Cabozantinib Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 1, 2024.

Applies to cabozantinib: oral capsule, oral tablet.

Serious side effects of cabozantinib

Along with its needed effects, cabozantinib may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking cabozantinib:

More common side effects

• blurred vision
• burning, numbness, tingling, or painful sensations
• confusion
• constipation
• dark urine
• darkening of the skin
• decreased urination
• diarrhea
• difficulty with breathing or swallowing
• dizziness
• dry mouth
• dry skin and hair
• fainting
• feeling cold
• hair loss
• headache
• hoarseness or husky voice
• increase in heart rate
• lightheadedness
• loss of appetite
• mental depression
• muscle cramps, spasms, and stiffness
• nausea or vomiting
• nervousness
• pain in the chest, groin, or legs, especially the calves
• pounding in the ears
• rapid breathing
• redness, swelling, or pain of the skin
• scaling of the skin on the hands and feet
• severe, sudden headache
• skin rash or ulcers
• slow or fast heartbeat
• slurred speech
• stomach pain
• sudden loss of coordination
• sudden, severe weakness or numbness in the arm or leg
• sunken eyes
• thirst
• unsteadiness or awkwardness
• unusual tiredness or weakness
• vision changes
• weakness in the arms, hands, legs, or feet
• weight gain
• wrinkled skin
• yellow eyes or skin

Less common side effects

• 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
• mood or mental changes
• muscle cramps in the hands, arms, feet, legs, or face
• nosebleeds
• numbness and tingling around the mouth, fingertips, or feet
• pain, swelling, or numbness in the mouth or jaw
• paralysis
• prolonged bleeding from cuts
• red or dark brown urine
• seizures
• severe stomach pain, cramping, or burning
• tremor
• trouble breathing
• vomiting of material that looks like coffee grounds, severe and continuing

Rare side effects

• disturbed color perception
• double vision
• halos around lights
• night blindness
• overbright appearance of lights
• tunnel vision

Incidence not known

• cloudy or bloody urine
• high blood pressure
• swelling of the face, feet, or lower legs

Other side effects of cabozantinib

Some side effects of cabozantinib may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• belching
• bleeding after defecation
• change in taste
• changes in hair color
• decreased appetite
• decreased weight
• difficulty having a bowel movement
• difficulty with moving
• fear
• lack or loss of strength
• loss of taste
• muscle pain
• 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

For healthcare professionals

Applies to cabozantinib: oral capsule, oral tablet.

General adverse events

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

Hepatic

• 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]

Gastrointestinal

• 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]

Endocrine

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

Hematologic

• 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
• Postmarketing reports: Arterial (including aortic) aneurysms, dissections, and rupture^[Ref]

Dermatologic

• 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]

Metabolic

• 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]

Other

• 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]

Musculoskeletal

• 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 (ONJ)
• Uncommon (0.1% to 1%): Rhabdomyolysis^[Ref]

Cardiovascular

• 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]

Genitourinary

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

Ocular

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

Psychiatric

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

Respiratory

• 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]

Renal

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

Frequently asked questions

• How long do you take Cabometyx for?
• What is the success rate of Cabometyx (cabozantinib)?
• Does Cabometyx (cabozantinib) cure cancer?
• What is the difference between Cabometyx and Cometriq?

Further information

Cabozantinib side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer