CABOMETYX 20MG

Description

Cabometyx 20mg belongs to a small molecule inhibitor of several tyrosine kinases which are thought to be including in tumour growth and angiogenesis. It is used for patients with renal cell carcinoma which has progressed after being treated with a vascular endothelial growth factor receptor inhibitor such as sorafenib, pazopanib or axitinib.

Cabometyx 20mg is a prescription drug which is used under the supervision of doctors.

Indication

Cabometyx 20mg is used for the treatment of conditions as follows

Metastatic medullary thyroid cancer and;

Advanced renal cell carcinoma (RCC) who have getting before anti-angiogenic therapy.

Hepatocellular cancer who have previously received sorafenib.

Mechanism of action

Artificially biochemical and/or cellular assays have shown that Cabozantinibprohibits the tyrosine kinase activity of MET, VEGFR-1, -2 and -3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2. The following receptor tyrosine kinases are including in both normal cellular function and pathologic processes such as oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.

ADME Properties

Peak plasma concentration is observed in 2-5 hours

Human plasma protein bounding of Cabometyx is ≥ 99.7%

Mostly metabolized by CYP3A4 and minorly by CYP2C9.

Eliminated mostly via feces 54 % and in urine 27% and half-life is 55 hours.

Dosage and administration

Avoid substitute Cabometyx tablets with Cabozantinib capsules.

The prescribed dose of Cabometyx is 60 mg.

Administration Cabometyx is without food.

Advise the patients not to eat for at least 2 hours before and 1 hour after taking cabometyx. Follow the treatment until patient no longer experiences clinical benefit or experiences unacceptable toxicity.

Swallow Cabometyx tablets whole. Do not crush Cabometyx tablets.

Side effects

• GI perforations and fistulas
• Thrombotic events
• Hypertension and hypertensive crisis
• Diarrhea
• Palmar-plantar erythrodysesthesia
• Haemorrhage
• Reversible posterior leukoencephalopathy syndrome

Drug interaction

While concurrent use with strong CYP3A4 inhibitor will increase the single dose plasma Cabometyx 20mg exposure by 38%.

While Co administration with strong CYP3A4 inducers will decreased the single dose plasma Cabometyx 20mg exposure by 77%

Concomitant use with MRP2 inhibitors may increase the exposure to Cabometyx 20mg.

Contraindication

Cabometyx 20mg is contraindicated patients having hypersensitivity reaction to the active substance or its excipients.

Precautions

Monitor the patients for symptoms of perforations and fistulas, contain abscess. stop Cabometyx 20mg in patients who experience a perforation or a fistula.

Do not administerCabometyx 20mg to patients with a present history of haemorrhage or haemoptysis.

Discontinue theCabometyx 20mg in patients who develop an acute myocardial infarction, cerebral infarction, or any other clinically significant arterial thromboembolic complication.

Discontinue the Cabometyx 20mg for patient if have severe hypertension that cannot be controlled with anti-hypertensive therapy.

Discuss pregnant women aboutpossible risk to a foetus. Advise females of reproductive possible to use effective contraception during treatment with Cabometyx 20mg and for 4 months after the last dose.

Pregnancy

Based on studies of animal and mechanism of action, cabometyx 20mg will cause fetal harm when given to pregnant women. Advice the female not to become pregnant while on treatment with cabometyx 20mg.

Lactation

During treatment with cabometyx 20mg, advise the women not to breastfed to infants

Storage

Store the drug at 20⁰C to 25⁰ C

Keep away from the children resistances

Missed Dose

If the patient missed to take a dose, then should not to take an extra dose, but to take the next dose at the regular time, skip the missed dose. Do not take the missed dose within 12 hours of next dose.