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Same active ingredient — pay up to 41% less
These brands contain the same active ingredient (Cabozantinib). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Comarit
Other strengths and forms by Genvio Pharma Ltd.
Indications & Uses
Comarit is indicated for:
Pharmacology
Cabozantinib blocks the tyrosine kinase activity of MET, VEGFR-1, -2 and -3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3 and TIE-2, according to in vitro biochemical and/or cellular assays. These receptor tyrosine kinases take part in normal cell function, and also in disease processes such as oncogenesis, metastasis, tumor angiogenesis, drug resistance and maintenance of the tumor microenvironment.
Absorption: The median time to peak cabozantinib concentrations (Tmax) ranged from 3 to 4 hours after the dose. After a single 140 mg dose, the Cmax of Cabozantinib was 19% higher than with a Cabozantinib capsule formulation. The AUC differed by less than 10% between the two.
Distribution: The oral volume of distribution (Vz/F) of Cabozantinib is approximately 319 L. Cabozantinib is highly protein-bound in human plasma (≥99.7%).
Elimination: The predicted terminal half-life is approximately 99 hours, and clearance (CL/F) at steady state is estimated to be 2.2 L/hr.
Metabolism: In vitro, Cabozantinib is a substrate of CYP3A4.
Excretion: Healthy subjects were given a single dose of radiolabeled 14 C-Cabozantinib, and approximately 81% of the total administered radioactivity was recovered within a 48-day collection period. About 54% was found in feces and 27% in urine. Unchanged Cabozantinib made up 43% of the total radioactivity in feces, and it could not be detected in urine over a 72-hour collection.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Recommended Dosage for Renal Cell Carcinoma
The usual dose of Cabozantinib is 60 mg once daily, taken without food. Treatment continues until the patient no longer gets clinical benefit or has unacceptable toxicity.
Recommended Dosage for Hepatocellular Carcinoma
The usual dose of Cabozantinib is 60 mg once daily, taken without food. Treatment continues until the disease progresses or toxicity becomes unacceptable. The dose may also be set as directed by the registered physician.
Stop Cabozantinib at least 28 days before any scheduled surgery, dental surgery included. Cabozantinib tablets must not be swapped for Cabozantinib capsules. Don't take it with food. Take it at least 1 hour before eating or at least 2 hours after. Swallow the tablets whole and don't crush them. If a dose is missed, don't take it within 12 hours of the next dose.
The dose needs to be changed for some patients with hepatic impairment, and for patients taking drugs known to strongly induce or inhibit CYP450.
Pediatric Use
The safety and effectiveness of Cabozantinib in pediatric patients have not been established.
Side Effects
Hemorrhage, perforations and fistulas, thrombotic events, hypertension and hypertensive crisis, diarrhea, palmar-plantar erythrodysesthesia, proteinuria, osteonecrosis of the jaw, wound complications, reversible posterior leukoencephalopathy syndrome.
Cautions & Contraindications
Warnings & Precautions
Hemorrhage: Severe and fatal bleeding has occurred with Cabozantinib. Stop the medicine for Grade 3 or 4 hemorrhage. Don't give it to patients who have recently had bleeding, including hemoptysis, hematemesis or melena. Perforations and Fistulas: Fistulas, including fatal cases, occurred in 1% of patients treated with Cabozantinib. Gastrointestinal (GI) perforations, including fatal cases, also occurred in 1%. Watch patients for signs and symptoms of fistulas and perforations, including abscess and sepsis. Stop the medicine in a patient who has a fistula that can't be managed properly or who has a GI perforation. Thrombotic Events: Cabozantinib raised the risk of thrombotic events. Venous thromboembolism occurred in 7% of patients (4% of them pulmonary embolism), and arterial thromboembolism occurred in 2%. Some thrombotic events were fatal. Stop the medicine in patients who develop an acute myocardial infarction or a serious arterial or venous thromboembolic event that needs medical intervention. Hypertension and Hypertensive Crisis: Cabozantinib can cause hypertension, including hypertensive crisis. Don't start it in patients whose hypertension is uncontrolled. Check blood pressure regularly during treatment. If hypertension isn't adequately controlled with medical management, withhold the medicine; when it is controlled, restart at a reduced dose. Stop Cabozantinib for severe hypertension that can't be controlled with anti-hypertensive therapy, or for hypertensive crisis. Diarrhea: Diarrhea occurred in 63% of patients treated with Cabozantinib. For intolerable Grade 2 diarrhea, Grade 3 diarrhea that standard antidiarrheal treatments can't manage, or Grade 4 diarrhea, withhold the medicine until it improves to Grade 1, then resume at a reduced dose. Palmar-Plantar Erythrodysesthesia: Palmar-plantar erythrodysesthesia (PPE) occurred in 44% of patients treated with Cabozantinib. For intolerable Grade 2 PPE or Grade 3 PPE, withhold the medicine