Caboxen contains Cabozantinib, a potent tyrosine kinase inhibitor used in the treatment of advanced cancers. It is specifically indicated for patients with advanced renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC) who have previously been treated with Sorafenib. Caboxen works by inhibiting multiple receptor tyrosine kinases involved in tumor growth, angiogenesis, metastasis, and drug resistance.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications:

• Treatment of patients with advanced renal cell carcinoma (RCC).

• Treatment of hepatocellular carcinoma (HCC) in patients previously treated with Sorafenib.

Pharmacology:
Cabozantinib inhibits tyrosine kinase activity of MET, VEGFR-1, -2, -3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2, which play roles in cancer progression and tumor microenvironment maintenance. Key pharmacokinetic properties include:

• Absorption: Peak plasma concentrations reached 3–4 hours post-dose.

• Distribution: Oral volume of distribution approximately 319 L; highly protein-bound (≥99.7%).

• Metabolism: Substrate of CYP3A4.

• Excretion: ~81% of administered dose recovered in feces (54%) and urine (27%) over 48 days.

• Half-life: Terminal half-life approximately 99 hours; clearance 2.2 L/hr at steady state.

Dosage & Administration:

• Recommended dose: 60 mg once daily without food.

• Continue until disease progression or unacceptable toxicity occurs.

• Pediatric use: Safety and efficacy not established.

Interactions:

• Avoid strong CYP3A4 inhibitors (e.g., ketoconazole) and inducers (e.g., rifampin, St. John’s Wort). Dose adjustments may be required if co-administration is unavoidable.

• Avoid grapefruit or grapefruit juice.

Contraindications:

• Known hypersensitivity to Cabozantinib or any component of the formulation.

Side Effects:

• Common: Diarrhea, palmar-plantar erythrodysesthesia (PPE), proteinuria.

• Serious: Hemorrhage, fistulas, gastrointestinal perforation, thromboembolic events, hypertension, osteonecrosis of the jaw, wound healing complications, reversible posterior leukoencephalopathy syndrome (RPLS).

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions & Warnings:

• Monitor blood pressure, urine protein, and for signs of thrombotic events.

• Discontinue therapy for severe hemorrhage, GI perforation, acute myocardial infarction, uncontrolled hypertension, or RPLS.

• Perform dental examination before treatment; advise good oral hygiene.

• Pregnancy: Can cause fetal harm. Use effective contraception during treatment and for 4 months after last dose.

• Lactation: Breastfeeding not recommended during treatment and for 4 months post-treatment.

• Fertility: May impair fertility in males and females of reproductive potential.

Overdose:

• Symptoms reported include memory impairment, mental status changes, cognitive disturbances, and weight loss. Immediate medical evaluation is recommended.

Therapeutic Class:

• Tyrosine Kinase Inhibitor

Storage Conditions:

• Store below 30°C in a cool, dry place away from sunlight.

• Keep out of reach of children.