Cabozantinib

Cabozantinib – Baidu Health
Functions and indications:
For the treatment of progressive and metastatic medullary thyroid carcinoma.
Usage and dosage:
The dosage and administration of this product may vary for different dosage forms and specifications. Please read the specific drug instructions for use or follow the doctor’s advice. Tablets and capsules: 1. The recommended dose of this product is 140 mg/day (80 mg per dose, 20 mg for three doses). It cannot be taken with food (taken at least 1 hour before meals or at least 2 hours after meals). Continue treatment until the disease worsens or unacceptable toxicity occurs. The capsules of this product should be swallowed whole and cannot be opened. Foods that inhibit CYP enzyme activity (such as grapefruit or grapefruit juice) or nutritional supplements cannot be taken at the same time. The use of this product must be suspended in the event of NCICTCAE grade 4 hematological toxicity, grade 3 non-hematological toxicity, or intolerable grade 2 toxicity. After the adverse reaction improves (such as recovery to the limit or improvement to grade 1), adjust the dose as follows. (1) If the original dose is 140 mg/day, restart at 100 mg/day. (2) If the original dose is 100 mg/day, restart at 60 mg/day. (3) If the original dose is 60 mg/day, restart at 60 mg/day if tolerated, otherwise stop using. 2. If the following conditions occur (such as visceral bleeding or fistula formation, severe bleeding, severe arterial thrombosis (such as myocardial infarction, cerebral infarction), nephrotic syndrome, malignant hypertension, hypertensive crisis, uncontrolled persistent hypertension, osteonecrosis of the jaw, reversible posterior leukoencephalopathy syndrome (RPLS)), the use of this product should be permanently discontinued. 3. Avoid taking strong CYP3A4 inhibitors (such as ketoconazole, itraconazole, clarithromycin, atazanavir, nefazodone, saquinavir, telithromycin, ritonavir, indinavir, nelfinavir, voriconazole) at the same time. 4. Patients who need to use it with a strong CYP3A4 inhibitor should reduce the dose of this product by 40 mg (such as 140 mg/day reduced to 100 mg or 100 mg/day reduced to 60 mg). 2-3 days before stopping the strong CYP3A4 inhibitor, resume the original dose. 5. If there is an alternative method, avoid the simultaneous use of strong CYP3A4 inducers (such as phenytoin, carbamazepine, rifampicin, rifabutin, levopentine, phenobarbital, Hypericum perforatum). 6. Patients who need to use it with a strong CYP3A4 inducer should increase the dose of this product by 40 mg (such as 140 mg/day increased to 180 mg or 100 mg/day increased to 140 mg/day). 2-3 days before stopping the strong CYP3A4 inducer, resume the original dose. The daily dose cannot exceed 180 mg.
Adverse reactions:
1. Fatal adverse reactions: bleeding, pneumonia, sepsis, fistula, cardiac arrest, respiratory failure and unexplained death. 2. Common adverse reactions in clinical trials: diarrhea, stomatitis, palmar-plantar syndrome, weight loss, loss of appetite, nausea, fatigue, oral pain, hair color changes, taste disorders, hypertension, abdominal pain and constipation. 3. The most common (>25%) laboratory abnormalities: increased AST and (or) ALT, lymphopenia, increased ALP (ALP), hypocalcemia, neutropenia, thrombocytopenia, hypophosphatemia and hyperbilirubinemia. 4. Other adverse reactions: abdominal pain, dysphagia, dyspepsia, hemorrhoids, dehydration, joint pain, muscle cramps, lymphopenia, hypocalcemia, fatigue, headache, dizziness, paresthesia, weakness, peripheral sensory neuropathy, anxiety, rash, dry skin, alopecia, erythema, hyperkeratosis, hypotension. 5. Adverse reactions leading to permanent discontinuation of the drug: hyponatremia, elevated lipase, palmar-foot syndrome, diarrhea, fatigue, hypertension, nausea, pancreatitis, tracheal fistula formation and vomiting. 6. Increased thyroid hormone levels: After the first dose, about 57% of patients treated with this product had a 19% increase in thyroid hormone levels compared with those who received placebo.
Contraindications:
1. It is not recommended for patients with moderate and severe liver dysfunction. 2. Based on its mechanism of action, the use of this product by pregnant women may cause fetal damage. If the patient uses this product during pregnancy or becomes pregnant during medication, the patient should be informed of the harm to the fetus.