Capecitabine  

Brand name: Xeloda®  

Generic name: Capecitabine 

Therapeutic Class: antimetabolite  

Manufacturer / Distributor: Roche  

Availability: Capecitabine is available by prescription only  

FDA Approval: On June 2005, Capecitabine (Capecitabine) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain colon cancers. (The drug is used to treat other forms of cancer; see indication) 

Indication: Capecitabine is used alone or in combination with chemotherapy medications to treat: 

• stage III colon cancer after resection of the tumor  
• metastatic colorectal cancer, as first-line treatment (first-line therapy)
• Advanced or metastatic breast cancer, alone or in combination with docetaxel after failure of first line chemotherapy.

Dosage form: Capecitabine comes in tablet form to take by mouth  

Dosage: Basing on certain criteria such as your age, medications you are taking, and your body surface area (BSA), your oncologist will recommend the most effective Capecitabine dosage to combat the cancer. It is important that you take the medication exactly as indicated in the prescription. Even if you experience side effects during the therapy, do not stop or change the way you are recommended to take the medication. Modifying or stopping the treatment without first contacting your doctor can lead to serious health problems.  

Usually, Capecitabine is taken in two equal doses twice daily, 12 hours apart for two weeks followed by a break period of one week. Cycles can be repeated every three weeks until the end of the therapy. Do not crush the tablet; Capecitabine should be swallowed whole with water within 30 minutes after a meal.  

A regular monitoring is very important during treatment with Capecitabine. Therefore, it is important to respect all appointments with your doctors and lab specialists; this allows them to perform cardiac examination, neurological evaluation and blood tests to detect minor problems in their genesis before they become serious issues.  

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. 

Mechanism of action (MOA): Capecitabine is an antineoplastic; it kills cancer cells by selectively inhibiting the synthesis of their DNA.  

Interactions: It is not recommended to use Capecitabine in combination with certain prescription and non prescription medicines. In addition, the following drugs can alter the effects of Capecitabine, or increase the risk of side effects.  Talk with your oncologist before taking:  

·         vitamins 

·         phenytoin 

·         folic acid  

·         antacids  

·         allopurinol  

·         interferon alpha  

·         anticoagulants  

·         radiotherapy  

·         And certain other anticancer drugs.  

Side effects: by attacking cancer cells, Capecitabine also affects 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 
• Persistent or sever vomiting
• Severe diarrhea 
• Signs of infections: chills, sore throat, fever chill, ect. 
• swollen glands 
• swelling of face, fingers, feet or lower legs  
• instability or lack of coordination  
• sudden blood pressure lowering or rising  
• nosebleeds  
• light-colored stools  
• dark urine 
• numbness, 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.