until it improves to Grade 1, then resume at a reduced dose. Proteinuria: Proteinuria was seen in 7% of patients receiving Cabozantinib. Check urine protein regularly during treatment. Stop the medicine in patients who develop nephrotic syndrome. Osteonecrosis of the Jaw: Osteonecrosis of the jaw (ONJ) occurred in less than 1% of patients treated with Cabozantinib. It can show up as jaw pain, osteomyelitis, osteitis, bone erosion, tooth or periodontal infection, toothache, gingival ulceration or erosion, persistent jaw pain, or slow healing of the mouth or jaw after dental surgery. Examine the mouth before starting Cabozantinib and from time to time during treatment. Advise patients on good oral hygiene. If possible, withhold the medicine for at least 28 days before scheduled dental surgery or invasive dental procedures. If ONJ develops, withhold Cabozantinib until it has completely resolved. Wound Complications: Wound complications have been reported with Cabozantinib. Stop it at least 28 days before scheduled surgery. After surgery, restart based on the clinician's judgment that the wound has healed adequately. Withhold the medicine in patients with dehiscence or wound healing complications that need medical intervention. Reversible Posterior Leukoencephalopathy Syndrome: Reversible Posterior Leukoencephalopathy Syndrome (RPLS) can occur with Cabozantinib. It is a syndrome of subcortical vasogenic edema, diagnosed by characteristic findings on MRI. Evaluate for RPLS in any patient who presents with seizures, headache, visual disturbances, confusion or altered mental function. Stop the medicine in patients who develop RPLS. Embryo-Fetal Toxicity: Based on animal studies and how the medicine works, Cabozantinib can harm a fetus when given to a pregnant woman. Tell pregnant women about the possible risk to the fetus. Advise females who can become pregnant to use effective contraception during treatment and for 4 months after the last dose.
Contraindications
Don't give Cabozantinib to anyone who is known to be hypersensitive to it or to any other component of the product.
Pregnancy & Breastfeeding
Pregnancy: Cabozantinib can harm an unborn baby if a pregnant woman takes it. There are no data in pregnant women that could show what the exact risk is.
Breastfeeding: Nobody knows whether Cabozantinib or its metabolites pass into human milk, or what they might do to a breastfed child or to milk production. Because serious side effects in a breastfed child are possible, women should be advised not to breastfeed while on Cabozantinib and for 4 months after the final dose.
Contraception: As Cabozantinib can cause fetal harm when given to a pregnant woman, females of reproductive potential should be advised to use effective contraception during treatment and for 4 months after the final dose.
Infertility: Animal findings suggest that Cabozantinib may impair fertility in both females and males of reproductive potential.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
One case of overdose was reported with another formulation of Caboz. A patient took twice the intended dose by mistake for 9 days. The patient had Grade 3 memory impairment, Grade 3 mental status changes and Grade 3 cognitive disturbance, along with Grade 2 weight loss and a Grade 1 increase in BUN. How far the patient recovered was not documented.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Cabozantinib in a cool, dry place where the temperature stays below 30°C, and away from sunlight. Make sure children cannot reach it.
Drug Interactions
Common questions about Comarit 20 mg
What is Comarit 20 mg Capsule?
Comarit 20 mg Capsule is a medicine that contains Cabozantinib. It is made by Genvio Pharma Ltd. It belongs to the Tyrosine Kinase Inhibitor group of medicines.
What is Comarit used for?
Comarit is used for: Cancer.
What are the side effects of Comarit?
Hemorrhage, perforations and fistulas, thrombotic events, hypertension and hypertensive crisis, diarrhea, palmar-plantar erythrodysesthesia, proteinuria, osteonecrosis of the jaw, wound complications, reversible posterior leukoencephalopathy syndrome.
Can I take Comarit during pregnancy or while breastfeeding?
Pregnancy: Cabozantinib can harm an unborn baby if a pregnant woman takes it. There are no data in pregnant women that could show what the exact risk is. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Comarit?
One case of overdose was reported with another formulation of Caboz. A patient took twice the intended dose by mistake for 9 days. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Comarit?
Keep Cabozantinib in a cool, dry place where the temperature stays below 30°C, and away from sunlight. Make sure children cannot reach it.
Can I take other medicines with Comarit?
Some medicines can interact with Cabozantinib, for example: St. John's Wort. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Caboxen by Everest Pharmaceuticals Ltd. has the same ingredient and strength for ৳355.00 per unit, compared with ৳600.00 for Comarit. Ask your doctor or pharmacist before switching.
Do I need a prescription for Comarit?
Comarit is a prescription (Rx) medicine. Take it as your doctor advises.