Capecitabine (Xeloda®)

Warning: Serious, potentially life-threatening bleeding may occur if you take Capecitabine in combination with anticoagulant drugs such as warfarin (brand name Coumadin). If you are taking warfarin or another blood thinner, tell your doctor. Your doctor will perform blood tests to monitor your blood’s ability to clot. If necessary, your doctor may adjust your dose of warfarin.

 

Indication: Capecitabine is a medication used in the treatment of breast cancer that has come back after earlier cancer treatments; this drug is used in combination with others for maximum efficacy.  Capecitabine may also be used to treat breast cancer that has not responded to treatment; in this case, Capecitabine may be prescribed on its own.  Your doctor will be able to determine what combination of drugs (if any) is appropriate for your individualized treatment.  Cancer that begins in the large intestine (such as colon or rectal cancer) may also be treated with Capecitabine.  The drug may also be used to prevent the re-growth of colon or rectal cancer after surgery to remove the tumor has taken place.  Capecitabine may also be used in the treatment of stomach cancer.  Capecitabine is part of a class of drugs called antimetabolites.  These drugs work by slowing or stopping the growth of cancer cells.

 

Dosage: Capecitabine is available in tablet form; it should be taken whole and never chewed or crushed.  A dose is usually taken twice a day, in the morning and evening. It should be taken within thirty minutes after a meal; swallow the tablet with a glass of water.  This dosing practice will continue daily for two weeks, then you will have a break for one week.  Your doctor will be able to tell you how long you should continue this three week dosing cycle. For maximum efficacy, it’s very important that you take Capecitabine at the same time each day.  Carefully follow the instructions given to you with your prescription information packet and ask your doctor or pharmacist to explain any part that you don’t understand.  Your doctor will monitor your progress and adjust or stop the Capecitabine treatment as necessary.  Be sure to tell your doctor about any side effects you experience while taking this medication.

 

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)

·         Glucosegalactose malabsorption

·         In combination with sorivudine therapy or chemically related analogues, such as brivudine.

 

Interactions: Though no specific drug interactions are known to occur with Capecitabine, you should discuss your concerns with your doctor.  Be sure to tell your doctor about any vitamins, herbs, nutritional supplements, and prescription and non-prescription drugs you are currently taking.  It is recommended that you keep a list of the medication and supplements you use so you can share this with your doctor.

Talk with your oncologist before taking:

  • 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 appetite

·         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, etc.

·         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

 

 

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