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Medications Lexicon

How does this medication work? What will it do for me?

Capecitabine belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as antimetabolites. Capecitabine fights cancer by killing cancer cells and preventing their growth. Capecitabine is usually used alone or in combination with other medications to treat certain types of breast cancer and colorectal cancer.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended dose of capecitabine varies according to body size. You may need to take a combination of 150 mg and 500 mg tablets. Capecitabine is normally given in 2 equal doses twice a day for 2 weeks followed by a rest period of one week. This cycle is repeated until treatment is complete, as assessed by your doctor.

Capecitabine tablets should be swallowed with water within 30 minutes after the end of a meal.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that you take this medication exactly as prescribed by your doctor. If you vomit shortly after taking capecitabine, contact your doctor for instruction on whether to take more medication or not. If you miss a dose of this medication, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

As well as interfering with the growth of cancer cells, capecitabine can interfere with some of your normal cells. This can cause a number of side effects such as mouth sores. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Store this medication at room temperature, protect it from excessive heat and direct light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

150 mg
Each light peach-colored, biconvex, film-coated, oblong-shaped tablet, with "XELODA" engraved on one side and "150" on the other, contains capecitabine 150 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl methylcellulose, lactose anhydrous, magnesium stearate, microcrystalline cellulose, synthetic red iron oxide, synthetic yellow iron oxide, talc, and titanium dioxide.

500 mg
Each peach-colored, biconvex, film-coated, oblong-shaped tablet, with "XELODA" engraved on one side and "500" on the other, contains capecitabine 500 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl methylcellulose, lactose anhydrous, magnesium stearate, microcrystalline cellulose, synthetic red iron oxide, synthetic yellow iron oxide, talc, and titanium dioxide.

Who should NOT take this medication?

Do not take capecitabine if you:

  • are allergic to capecitabine, 5-fluorouracil, or to any of the ingredients of the medication
  • are being treated or have been treated in the last 4 weeks with brivudine or sorivudine as part of herpes zoster (chickenpox or shingles) therapy
  • have dihydropyrimidine dehydrogenase (DPD) deficiency
  • have severely reduced kidney function

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • heartburn
  • loss of appetite
  • mild diarrhea
  • mild nausea or vomiting
  • tiredness or fatigue

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal or stomach pain
  • mild blistering, peeling, redness, or swelling of palms of hands or bottoms of feet
  • mouth irritation, swelling, sores, or ulcer in mouth
  • numbness, pain, tingling, or other unusual sensations in palms of hands or bottoms of feet
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of infection (e.g., fever, chills, sore throat, cough, painful urination)
  • skin rash or itching
  • swelling of fingers, feet, or lower legs
  • unusual bruising or bleeding (e.g., bleeding gums, blood in the urine, nosebleeds, cuts that take longer to stop bleeding)
  • unusual tiredness or weakness

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • abnormal heart rate
  • chest pain
  • diarrhea (more than 4 episodes during the day or any episodes at night)
  • any diarrhea in combination with soreness of the mouth that affects your ability to drink enough fluids
  • severe skin reactions (e.g., redness, pain, swelling or blistering of lips, eyes or mouth, skin peeling, and flu-like symptoms)
  • signs of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, throat, or tongue)
  • vomiting (more than once in 24 hours), especially in combination with diarrhea
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood counts: This medication can decrease the number of red blood cells (anemia), white blood cells (neutropenia), and platelets (thrombocytopenia). Your doctor will do blood tests to monitor for this and adjust your dose of capecitabine or temporarily stop it if your blood counts are too low. If you develop a fever while your blood cell counts are low, contact your doctor immediately.

Diarrhea or dehydration: This medication frequently causes diarrhea. If you develop diarrhea that occurs more than 4 times a day or at all during the night, contact your doctor. Your doctor will monitor you closely for dehydration. Severe dehydration can cause rapid loss of kidney function and is a medical emergency. If you experience any symptoms of severe dehydration (e.g., increased thirst, dry mouth),  stop taking the medication and contact your doctor immediately.

Hand and foot syndrome: This medication can cause hand and foot syndrome (numbness, redness, tingling, burning, or pain in the hands and feet; blistering or peeling of the hands and feet). If you experience any of these symptoms, contact your doctor. If the symptoms are severe and interfere with your ability to walk or do other daily activities, stop taking this medication and contact your doctor immediately.

Heart disease: People with a history of heart disease may be more likely to experience side effects that affect the heart when taking this medication. Stop using the medication and contact your doctor immediately if you experience symptoms such as abnormal heart rate, chest pain, and swelling of your extremities while taking this medication.

Kidney disease: If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with moderately-to-severely reduced kidney function will need lower doses of this medication.

Liver function: If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication may harm the baby if used during pregnancy. Both men and women should use effective birth control (e.g., condoms, birth control pill) during treatment. If you or your partner become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if capecitabine passes into breast milk. Because of the risks associated with this medication, women should not breast-feed while taking capecitabine.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children under 18 years of age.

What other drugs could interact with this medication?

There may be an interaction between capecitabine and any of the following:

  • celecoxib
  • cimetidine
  • clozapine
  • dapsone
  • echinacea
  • fluoxetine
  • leflunomide
  • leucovorin
  • live vaccines (e.g., BCG, typhoid, yellow fever)
  • losartan
  • montelukast
  • natalizumab
  • nateglinide
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., diclofenac, ibuprofen, ketorolac, naproxen)
  • other cancer-fighting medications
  • phenytoin
  • pimecrolimus
  • roflumilast
  • some antacids
  • sulfonamide antibiotics ("sulfas"; sulfadiazine, sulfamethoxazole, sulfisoxazole)
  • sulfonylurea diabetes medications (e.g., chlorpropamide, gliclazide, glyburide, tolbutamide)
  • tacrolimus (topical)
  • tamoxifen
  • tofacitinib
  • trimethoprim
  • voriconazole
  • warfarin
  • zafirlukast

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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