Capecitabine

Generic Name: capecitabine

Nucleoside Metabolic Inhibitor [EPC]Over-the-Counter (OTC)

Brand Names:

Xeloda

Capecitabine is indicated for colorectal cancer adjuvant, perioperative, and metastatic treatment; breast cancer advanced and metastatic treatment; gastric and esophageal cancer unresectable and metastatic treatment; and pancreatic cancer adjuvant treatment as single agent or combination therapy.

Overview

Capecitabine is indicated for colorectal cancer adjuvant, perioperative, and metastatic treatment; breast cancer advanced and metastatic treatment; gastric and esophageal cancer unresectable and metastatic treatment; and pancreatic cancer adjuvant treatment as single agent or combination therapy.

Uses

Indicated for colorectal cancer (adjuvant, perioperative, metastatic), breast cancer (advanced, metastatic), gastric and esophageal cancer (unresectable, metastatic), and pancreatic cancer (adjuvant) as single agent or combination therapy.

Dosage

Dosing varies by indication. Colon cancer adjuvant: 1,250 mg/m2 twice daily days 1-14 of 21-day cycles (8 cycles max). Metastatic colorectal: 1,250 mg/m2 single agent or 1,000 mg/m2 with oxaliplatin. Breast cancer: 1,000-1,250 mg/m2 twice daily days 1-14. Reduce 25% for CLcr 30-50 mL/min.

Side Effects

Common adverse reactions include palmar-plantar erythrodysesthesia syndrome (54-63%), diarrhea (47-67%), nausea (34-53%), stomatitis (22-67%), vomiting (15-37%), fatigue (16-42%), hyperbilirubinemia (15-48%), anemia (72-80%), neutropenia (13-86%), and myelosuppression.

Interactions

Avoid allopurinol (decreases active metabolites). Monitor closely with leucovorin, CYP2C9 substrates, vitamin K antagonists (monitor INR frequently), phenytoin (monitor levels), and nephrotoxic drugs.

Warnings

Serious adverse reactions and death possible in patients with complete DPD deficiency. Test for DPYD variants before initiating unless immediate treatment needed. Increased bleeding risk with concomitant vitamin K antagonists. Monitor for cardiotoxicity, diarrhea, dehydration, renal toxicity, serious skin toxicities including Stevens-Johnson Syndrome and toxic epidermal necrolysis. Contraindicated in patients with history of severe hypersensitivity to fluorouracil or capecitabine.

Pregnancy

Can cause fetal harm. Epidemiological data suggest association with congenital malformations. Animal studies showed embryolethality and teratogenicity.

Frequently Asked Questions

What is Capecitabine used for?

Indicated for colorectal cancer (adjuvant, perioperative, metastatic), breast cancer (advanced, metastatic), gastric and esophageal cancer (unresectable, metastatic), and pancreatic cancer (adjuvant) as single agent or combination therapy.

What are the side effects of Capecitabine?

Common adverse reactions include palmar-plantar erythrodysesthesia syndrome (54-63%), diarrhea (47-67%), nausea (34-53%), stomatitis (22-67%), vomiting (15-37%), fatigue (16-42%), hyperbilirubinemia (15-48%), anemia (72-80%), neutropenia (13-86%), and myelosuppression.

Can I take Capecitabine during pregnancy?

Can cause fetal harm. Epidemiological data suggest association with congenital malformations. Animal studies showed embryolethality and teratogenicity.

What are the important warnings for Capecitabine?

Serious adverse reactions and death possible in patients with complete DPD deficiency. Test for DPYD variants before initiating unless immediate treatment needed. Increased bleeding risk with concomitant vitamin K antagonists. Monitor for cardiotoxicity, diarrhea, dehydration, renal toxicity, serious skin toxicities including Stevens-Johnson Syndrome and toxic epidermal necrolysis. Contraindicated in patients with history of severe hypersensitivity to fluorouracil or capecitabine.

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Medical Disclaimer

This drug information is for educational purposes only and should not replace professional medical advice. Drug information is sourced from the FDA National Drug Code Directory and Structured Product Labeling. Always consult with a healthcare provider before starting, stopping, or changing any medication.