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Cometriq Side Effects

Generic Name: cabozantinib

Note: This page contains information about the side effects of cabozantinib. Some of the dosage forms included on this document may not apply to the brand name Cometriq.

For the Consumer

Applies to cabozantinib: oral capsule

In addition to its needed effects, some unwanted effects may be caused by cabozantinib (the active ingredient contained in Cometriq). In the event that any of these side effects do occur, they may require medical attention.

Severity: Major

You should check with your doctor immediately if any of these side effects occur when taking cabozantinib:

More common:
  • Blurred vision
  • burning, numbness, tingling, or painful sensations
  • dehydration
  • difficulty with breathing or swallowing
  • dizziness
  • headache
  • nervousness
  • pain in the chest, groin, or legs, especially the calves
  • pounding in the ears
  • redness, swelling, or pain of the skin
  • scaling of the skin on the hands and feet
  • severe, sudden headache
  • skin ulcers
  • slow or fast heartbeat
  • slurred speech
  • sudden loss of coordination
  • sudden, severe weakness or numbness in the arm or leg
  • sudden, unexplained shortness of breath
  • tingling of the hands and feet
  • unsteadiness or awkwardness
  • vision changes
  • weakness in the arms, hands, legs, or feet
Less common:
  • Bleeding gums
  • bloody, black, or tarry stools
  • coughing up blood
  • heartburn
  • heavy jaw feeling
  • increased menstrual flow or vaginal bleeding
  • indigestion
  • loosening of a tooth
  • nausea
  • nosebleeds
  • pain, swelling, or numbness in the mouth or jaw
  • paralysis
  • prolonged bleeding from cuts
  • red or dark brown urine
  • severe abdominal or stomach pain, cramping, or burning
  • trouble breathing
  • vomiting of material that looks like coffee grounds, severe and continuing
  • Confusion
  • disturbed color perception
  • double vision
  • halos around lights
  • night blindness
  • overbright appearance of lights
  • seizures
  • tunnel vision

Severity: Minor

Some of the side effects that can occur with cabozantinib may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Acid or sour stomach
  • belching
  • bleeding after defecation
  • change in taste
  • changes in hair color
  • decreased appetite
  • decreased weight
  • diarrhea
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • dry skin
  • fear
  • hair loss or thinning of the hair
  • hoarseness
  • lack or loss of strength
  • loss of taste
  • muscle pain or stiffness
  • muscle spasm
  • pain in the joints
  • rash
  • sore throat
  • stomach discomfort, upset, or pain
  • swelling or inflammation of the mouth
  • uncomfortable swelling around the anus
  • voice changes
  • vomiting

For Healthcare Professionals

Applies to cabozantinib: oral capsule


Fatal adverse reactions occurred in 6% of patients resulting from hemorrhage, pneumonia, septicemia, fistulas, cardiac arrest, respiratory failure, and unspecified death.

The most frequent adverse reactions leading to discontinuation in treatment include hypocalcemia, increased lipase, palmar-plantar erythrodysesthesia syndrome (PPES), diarrhea, fatigue, hypertension, nausea, pancreatitis, tracheal fistula formation, and vomiting.


Very common (10% or more): Hypertension (33%)
Common (1% to 10%): Hypotension (7%)[Ref]


Very common (10% or more): PPES (50%), hair color changes/depigmentation, graying (34%), rash (19%), dry skin (19%), alopecia (16%), erythema (11%)
Common (1% to 10%): Hyperkeratosis (7%)[Ref]


Very common (10% or more): Diarrhea (63%), stomatitis (51%; includes aphthous stomatitis, mouth ulcerations, and mucosal inflammation), nausea (43%), oral pain (36%; includes oropharyngeal pain, glossitis, burning mouth syndrome, and glossodynia), abdominal pain (27%; includes lower and upper abdominal pain, abdominal rigidity and tenderness, and esophageal pain, constipation (27%), vomiting (24%), dysphagia (13%), dyspepsia (11%)
Common (1% to 10%): Hemorrhoids (9%)[Ref]


Very common (10% or more): Lymphopenia (53%), neutropenia (35%), thrombocytopenia (35%)[Ref]


Very common (10% or more): Decreased weight (48%), decreased appetite (46%)
Common (1% to 10%): Dehydration (7%)[Ref]


Very common (10% or more): Arthralgia (14%), muscle spasms (12%)
Common (1% to 10%): Musculoskeletal chest pain (9%)[Ref]

Nervous system

Very common (10% or more): Fatigue (41%), dysgeusia (34%), asthenia (21%), headache (18%), dizziness (14%)
Common (1% to 10%): Paresthesia (7%), peripheral sensory neuropathy (7%), peripheral neuropathy (5%)[Ref]


Laboratory abnormalities:
Very common (10% or more): Increased AST (86%), increased ALT (86%), increased ALP (52%), hypocalcemia (52%), hypophosphatemia (28%), hyperbilirubinemia (25%). hypomagnesemia (19%), hypokalemia (18%), hyponatremia (10%), increased thyroid stimulating hormone (TSH)[Ref]


Common (1% to 10%): Anxiety (9%)[Ref]


Very common (10% or more): Dysphonia (20%)[Ref]


1. "Product Information. Cometriq (cabozantinib)." Exelixis Inc, S San Francisco, CA.

Not all side effects for Cometriq may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.