During the use of cabozantinib, special attention should be paid to monitoring and managing hypertension, diarrhea, and hand foot syndrome. Hypertension needs to be regularly monitored and controlled, diarrhea requires timely intervention and dosage adjustment, and hand foot syndrome requires prevention of skin damage and timely suspension of medication. The following items detail specific precautions.

1. Precautions for hypertension

Before treatment, it is necessary to confirm stable blood pressure control, and uncontrolled hypertension patients are prohibited from using it. Monitor blood pressure weekly during treatment, and seek medical attention immediately if severe headaches, dizziness, or changes in vision occur. When there is a hypertensive crisis or medication cannot be controlled, permanent discontinuation of medication is necessary. After blood pressure stabilizes, reduced dose recovery treatment may be considered.

2 Key points for diarrhea management

When diarrhea occurs, medication should be suspended until it subsides to level 1, and then reduced and restored. Pay attention to replenishing water and electrolytes, and investigate infectious factors for severe diarrhea. If accompanied by abdominal pain and fever, be alert to the risk of intestinal perforation. If relevant symptoms occur, stop taking medication immediately and seek medical attention.

3. Coping measures for hand foot syndrome

Manifesting as redness, swelling, pain, or blisters on the palms/soles, mechanical friction and high temperature stimulation should be avoided. If symptoms of grade 2 or above occur, medication should be suspended and reduced before recovery. Daily care requires the use of moisturizers, avoiding contact with irritating chemicals, and paying attention to protection when trimming nails.

4 Comprehensive monitoring requirements

Regularly conduct blood pressure, urine protein, and liver function tests. Medication should be stopped for 3 weeks before surgery, and can only be resumed after 2 weeks of wound healing after surgery. Women of childbearing age should strictly use contraception until 4 months after the last dose. If there are signs of pregnancy, stop taking the medication immediately and seek medical attention.