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Cabozantinib Side Effects

In Summary

Commonly reported side effects of cabozantinib include: diarrhea, hypocalcemia, hypertension, and palmar-plantar erythrodysesthesia. Other side effects include: venous thromboembolism, asthenia, fatigue, and decreased appetite. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to cabozantinib: oral capsule, oral tablet

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

Major Side Effects

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

Minor Side Effects

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, oral tablet


Very common (10% or more): Elevated blood pressure (up to 96%), hypertension (up to 61%)
Common (1% to 10%): Hypotension, venous thromboembolism, arterial thromboembolism, atrial fibrillation
Uncommon (0.1% to 1%): Angina pectoris, supraventricular tachycardia, shortened activated partial thromboplastin time
Frequency not reported: QT interval prolongation[Ref]


Very common (10% or more): Increased ALT (up to 86%), increased AST (up to 86%), increased alkaline phosphatase (up to 52%), hyperbilirubinemia (up to 25%)
Common (1% to 10%): Cholelithiasis
Uncommon (0.1% to 1%): Hepatic encephalopathy[Ref]


Very common (10% or more): Diarrhea (up to 63%), stomatitis (up to 51%), nausea (up to 43%), oral pain (up to 36%), constipation (up to 27%), abdominal pain (up to 27%), vomiting (up to 24%), dysphagia (up to 13%), dyspepsia (up to 11%), glossodynia
Common (1% to 10%): Hemorrhoids, GI perforation, GI fistula, GI hemorrhage, pancreatitis, anal fissure, anal inflammation, cheilitis
Uncommon (0.1% to 1%): Esophagitis[Ref]


Very common (10% or more): Increased blood thyroid stimulating hormone (up to 57%)
Common (1% to 10%): Hypothyroidism
Uncommon (0.1% to 1%): Amenorrhea[Ref]


Very common (10% or more): Lymphopenia (up to 53%), neutropenia (up to 35%), thrombocytopenia (up to 35%)
Uncommon (0.1% to 1%): Increased eosinophil count, increased platelet count[Ref]


Very common (10% or more): Palmar-plantar erythrodysesthesia syndrome (up to 50%), hair color changes/depigmentation/graying (up to 34%), rash (up to 19%), dry skin (up to 19%), alopecia (up to 16%), erythema (up to 11%)
Common (1% to 10%): Hyperkeratosis, folliculitis, acne, blister, abnormal hair growth, skin exfoliation, skin hypopigmentation
Uncommon (0.1% to 1%): Skin ulcer, telangiectasia[Ref]


Very common (10% or more): Decreased weight (up to 48%), decreased appetite (up to 46%), hypocalcemia (up to 52%), hypophosphatemia (up to 28%), hypomagnesemia (up to 19%), hypokalemia (up to 18%), hyponatremia (up to 10%), increased blood lactate dehydrogenase, increased blood creatinine phosphokinase
Common (1% to 10%): Dehydration, hypoalbuminemia[Ref]


Very common (10% or more): Fatigue (up to 41%), asthenia (up to 21%), mucosal inflammation
Common (1% to 10%): Abscess (including visceral, intra-abdominal, skin, tooth), fungal infection (including skin, oral, genital), ear pain, tinnitus, pallor, peripheral coldness, impaired wound healing/wound complications, chills, face edema
Uncommon (0.1% to 1%): Aspergilloma, hypoacusis, cyst, facial pain, localized edema
Frequency not reported: Hemorrhage[Ref]

Nervous system

Very common (10% or more): Dysgeusia (up to 34%), headache (up to 18%), dizziness (up to 14%)
Common (1% to 10%): Paresthesia, peripheral sensory neuropathy, peripheral neuropathy, ageusia, tremor
Uncommon (0.1% to 1%): Reversible posterior leukoencephalopathy syndrome, ataxia, attention disturbance, loss of consciousness, speech disorder, transient ischemic attack[Ref]


Very common (10% or more): Arthralgia (up to 14%), muscle spasms (up to 12%)
Common (1% to 10%): Musculoskeletal chest pain, osteonecrosis of the jaw
Uncommon (0.1% to 1%): Rhabdomyolysis[Ref]


Patients should be closely monitored for the first 8 weeks as most adverse events have occurred early in the course of treatment.[Ref]


Common (1% to 10%): Proteinuria, dysuria, hematuria
Uncommon (0.1% to 1%): Vaginal hemorrhage[Ref]


Common (1% to 10%): Blurred vision
Uncommon (0.1% to 1%): Cataract, conjunctivitis[Ref]


Common (1% to 10%): Anxiety, depression, confusional state
Uncommon (0.1% to 1%): Abnormal dreams, delirium[Ref]


Very common (10% or more): Dysphonia (up to 20%),oropharyngeal pain
Common (1% to 10%): Non-GI fistula (including tracheal, pneumomediastinum, tracheo-esophageal), pulmonary embolism, respiratory tract hemorrhage (including pulmonary, bronchial, tracheal), pneumonia, pneumonia aspiration
Uncommon (0.1% to 1%): Atelectasis, pharyngeal edema, pneumonitis[Ref]


Uncommon (0.1% to 1%): Acute renal failure[Ref]


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

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

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