Cabozantinib 20 mg capsule (Caboxen)

What is Cabozantinib?

Cabozantinib 20 mg capsule (Caboxen) has received FDA approval to treat several cancers, including advanced renal cell carcinoma (RCC) in 2016, differentiated thyroid cancer (DTC) in 2021, and pancreatic and extrapancreatic neuroendocrine tumors (2025).

The approval for neuroendocrine tumors (NETs) in March 2025 for both adults and pediatric patients 12 and older was based on a cabinet trial, which showed significant improvement in progression-free survival compared to placebo. 

Cabozantinib Indications and Usage

It is a tyrosine kinase (a type of protein that helps cancer cells grow) inhibitor used to treat the following conditions, according to the FDA approval, alone or in combination with other therapies

• Patients with advanced renal cell carcinoma.
• Patients with advanced renal cell carcinoma as a first-line treatment in combination with nivolumab.
• Patients with hepatocellular carcinoma who have previously been treated with sorafenib.
• It is also used in medullary thyroid cancer that has metastasized or can not be removed by surgery.

How does Cabozantinib work in Renal Cell Carcinoma and in other cancers?

Laboratory studies have shown that cabozantinib works by blocking several proteins (called tyrosine kinases) that help cancer cells grow and spread. These proteins are also involved in forming new blood vessels that feed tumors and in helping cancer resist treatment. By blocking these signals, the drug helps slow tumor growth, prevent new blood vessel formation, and reduce the cancer’s ability to spread.

How to take Cabozantinib capsule?

• The recommended dose to treat renal cell carcinoma and hepatocellular carcinoma is 60 mg daily without food until disease progression or unacceptable toxicity.
• 40 mg orally once daily in combination with nivolumab 240 mg every 2 weeks or 480 mg every 4 weeks.
• Administer at least one hour before or two hours after eating.
• Do not substitute a tablet for a capsule.
• Stop taking Caboxen capsule at least 28 days before any surgery, even dental surgery.

• It is an oral medication that should be taken on an empty stomach.
• Take the capsule whole; do not chew or crush.
• If you miss a dose or take an overdose of the medication, do not discontinue the treatment. Instead, talk to your doctor for better advice.

Cabozantinib Side Effects and Safety Information

Common side effects

• Hypertension and Hypertensive Crisis
• Diarrhea
• Palmar-plantar Erythrodysesthesia
• Proteinuria
• Osteonecrosis of the Jaw
• Wound Complications
• Reversible Posterior Leukoencephalopathy Syndrome
• Hemorrhage
• Perforations and Fistulas
• Thrombotic Events

When to seek medical attention

Call your doctor immediately if you can not tolerate the side effects. It is important to inform your doctor about your health condition when side effects are adverse.

Precautions and Warnings

Before starting

• Caboxen capsule can cause a risk of bleeding, especially when used with anticoagulants. It should be used with caution because it can cause intestinal perforation and fistula, high blood pressure, proteinuria, liver and thyroid dysfunction.
• Because this medication can slow wound healing, it is necessary to stop using the drug at least 28 days before surgery.
• Note: when using medicine for pregnant and lactating women, do not use the drug for this subject.
• Do not take this drug if the patient is allergic to cabozantinib or any other ingredients in the medicine. Patients with fistula or unhealed wounds should not use it.

Drug Interaction

Some of the medicines can interact with each other if they are used together. So, your doctor should know if you are using any of the medicines that have an interaction with caboxen 20 mg capsule. Tell your doctor if you are using any of the medicines from the list below.

• Dengue Tetravalent Vaccine, Live
• Mumps Virus Vaccine, Live
• Measles Virus Vaccine, Live
• Bacillus of Calmette and Guérin Vaccine, Live
• Rubella Virus Vaccine, Live
• Smallpox Monkeypox Vaccine
• Typhoid Vaccine
• Varicella Virus Vaccine
• Yellow Fever Vaccine

Food and Alcohol Interaction

This medicine can also interact with some specific foods, alcohol, tobacco, or drugs. Though it is not specific, ask your health care professional to know more about other interactions. Doctors may forbid taking grapefruit or juice, star fruits, and pineapple, or other fruits of this kind with the drug.

Use in Pregnancy and Lactation

It was experienced in animal studies that taking Caboxen during pregnancy may harm the fetus in the womb. It is not recommended to take this medication and use proper contraception to prevent unwanted pregnancy.

It may contain many chemical substitutions, which may be intolerable for children. So breastfeeding while taking caboxen is not recommended by doctors. If you have children and need to take this medication, contact the doctor before taking it.

What should I know before taking Cabozantinib capsules?

• Inform your doctor if you have any kind of allergies to any foods, medicines, or preservatives. Then the doctor will test if this medicine is allergic to you. In case of non-prescription medicine, read the label of the medicine carefully.
• Do not use this medication without proper consultation with a doctor to treat children. Because there is no official approval for children. In case of an emergency doctor may use this medicine in children with dosage modification or in combination with other medications to reduce the toxicity and increase the tolerability.

Source: Mayo Clinic 

Tell your doctor if you have the following medical problems

Some medical problems can impede your journey 

• Bleeding problems.
• Blood clots
• Heart problems
• Kidney problems
• High blood pressure
• Low calcium in the blood
• Hypothyroidism
• Protein in the urine
• Stomach fistula
• Stroke
• Dental problem or dental surgery
• Oral disease
• Vomiting of blood
• Coughing up blood
• Black or tarry stools ( In this condition, caboxen 20 mg should not be used in patients)
• Mild to moderate liver disease.

Storage instruction

Store below 30 degrees C to keep it active and effective. Keep it away from children and direct sunlight.

Cabozantinib 20 mg Capsule Price in Bangladesh

The cost of Generic Cabozantinib varies depending on the country, manufacturer, and dosage strength. In Bangladesh, it is generally available at an affordable price compared to imported versions. In India and Pakistan, prices differ based on pack size and local pharmaceutical brands, with the higher-strength packs costing noticeably more.

In Turkey and Singapore, the price of Generic Cabozantinib tends to be higher due to import expenses and regulatory differences. Overall, global pricing typically falls within a moderate-to-high range for targeted cancer therapies, reflecting variations in healthcare policies and distribution costs.

Frequently Asked Questions about Cabozantinib

Disclaimer: Disclaimer: Information above is not for use as a medical advice alternative; always consult your doctor before taking any prescription medicines.