Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Xeloda

Descriptions


Capecitabine is used to help treat patients with Dukes' C colon cancer (colon cancer that has spread to lymph nodes in the area close to the colon), after having surgery. This medicine is also used to treat metastatic colorectal cancer (cancer of the colon or rectum that has spread to other parts of the body).

Capecitabine is also used together with docetaxel to treat metastatic breast cancer (breast cancer that has spread to other parts of the body) in patients who have received other medicines (eg, paclitaxel) but did not worked well, or in patients who cannot receive cancer medicines anymore.

Capecitabine belongs to the group of medicines called antineoplastics (cancer medicines). It interferes with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal cells may also be affected by the medicine, other side effects may also occur. Some of these may be serious and must be reported to your doctor.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, capecitabine is used in certain patients with the following medical conditions:

  • Advanced or metastatic stomach cancer (cancer that has spread to other areas of the body), first-line therapy.
  • Metastatic colorectal cancer (cancer of the colon or rectum that has spread to other areas of the body), first-line therapy, in combination with bevacizumab and oxaliplatin.
  • Gastric cancer (stomach cancer), stage II to IIIB, in combination with oxaliplatin.
  • Rectal cancer (cancer of the rectum), locally advanced, adjuvant or neoadjuvant therapy, in combination with radiation therapy.

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of capecitabine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of capecitabine in the elderly. However, elderly patients are more likely to have unwanted side effects (eg, severe diarrhea, nausea or vomiting, hand-and-foot syndrome) or age-related kidney or liver problems, which may require caution and an adjustment in the dose for patients receiving capecitabine.

Pregnancy

Information about this capecitabine-oral-route
Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live
  • Tegafur

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Poliovirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Warfarin
  • Yellow Fever Vaccine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Fosphenytoin
  • Leucovorin
  • Levoleucovorin
  • Phenytoin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to 5-fluorouracil or
  • Kidney disease, severe or
  • Shortage of an enzyme called dihydropyrimidine dehydrogenase (DPD) that your body needs—Should not be used in patients with these conditions.
  • Coronary heart disease, history of—May cause side effects to become worse.
  • Dehydration or
  • Kidney disease, mild or moderate or
  • Liver disease—Use with caution. May make these conditions worse.
  • Infection—May decrease your body's ability to fight infection.

Proper Use

Medicines used to treat cancer are very strong and can have many side effects. Before using this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Take this medicine with food or within 30 minutes after you eat.

Swallow the tablet whole with water. Do not cut, crush, break, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For metastatic breast and colorectal cancer:
      • For patients receiving this medicine alone:
        • Adults—Dose is based on body size and must be determined by your doctor. At first, 2500 milligrams (mg) per square meter (m(2)) of body size per day, divided in 2 doses and taken about 12 hours apart. These doses are taken for 2 weeks, followed by 1 week rest, given as 3 weeks cycle. Your doctor may adjust your dose if needed.
        • Children—Use and dose must be determined by your doctor.
      • For patients receiving this medicine with docetaxel:
        • Adults—Dose is based on body surface and must be determined by your doctor. At first, 2500 milligrams (mg) per square meter (m(2)) of body surface area per day, divided in 2 doses and taken about 12 hours apart. These are taken for 2 weeks, followed by 1 week rest, given as 3 weeks cycle Your doctor may adjust your dose if needed.
        • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Your doctor may request that you have a test to determine if your blood is clotting properly, and may preform this test frequently if you are also taking a blood thinner.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. Tell your doctor right away if you think you have become pregnant.

This medicine may cause heart problems. Check with your doctor right away if you have chest pain that may spread to your arms, jaw, back, or neck, faintness, nausea, swelling in your hands, ankles, or feet, trouble breathing, or unusual sweating.

Check with your doctor right away if any of the following symptoms occur:

  • Diarrhea, moderately severe (four to six stools a day more than usual, or during the night).
  • Nausea that is severe enough to cause you to eat less than usual.
  • Vomiting two or more times in a 24-hour period.
  • Pain and redness, swelling, or sores or ulcers in your mouth or on your lips that are severe enough to interfere with eating.

