Can you take Cabozantinib with Quadramet?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- cabozantinib
- Quadramet (samarium sm 153 lexidronam)
Drug interactions
Major drug interactions
Major:
samarium sm 153 lexidronam cabozantinib
Applies to: Quadramet (samarium sm 153 lexidronam) and cabozantinib
Using samarium sm 153 lexidronam together with cabozantinib may increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should seek medical attention if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
cabozantinib Food/Lifestyle
Applies to: cabozantinib
Cabozantinib should be taken on an empty stomach, one hour before or two hours after a meal. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with cabozantinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of cabozantinib. You may be more likely to experience side effects such as nausea; vomiting; diarrhea; loss of appetite; weight loss; mouth sores; abdominal pain; skin rash (primarily on the palms of the hands and soles of the feet); delayed wound healing; high blood pressure; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of bleeding problems and infections. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
11 potential interactions Applies to: 11 conditions, including High Blood Pressure, Heart Attack, Diverticulitis, Thrombotic/Thromboembolic Disorder, and Liver Disease.
Bleeding Disorder
Major:
cabozantinib
Cabozantinib has a major potential interaction with Bleeding Disorder.
Fatal hemorrhagic events have been reported with the use of cabozantinib. Therapy with cabozantinib is not recommended in patients that have or are at risk for severe hemorrhage.
Diverticulitis
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Diverticulitis.
Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Gastrointestinal Perforation
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Gastrointestinal Perforation.
Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Heart Attack
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Heart Attack.
Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
High Blood Pressure
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with High Blood Pressure.
The use of cabozantinib causes hypertension. Blood pressure should be well-controlled prior to initiating cabozantinib and monitored and treated as needed with standard anti-hypertensive therapy. It is recommended to reduce the dose in case of persistent hypertension despite use of anti-hypertensive medications and to discontinue therapy if hypertension is severe and persistent despite these measures. Discontinue cabozantinib therapy for severe hypertension that cannot be controlled with anti-hypertensive therapy and if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management. Close monitoring is recommended.
Interstitial Lung Disease
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Interstitial Lung Disease.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Liver Disease
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Liver Disease.
Increased exposure to cabozantinib has been observed in patients with mild to moderate hepatic impairment. It is recommended to reduce the cabozantinib dose in patients with mild or moderate hepatic impairment. The use of cabozantinib is not recommended in patients with severe hepatic impairment. It is recommended to monitor liver function and urine bilirubin tests periodically during therapy.
Posterior Reversible Encephalopathy Syndrome
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.
Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving cabozantinib. It is recommended to discontinue therapy in patients developing RPLS. The safety of reinitiating therapy in patients previously experiencing RPLS is not known. Care and close monitoring should be considered in these patients.
Pulmonary Impairment
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Pulmonary Impairment.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Renal Dysfunction
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Renal Dysfunction.
No dose adjustment is required in patients with mild or moderate renal impairment. There is no experience with cabozantinib in patients with severe renal impairment. Care should be exercised in these patients.
Thrombotic/Thromboembolic Disorder
Moderate:
cabozantinib
Cabozantinib has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
More resources
cabozantinib
A total of 560 drugs are known to interact with cabozantinib.
- Cabozantinib is in the following drug classes: multikinase inhibitors, VEGF/VEGFR inhibitors.
- Cabozantinib is used to treat the following conditions:
Quadramet
A total of 223 drugs are known to interact with Quadramet.
- Quadramet is in the drug class therapeutic radiopharmaceuticals.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.