Any suggestions on what to use on bottom of feet with blister like symptoms from taken Cabometyx 40mg? I have been...

Managing Foot Blisters from Cabometyx (Cabozantinib)

I'm sorry you're dealing with this side effect—foot blistering is a known challenge with Cabometyx, and it's good you're being proactive about managing it.

What's Happening

Cabometyx commonly causes hand-foot skin reaction (HFSR), which appears as blistering, redness, and peeling on palms and soles. This occurs because the medication concentrates in areas of friction and pressure.

Evidence-Based Approaches to Try

According to NCCN Guidelines for supportive care in targeted therapy, here are strategies that have shown benefit:

Preventive/Protective Measures:

• Minimize pressure and friction - This is foundational. Wear soft, well-fitting socks (cotton blend) and cushioned shoes
• Keep feet cool and dry - Moisture worsens irritation
• Avoid prolonged standing/walking when possible
• Elevate feet when resting to reduce swelling

Topical Treatments to Discuss with Your Doctor:

• High-potency topical corticosteroids (stronger than what you may currently be using) - Ask if your prescribed cream is potent enough
• Urea-based creams (like what you're using) - these help with peeling, but may need higher concentration
• Salicylic acid preparations - can help with callus/blister management
• Silicone gel pads or moleskin - protective barriers for pressure areas
• Antibiotic ointment - if blisters open/become infected

Systemic Options Your Oncologist May Consider:

• Dose reduction or temporary hold of Cabometyx if HFSR is severe
• Oral medications - gabapentin or pregabalin (nerve pain medications) have helped some patients with HFSR-related discomfort
• Pyridoxine (Vitamin B6) - some evidence suggests high-dose B6 may help prevent HFSR

Important Questions to Ask Your Oncologist

1. Is my current topical steroid potent enough? (Ask specifically about Class I or II strength steroids)
2. Should I try a higher-concentration urea cream (20-40% urea products exist)?
3. Would a dose reduction help while we manage this? (Some patients tolerate lower doses better)
4. Should I start preventive gabapentin or B6 supplementation?
5. Do you recommend any protective padding or special footwear?

What NOT to Do

• Don't ignore opening/infected blisters - contact your doctor
• Avoid harsh scrubbing or peeling attempts
• Don't apply products with alcohol or strong fragrances

Bottom Line

Your doctor may need to adjust your topical regimen or consider other interventions. HFSR is manageable, but it often requires a multi-pronged approach combining protection, topical treatment, and sometimes systemic support. This is worth a dedicated conversation with your oncology team—they may have additional strategies based on your specific situation.

---

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.