Buy Cabozantinib 20 mg online, Buy Cometriq / Cabometyx online.

Caboxen 20 (Cabozantinib) 20 mg (Cometriq/ Cabometyx) by Everest Pharmaceuticals is used to treat Thyroid Cancer, Liver Cancer, Kidney Cancer(Renal Cell Carcinoma-RCC).

Caboxen is the alternative & generic version of Cometriq/ Cabometyx by Exelixis. Caboxen is manufactured by Everest Pharmaceuticals Bangladesh which is the biggest pharmaceutical company in Bangladesh.

Caboxen 20 mg (Cabozantinib)  is a generic kinase inhibitor indicated for the treatment of patients with progressive, metastatic medullary thyroid cancer.

Pharmacology

In vitro biochemical and/or cellular assays have shown that Cometriq inhibits the tyrosine kinase activity of MET, VEGFR-1, -2 and -3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2. These receptor tyrosine kinases are involved in both normal cellular function and pathologic processes such as oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.

Dosage

Recommended Dosage for Renal Cell Carcinoma: The recommended dosage of Cometriq is 60 mg once daily without food until the patient no longer experiences clinical benefit or experiences unacceptable toxicity.

Recommended Dosage for Hepatocellular Carcinoma: The recommended dosage of Cabozantinib is 60 mg once daily without food until disease progression or unacceptable toxicity.

Administration

• Stop treatment with Cometriq at least 28 days prior to scheduled surgery, including dental surgery

• Do not substitute Cometriq tablets with cabozantinib capsules.

• Do not administer Cometriq with food. Administer at least 1 hour before or at least 2 hours after eating

• Swallow Cabozantinib tablets whole. Do not crush Cabozantinib tablets.

• Do not take a missed dose within 12 hours of the next dose.

• Modify the dose for certain patients with hepatic impairment and for patients taking drugs known to strongly induce or inhibit CYP450

Interaction

• Strong CYP3A4 inhibitors: Reduce the Cabozantinib dosage if coadministration cannot be avoided.

• Strong CYP3A4 inducers: Increase the Cabozantinib dosage if coadministration cannot be avoided.

Side Effects

Cabozantinib may cause serious side effects, including:

• bleeding (hemorrhage)

• a tear in your stomach or intestinal wall (perforation) or an abnormal connection between 2

• parts of your body (fistula)

• blood clots, stroke, heart attack, and chest pain

• high blood pressure (hypertension)

• diarrhea

• a skin problem called hand-foot skin reaction

• protein in your urine and possible kidney problems

Pregnancy & Lactation

Based on findings from animal studies and its mechanism of action, Cabozantinib can cause fetal harm when administered to a pregnant woman. There is no information regarding the presence of Cabozantinib or its metabolites in human milk, or their effects on the breastfed child or milk production.

Precautions & Warnings

• Hemorrhage: Do not administer Cabometyx if recent history of hemorrhage.

• Perforations and Fistulas: Monitor for symptoms. Discontinue Cabozantinib for unmanageable fistula or GI perforation.

• Thrombotic Events: Discontinue Cabozantinib for myocardial infarction, cerebral infarction, or other serious thromboembolic events.

• Hypertension and Hypertensive Crisis: Monitor blood pressure regularly. Interrupt for hypertension that is not adequately controlled with anti-hypertensive therapy. Discontinue Cabozantinib for hypertensive crisis or severe hypertension that cannot be controlled with

• anti-hypertensive therapy.

• Diarrhea: May be severe. Interrupt Cabometyx immediately until diarrhea resolves or decreases to Grade 1. Recommend standard antidiarrheal treatments.

• Palmar-plantar erythrodysesthesia (PPE): Interrupt Cabometyx treatment until PPE resolves or decreases to Grade 1.

• Proteinuria: Monitor urine protein. Discontinue for nephrotic syndrome.

• Osteonecrosis of the jaw: Withhold Cabometyx for at least 28 days prior to invasive dental procedures and for development of ONJ.

• Wound complications: Withhold Cabometyx for dehiscence or complications requiring medical intervention.

• Reversible posterior leukoencephalopathy syndrome (RPLS): Discontinue Cabometyx.

• Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment and for 4 months after the last dose.

Use in Special Populations

• Pediatric Use: The safety and effectiveness of Cabometyx in pediatric patients have not been established.

• Geriatric Use: No overall differences in safety or effectiveness were observed between these patients and younger patients.

• Renal Impairment: No dosage adjustment is recommended in patients with mild or moderate renal impairment.

Overdose Effects

One case of overdosage was reported following administration of another formulation of Cabometyx; a patient inadvertently took twice the intended dose for 9 days. The patient suffered Grade 3 memory impairment, Grade 3 mental status changes, Grade 3 cognitive disturbance, Grade 2 weight loss, and Grade 1 increase in BUN. The extent of recovery was not documented.

Storage Conditions: Store Cabozantinib at room temperature 20°C to 25°C