Capecitabine
Generic Name
Capecitabine (ca pe-SE-ta h -been)
Brand Name
XelVA
Type of Drug Antimetabolite.
Prescribed For
Breast cancer and colorectal cancer.
General Information
Capecitabine is prescribed for stages of breast and colorectal cancer in place of 5-FU, an injected drug that has been the basis for many chemotherapy programs. Capecitabine is converted in the body to 5-FU. Unlike many anticancer medications, capecitabine can be taken by mouth and has relatively few serious side effects.
Cautions and Warnings
Do not take capecitabine if you are allergic or sensitive to any of its ingredients or to 5-FU.
People taking warfarin or certain other blood-thinning medications are at risk of potentially fatal bleeding when capecitabine is added to their therapy. People taking these medications together should be closely monitored for changes in their response to the blood thinner.
People with liver disease should be carefully monitored by their doctors because capecitabine’s effect on the liver is not known.
This drug is largely eliminated through the kidneys. People with severe kidney disease should not take it. Dose adjustments are required for those with moderate kidney disease.
Capecitabine may reduce fertility.
Capecitabine use is associated with heart and blood-vessel disease.
Capecitabine may cause severe diarrhea. Call your doctor if you experience symptoms (see “Special Information”).
Jaundice has occurred in patients taking capecitabine requiring an interruption of medication until symptoms resolved.
Possible Side Effects
✓ Most common: diarrhea, constipation, nausea, vomiting, mouth sores, abdominal pain, hand-and-foot syndrome (see “Special Information”), inflammation of the skin, tingling or pain in the hands or feet, fatigue, loss of appetite, low blood-cell counts, eye irritation, and fever.
✓ Common: upset, &~)MaCb, nail problems, headache, dizziness, sleeplessness, dehydration, swelling, muscle aches, and pain in the arms or legs.
✓ Less common and rare side effects can affect the stomach and intestines, skin, nervous system, tear ducts, lungs and Possible Side Effects (continued)
respiratory system, heart and blood vessels, blood, urinary and reproductive tracts, liver, and other organs. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining antacids and capecitabine can increase the amount of drug absorbed by about 20%. Separate doses of antacids and capecitabine by 2 hours.
• Leucovorin (a drug used in cancer treatment) increases the side effects of 5-FU. This combination has caused death in several seniors.
• Combining capecitabine with warfarin can cause excessive bleeding.
• When combining capecitabine with phenytoin, doses of phenytoin may need to be reduced due to an increase in side effects.
Food Interactions
Capecitabine should be taken within 30 minutes of a meal to avoid stomach problems.
Usual Dose
Adult (age 18 and over): 3000-5600 mg a day, depending on height and weight, in 2 doses. Capecitabine is used in 3-week cycles: 2 weeks on the drug, followed by 1 week off. Dosage may be reduced by 50% in people who experience severe side effects.
Child (under age 18): not recommended.
Overdosage
Symptoms include nausea, vomiting, diarrhea, bleeding and reduced blood-cell counts, and stomach irritation. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Stop taking capecitabine and call your doctor if you have 4-6 more bowel movements a day than normal, vomit 2-5 times in 1 day, or become very nauseous. Depending on the severity of your symptoms, your doctor may reduce your dosage.
Capecitabine has caused hand-and-foot syndrome. Symptoms of this condition include numbness, tingling, pain, swelling, redness, and skin loss and blistering of the hands or feet. Stop taking the drug and call your doctor if you experience any of these Symptoms.
People who develop stomatitis (symptoms include swelling, pain, or sores in the area of the mouth or tongue) should stop taking the drug and call their doctor at once.
Call your doctor, but do not stop taking the drug, if you develop a fever of 100.5°F or higher or other signs of infection.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose right away and space the remaining daily dosage evenly throughout the day. Go back to your regular schedule the next morning. Call your doctor if you miss more than 2 doses in a row.
Special Populations
Pregnancy/Breast-feeding: Capecitabine can harm the fetus. Its potential benefits must be carefully weighed against its risks when capecitabine is considered crucial by your doctor. Effective contraception is absolutely necessary while taking this drug.
It is not known if capecitabine passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to side effects, especially diarrhea and other stomach problems.