Cabozantinib (thyroid cancer)
Cabozantinib (Cabometyx) is a targeted cancer medicine used to treat certain advanced thyroid cancers that have stopped responding to other treatments.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Cabozantinib (thyroid cancer): Patient Information Guide
A plain-language walkthrough of Cabozantinib (thyroid cancer) — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Cabozantinib (Cabometyx) treats several advanced cancers. For thyroid cancer specifically, it is approved for:
- Differentiated thyroid cancer (DTC) in adults and teens aged 12 and older, when the cancer has spread and progressed after prior VEGFR-targeted therapy and is no longer responding to radioactive iodine (or radioactive iodine is not an option)
It also treats advanced kidney cancer, liver cancer (after prior treatment with sorafenib), and certain neuroendocrine tumors — but those uses are covered separately.
⚙️How it works▾
Cabozantinib is a kinase inhibitor — it blocks a group of proteins called tyrosine kinases, including MET, VEGFR-1, -2, and -3, RET, AXL, and others. Cancer cells rely on these proteins to multiply, spread to other parts of the body, and build new blood vessels to feed themselves. By shutting down these signals, cabozantinib can slow cancer growth and cut off its blood supply.
Because it targets multiple pathways at once — including some linked to drug resistance — it can be effective even when other therapies have stopped working.
💊How it's taken▾
Cabozantinib is a tablet taken once daily by mouth. It must always be taken on an empty stomach — wait at least 1 hour before eating or at least 2 hours after a meal, because food significantly increases drug absorption and could raise side effect risk. Swallow tablets whole; do not crush, chew, or split them.
- If you miss a dose, skip it if your next dose is within 12 hours
- Do not substitute Cabometyx tablets with a different cabozantinib product (capsule form) — they are not interchangeable
- Your doctor may adjust your dose depending on side effects or if you take certain other medicines
🤒Side effects — in detail▾
The most common side effects people experience include:
- Diarrhea
- Fatigue
- Hand-foot syndrome (PPE) — redness, pain, or blistering on palms and soles
- Decreased appetite and weight loss
- High blood pressure
- Nausea and vomiting
- Constipation
More serious reactions — including significant bleeding, blood clots, liver damage, jaw bone problems, or a rare brain condition — require prompt medical attention. Report anything unusual to your doctor right away and don't wait for your next appointment.
⚠️Warnings & precautions▾
- Bleeding: Serious or fatal bleeding can occur. Do not take cabozantinib if you have had a recent hemorrhage. Tell your doctor about any unusual bleeding immediately.
- Blood clots and heart events: Cabozantinib can cause arterial or venous blood clots, including heart attack and stroke. Treatment should be stopped if these occur.
- High blood pressure: Can become severe or reach crisis levels. Your blood pressure will need regular monitoring and may require medication to control it.
- Perforations and fistulas: Rare but serious holes or abnormal tunnels can form in the stomach, bowel, or other organs.
- Liver toxicity: Liver enzyme levels may rise, especially if combined with nivolumab. Regular blood tests are needed.
- Jaw bone damage (ONJ): Stop cabozantinib at least 3 weeks before any dental procedure. Tell your dentist you are on this medicine.
- Wound healing problems: Stop cabozantinib at least 3 weeks before any planned surgery; do not restart for at least 2 weeks after major surgery.
- Thyroid and calcium changes: Your thyroid function and calcium levels should be monitored during treatment.
🔀What it interacts with▾
Cabozantinib is broken down by a liver enzyme called CYP3A4, so many common medicines and even certain foods can raise or lower its levels in your blood:
- Strong CYP3A4 inhibitors (e.g., certain antifungals like ketoconazole, some antibiotics, HIV protease inhibitors) — raise cabozantinib levels, increasing side effect risk; avoid if possible, or your dose may need to be reduced
- Strong or moderate CYP3A4 inducers (e.g., rifampin, certain anti-seizure medicines) — lower cabozantinib levels, potentially making it less effective; avoid if possible, or your dose may need to be increased
- St. John's Wort (herbal supplement) — acts like a CYP3A4 inducer and can reduce cabozantinib's effectiveness; avoid
- Grapefruit and grapefruit juice — can raise cabozantinib levels; avoid throughout treatment
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Pregnancy: Cabozantinib can cause serious harm or loss of a pregnancy. Use effective contraception during treatment and for some time after. Tell your doctor immediately if you become pregnant.