If vomiting occurs less often than mentioned above, or if nausea does not cause you to eat less than usual, it is not necessary for you to stop taking the medicine or to check with your doctor (unless these effects are particularly bothersome). Also, you do not need to stop taking the medicine if diarrhea occurs less often than mentioned above or if the other side effects listed are not severe enough to interfere with eating or other daily activities. However, check with your doctor as soon as possible if they occur.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, pain, swelling, or blisters on the palms of your hands or soles of your feet, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

While you are being treated with capecitabine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Capecitabine may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Capecitabine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Abdominal or stomach pain
  2. diarrhea
  3. nausea
  4. numbness, pain, tingling, or other unusual sensations in the palms of the hands or bottoms of the feet
  5. pain, blistering, peeling, redness, or swelling of the palms of the hands or bottoms of the feet
  6. pain, redness, swelling, sores, or ulcers in your mouth or on your lips
  7. unusual tiredness or weakness
  8. vomiting

Less common or rare

  1. Abdominal or stomach cramping or pain (severe)
  2. agitation
  3. back pain
  4. bleeding and bruising
  5. bleeding gums
  6. blood in the urine or stools
  7. bloody nose
  8. bloody or black, tarry stools
  9. blurred vision
  10. burning, dry, or itching eyes
  11. chest pain
  12. chills
  13. clumsiness or unsteadiness
  14. cold
  15. collapse
  16. coma
  17. confusion
  18. constipation
  19. convulsions
  20. cough or hoarseness (accompanied by fever or chills)
  21. cough producing mucus
  22. coughing or spitting up blood
  23. dark urine
  24. decreased frequency or amount of urine
  25. difficulty with breathing
  26. difficulty with swallowing or pain in the back of throat or chest when swallowing
  27. discharge from the eyes
  28. drowsiness
  29. dry mouth
  30. excessive tearing
  31. extra heartbeats
  32. eye redness, irritation, or pain
  33. fainting
  34. fast or irregular heartbeat
  35. fever or chills
  36. flu-like symptoms
  37. hallucinations
  38. headache, sudden and severe
  39. heavier menstrual periods
  40. high fever
  41. hot, red skin on the feet or legs
  42. inability to speak
  43. increased menstrual flow or vaginal bleeding
  44. increased thirst
  45. irritability
  46. itching in the genital or other skin areas
  47. lightheadedness
  48. light-colored stools
  49. loss of consciousness
  50. lower back or side pain (accompanied by fever or chills)
  51. muscle aches or cramps
  52. muscle spasms
  53. nosebleeds
  54. numbness or tingling in the hands, feet, or lips
  55. painful or difficult urination (accompanied by fever or chills)
  56. painful, swollen feet or legs
  57. pain, tenderness, or swelling in the upper abdominal or stomach area
  58. pale skin
  59. paralysis
  60. pinpoint red spots on the skin
  61. problems with coordination
  62. prolonged bleeding from cuts
  63. rapid, shallow breathing
  64. red or dark brown urine
  65. redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  66. scaling
  67. seizures
  68. severe constipation
  69. skin rash or itching
  70. slow or irregular heartbeat
  71. slurred speech
  72. sneezing, sore throat, or stuffy nose
  73. sores, ulcers, or white spots on the lips or in the mouth
  74. stiff neck
  75. stomach bloating, burning, or cramping
  76. swelling of the face, fingers, feet, or lower legs
  77. swelling of the lymph nodes
  78. swollen glands
  79. temporary blindness
  80. tiredness or weakness
  81. trouble with speaking
  82. troubled breathing or tightness in the chest
  83. unexplained nosebleeds
  84. unusual bleeding or bruising
  85. unusual lump or swelling in the chest
  86. vomiting blood or material that looks like coffee grounds
  87. weakness in the arm or leg on one side of the body, sudden and severe
  88. weight gain or loss
  89. white patches in the mouth or throat or on the tongue
  90. white patches with diaper rash
  91. yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  1. Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  2. changes or discoloration in the fingernails or toenails
  3. difficulty with moving
  4. discouragement
  5. dizziness
  6. headache
  7. heartburn
  8. increased sensitivity of the skin to sunlight
  9. muscle pain
  10. pain
  11. pain and redness of the skin at the place of x-ray treatment
  12. pain in the joints or limbs
  13. red, sore eyes
  14. sunken eyes
  15. thirst
  16. trouble sleeping
  17. weakness
  18. wrinkled skin

Rare

  1. Bone pain
  2. change in color of treated skin
  3. difficulty with walking
  4. discouragement
  5. feeling of constant movement of self or surroundings
  6. feeling sad or empty
  7. full or bloated feeling or pressure in the stomach
  8. general feeling of discomfort or illness
  9. hot flushes
  10. impaired balance
  11. increased sweating
  12. joint pain
  13. lack of appetite
  14. loss of interest or pleasure
  15. muscle weakness
  16. noisy breathing
  17. pain in the rectum
  18. pain, swelling, or redness in the joints
  19. passing less gas
  20. rough, scratchy sound to voice
  21. runny nose
  22. sensation of spinning
  23. shakiness in the legs, arms, hands, or feet
  24. shivering
  25. sores on the skin
  26. swelling of abdominal or stomach area
  27. tremor or shaking of the hands or feet
  28. trouble concentrating
  29. voice changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.