to your doctor about what types of exercise he or she may recommend for you

    AVOID:

    • Too much salt, caffeine, or alcohol
    CABOMETYX Blood pressure cuff icon

    LEARN MORE ABOUT

    CABOMETYX® Doctor Discussion Guide

    Talking to Your Doctor
    Help make the most of your medical appointments by creating a Doctor Discussion Guide to talk about what’s important to you.

    CABOMETYX Support resources icon

    Thyroid Cancer Resources
    There are many resources available for you or someone you are caring for to help throughout the treatment journey.

    INDICATIONS AND IMPORTANT SAFETY INFORMATION

    IMPORTANT SAFETY INFORMATION

    What are the possible side effects of CABOMETYX?

    CABOMETYX may cause serious side effects, including:

    Bleeding (hemorrhage). CABOMETYX can cause severe bleeding that may lead to death. Tell your healthcare provider right away if you get any signs of bleeding during treatment with CABOMETYX, including:

    • Coughing up blood or blood clots
    • Vomiting blood or if your vomit looks like coffee grounds
    • Red or black (looks like tar) stools
    • Menstrual bleeding that is heavier than normal
    • Any unusual or heavy bleeding

    A tear in your stomach or intestinal wall (perforation) or an abnormal connection between 2 parts of your body (fistula). Tell your healthcare provider right away if you get tenderness or pain in your stomach area (abdomen) that is severe or that does not go away.

    Blood clots, stroke, heart attack, and chest pain. Get emergency help right away if you get:

    • Swelling or pain in your arms or legs
    • Shortness of breath
    • Feel lightheaded or faint
    • Sweating more than usual
    • Numbness or weakness of your face, arm, or leg, especially on one side of your body
    • Sudden confusion, trouble speaking or understanding
    • Sudden trouble seeing in one or both eyes
    • Sudden trouble walking
    • Dizziness, loss of balance or coordination
    • A sudden severe headache

    High blood pressure (hypertension). Hypertension is common with CABOMETYX and sometimes can be severe. Your healthcare provider will check your blood pressure before starting CABOMETYX and regularly during treatment with CABOMETYX. If needed, your healthcare provider may prescribe medicine to treat your high blood pressure. Tell your healthcare provider if you develop severe headaches, nose bleeds, tiredness or confusion, vision changes, chest pain, trouble breathing, irregular heartbeat, or blood in your urine.

    Diarrhea. Diarrhea is common with CABOMETYX and can be severe. If needed, your healthcare provider may prescribe medicine to treat your diarrhea. Tell your healthcare provider right away if you have frequent loose, watery bowel movements.

    A skin problem called hand-foot skin reaction. Hand-foot skin reactions are common and can be severe. Tell your healthcare provider right away if you have rashes, redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.

    Protein in your urine and possible kidney problems. Symptoms may include swelling in your hands, arms, legs, or feet. Your healthcare provider will check you for this problem during treatment with CABOMETYX.

    Severe jaw bone problems (osteonecrosis). Your healthcare provider should examine your mouth before you start and during treatment with CABOMETYX. Tell your dentist that you are taking CABOMETYX. It is important for you to practice good mouth care during treatment with CABOMETYX. Tell your healthcare provider right away if you develop any symptoms of jaw problems, including: jaw pain, toothache, or sores on your gums.

    Wound healing problems. Wound healing problems have happened in people who take CABOMETYX. Tell your healthcare provider if you plan to have any surgery before or during treatment with CABOMETYX.

    • You should stop taking CABOMETYX at least 3 weeks before planned surgery.
    • Your healthcare provider should tell you when you may start taking CABOMETYX again after surgery.

    Reversible posterior leukoencephalopathy syndrome (RPLS). A condition called reversible posterior leukoencephalopathy syndrome can happen during treatment with CABOMETYX. Tell your healthcare provider right away if you have headaches, seizures, confusion, changes in vision, or problems thinking.

    Change in thyroid function. CABOMETYX can cause changes in your thyroid function, including changes to thyroid hormone levels in your blood. Your healthcare provider will do blood tests to check your thyroid function before and during treatment with CABOMETYX.

    Decreased calcium level in your blood (hypocalcemia). CABOMETYX can cause you to have a decreased amount of calcium in your blood. Your healthcare provider will do blood tests to check you for this problem and give you calcium if needed. Tell your healthcare provider right away if you get any of the following signs or symptoms:

    • Muscle stiffness or muscle spasms
    • Numbness or tingling in your fingers, toes, or around your mouth
    • Seizures
    • Sudden weight gain
    • Swelling of your arms, hands, legs, and ankles

    Your healthcare provider may change your dose, temporarily stop, or permanently stop treatment with CABOMETYX if you have certain side effects.

    The most common side effects of CABOMETYX include:

    • Tiredness
    • Decreased appetite
    • Nausea and vomiting
    • Weight loss
    • Constipation

    CABOMETYX may cause fertility problems in females and males, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

    These are not all of the possible side effects of CABOMETYX. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

    Before you take CABOMETYX, tell your healthcare provider about all of your medical conditions, including if you:

    • Have had a liver problem other than liver cancer.
    • Have a recent history of bleeding, including coughing up or vomiting blood, or black tarry stools.
    • Have an open or healing wound.
    • Have high blood pressure.
    • Have a low calcium level in your blood (hypocalcemia).
    • Plan to have any surgery, dental procedure, or have had a recent surgery. You should stop treatment with CABOMETYX at least 3 weeks before planned surgery.
    • Are pregnant, or plan to become pregnant. CABOMETYX can harm your unborn baby.
      • If you are able to become pregnant, your healthcare provider will check your pregnancy status before you start treatment with CABOMETYX.
      • Females who are able to become pregnant should use effective birth control (contraception) during treatment and for 4 months after your final dose of CABOMETYX.
      • Talk to your healthcare provider about birth control methods that may be right for you.
      • If you become pregnant or think you are pregnant, tell your healthcare provider right away.
    • Are breastfeeding or plan to breastfeed. It is not known if CABOMETYX passes into your breast milk. Do not breastfeed during treatment and for 4 months after your final dose of CABOMETYX.

    Tell your healthcare provider about all the medicines you take, including prescription or over-the-counter medicines, vitamins, and herbal supplements. CABOMETYX and certain other medicines may affect each other, causing side effects.

    What should I avoid while taking CABOMETYX?

    Avoid drinking grapefruit juice, eating grapefruit, or taking supplements that contain grapefruit or St. John’s wort during treatment with CABOMETYX.

    Please see the Patient Information in the full Prescribing Information.

    INDICATION

    What is CABOMETYX?

    CABOMETYX is a prescription medicine used to treat:

    • Adults and children 12 years of age and older who have a type of thyroid cancer called differentiated thyroid cancer (DTC) that has spread (locally advanced or metastatic), and,
      • has progressed after treatment with a VEGFR-targeted treatment, and
      • your DTC can no longer be treated with radioactive iodine, or you are not able to receive radioactive iodine treatment.

    It is not known if CABOMETYX is safe and effective in children younger than 12 years of age.

    • Adults and children 12 years of age and older who have a type of thyroid cancer called differentiated thyroid cancer (DTC) that has spread (locally advanced or metastatic), and,
      • has progressed after treatment with a VEGFR-targeted treatment, and
      • your DTC can no longer be treated with radioactive iodine, or you are not able to receive radioactive iodine treatment.

    It is not known if CABOMETYX is safe and effective in children younger than 12 years of age.