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Capecitabine (Xeloda® ) 

 

Warning:  If you take Capecitabine in combination with anticoagulant drugs (“blood thinners”) such as warfarin (also known by its brand name Coumadin), serious, life-threatening bleeding may occur.  If you are taking any anticoagulant drugs (“blood thinners”), tell your doctor before starting to take Capecitabine.  Your doctor will order blood tests to monitor your blood’s ability to clot and, if necessary, may adjust your warfarin dose.

 

Indication:  Capecitabine is used to treat advanced or metastatic breast cancer or breast cancer tha t has reappeared after previous treatments.  In this case, Capecitabine will most likely be used in combination with other drugs such as docetaxel .  Capecitabine may be prescribed on its own in the treatment of breast cancer that has not responded to current treatment. 

This medication may also be used in the treatment of other cancers, namely stomach, colon, and rectal cancer.  When used to treat colon and rectal cancer, the medication will be given after surgery has been performed to remove the tumor; Capecitabine will prevent the regrowth of colon or rectal cancer.  This medication is in the drug class antimetabolites, which are drugs used to stop or slow the growth of cancer cells.

 

Dosage: Capecitabine is a tablet and, as such, should never be split, crushed, or chewed.  It should be taken whole and swallowed with a glass of water.  Capecitabine is taken twice a day no more than thirty minutes after a meal (breakfast and dinner).  You will follow this dosing routine for two weeks, followed by one week when you take none.  This three week dosing cycle will be repeated as long as your doctor determines it to be necessary; the number of cycles will vary from patient to patient. 

You should be sure to take your Capecitabine doses at the same time each day.  When you fill your prescription, you will be given a drug information packet.  This packet will have instructions regarding the right way to take Capecitabine, so be sure to ask your doctor or pharmacist to explain anything you are unclear about.  Be sure to tell your doctor about any side effects that you experience while taking Capecitabine. 

 

Storage: Capecitabine should be kept tightly closed in the container it came, out of the reach of children. Keep the drug at room temperature (15-30 ° C), away from heat above 40 ° C, light and moisture. Capecitabine  and all other medications should not be used beyond the expiration date printed on the container.     

Overdose:  overdosing any chemotherapy drug can lead to death. The risk of complications increases considerably when the drug is overdosed for long term. Even in the absence of overdose, Capecitabine can cause serious bleeding and death when used with anticoagulants such as warfarin (Coumadin). Capecitabine tends to damage the bone marrow, and lead to decreased blood cells count. It is extremely important that you take Capecitabine as indicated by your physician or pharmacist; don’t ever take it more or more often.    

Missing dose: misusing any drug can be fatal; chance of complications is even higher when it comes to chemotherapy drugs. Take Capecitabine exactly as prescribed; taking less can decrease the therapeutic effects of the drug; taking more can lead to serious health problems and even death. Do your best to take the medication around the same time every day.  In case you forget to take a dose, take the missed one as soon as you remember it. However, if it is time or almost time for your next dose,  do not double the next dose to recover the missed one. Contact your doctor or wait to go back to your regular schedule.     

Contraindication:  Capecitabine is contraindicated or should be used with precaution in the following conditions: 

  • pregnancy   
  • breast-feeding  
  • neutropenia  
  • leucopenia  
  • thrombocytopenia  
  • severe liver disease  
  • severe kidney disease  
  • galactosemia or lactase deficiency   
  • allergy to Capecitabine or one of its components   
  • dihydropyrimidine dehydrogenase deficiency (DPD deficiency)  
  • Glucose-galactose malabsorption 
  • In combination with sorivudine therapy or chemically related analogues, such as brivudine.   

Interactions:   Though the FDA has listed no specific drug interactions, you should talk to your doctor if you have concerns regarding interactions.  To prevent any possible complications, it is important that you tell your doctor about any other prescription or over-the-counter drugs you are also taking.  Additionally, tell your doctor if you are taking herbal remedies or nutritional supplements including vitamins.

In general, talk with your oncologist before taking:  

  • phenytoin
  • folic acid
  • antacids
  • allopurinol
    interferon alpha
      anticoagulants
        radiation theerapy
          And certain other anticancer drugs

          Side effects: Capecitabine also affects cancerous and normal cells, and cause adverse reactions in some patients. Common Capecitabine side effects include: 

          • mouth blistering
          • dry mouth
          • loss of appetit
          • diarrhea
          • dehydration
          • stomach pain
          • constipation
          • weakness
          • tiredness
          • headache
          • sleeplessness
          • nausea and vomiting
          • Dry or itching skin 

          If  the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:  

          • Dizziness
          • Fainting
          • Chest pain
          • high blood pressure or sudden low blood pressure
          • Persistent or sever vomiting
          • Severe diarrhea
          • Infections (chills, sore throat, fever, ect.)
          • swelling of face, fingers, feet or lower legs
          • instability or lack of coordination
          • nosebleeds
          • light-colored stools
          • dark urine
          • n umbness, pain, tingling or other unusual sensations in the palms
          • irritation, swelling or ulceration of the mouth
          • stomachache
          • Blisters, redness, swelling or peeling of the skin in the hands or soles of feet