- Breastfeeding: Do not breastfeed while taking cabozantinib.
- Surgery or dental procedures: Stop cabozantinib at least 3 weeks before any scheduled surgery (including dental surgery); wait at least 2 weeks after major surgery before restarting.
- Liver problems: A dose reduction is needed for moderate liver impairment; cabozantinib should be avoided in severe liver impairment.
- Teens and adolescents (12+): Bone growth plates should be monitored; the drug may need to be paused if abnormalities develop.
- Kidney problems: Mild to moderate kidney impairment does not significantly affect how the drug works, but severe impairment has not been studied.
- All medicines and supplements: Share a full list with your prescriber, especially any herbal products or medicines that affect liver enzymes.
🚑If you take too much▾
One case of taking too much cabozantinib (roughly twice the intended dose for about 9 days) resulted in serious memory and mental status changes, confusion, and weight loss. If you think you or someone else has taken too much, seek emergency medical help immediately. Do not try to manage it at home.
📡Pharmacodynamics — effects in the body▾
Cabozantinib can cause a small increase in the heart's electrical interval (called the QTc interval), which was measured at about 10–15 milliseconds on average in clinical studies. While this was monitored carefully, no patients developed dangerously prolonged QTc values in major trials. The full relationship between cabozantinib blood levels and its effects on the body is not completely understood.
🔬Pharmacokinetics — how your body processes it▾
After you take cabozantinib, it reaches peak levels in the blood within about 3–4 hours. It builds up in the body with daily dosing, reaching steady levels by around day 15. The drug has a long half-life of roughly 99 hours, meaning it stays in your system for several days after a dose. It is primarily broken down by the liver enzyme CYP3A4, and most of it leaves the body through the stool, with some excreted in urine. Because food significantly raises drug absorption, the empty-stomach rule is important to keep levels predictable.
📦How to store it▾
Store CABOMETYX at 20°C to 25°C (68°F to 77°F); excursions are permitted from 15°C to 30°C (59°F to 86°F) .
📄 Written from Cabozantinib (thyroid cancer)’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Cabozantinib (thyroid cancer) — the kind of thing our pharmacy team would talk through with you at the counter.
Why is my doctor prescribing this specific medication for my thyroid cancer? ▾
Does it matter when I take it — like, can I take it with breakfast? ▾
What side effects should I just manage at home versus call my doctor about? ▾
Are there foods or other medicines I need to avoid while taking this? ▾
I have a dental appointment coming up — is that okay? ▾
Can I get pregnant or breastfeed while I'm on this medication? ▾
Is Cabozantinib (thyroid cancer) available over the counter? ▾
💬 Answers drafted from Cabozantinib (thyroid cancer)’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
📈 How widely Cabozantinib (thyroid cancer) is used
A general measure of how commonly Cabozantinib (thyroid cancer) is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Cabozantinib (thyroid cancer) is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Cabozantinib (thyroid cancer) prescribed? Of the 1,596 medications we measure, Cabozantinib (thyroid cancer) ranks #1,087 by Medicaid prescriptions — more than 32% of them.
Utilization by Cabozantinib (thyroid cancer) product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
cabozantinib 40 MG Oral Tablet Most dispensed
Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1790169
cabozantinib 20 MG Oral Tablet
Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1790161
cabozantinib 60 MG Oral Tablet
Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1790173
Other Cabozantinib (thyroid cancer) products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)
Summed across the 1 of 3 listed NDC products with Medicaid activity.
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Cabozantinib (thyroid cancer), and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 16 listed Cabozantinib (thyroid cancer) NDCs with Medicaid activity.
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Cabozantinib (thyroid cancer) — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Cabozantinib (thyroid cancer) in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Cabozantinib (thyroid cancer) went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 1363268 2 dose forms · 5 strengths
-
Dose form (SCDF) Oral Capsule RxCUI 1363272No current FDA listing -
Dose form (SCDF) Oral Tablet RxCUI 1790160No current FDA listing
Look up RxCUI 1363268 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Cabozantinib (thyroid cancer) is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
RxNorm drug class
Cabozantinib (thyroid cancer) belongs to the Kinase Inhibitor class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Exelixis, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.