Capecitabine

DEA Class; Rx

Common Brand Names; Xeloda

  • Antineoplastics, Antimetabolite

Antimetabolite antineoplastic agent; oral prodrug of fluorouracil
Used for the treatment of colorectal cancer and breast cancer
Has not been associated with alopecia, and myelosuppression is uncommon; hand-foot syndrome is dose-limiting

Indicated for the treatment of metastatic breast cancer.

For the treatment of colorectal cancer.
For the treatment of unresectable advanced or metastatic biliary tract cancer.
For the treatment of inoperable, recurrent, platinum- and taxane-resistant ovarian cancer.
For the treatment of gastric cancer.

Hypersensitivity to capecitabine or fluorouracil (5-FU)

Severe renal impairment (CrCl <30 mL/min)

  • Varies with carcinoma type
  • Diarrhea
  • Nausea
  • Anemia
  • Lymphopenia
  • Hand and foot syndrome
  • Edema
  • Fatigue
  • Fever
  • Headache
  • Pain
  • Paresthesia
  • Alopecia
  • Dermatitis
  • Abdominal pain
  • Anorexia
  • Appetite decreased
  • Constipation
  • Dyspepsia
  • Stomatitis
  • Vomiting
  • Neutropenia
  • Thrombocytopenia
  • Dyspnea
  • Bilirubin increased
  • Eye irritation

May result in bleeding, death; monitor anticoagulant response (eg, INR, PT) and adjust anticoagulant dose accordingly

Diarrhea may be severe; interrupt capecitabine treatment immediately until diarrhea resolves or decreases to grade 1; recommend standard antidiarrheal treatments

Cardiotoxicity observed, including MI/ischemia, angina, dysrhythmias, cardiac arrest, cardiac failure, sudden death, ECG changes, and cardiomyopathy; more common with history of coronary artery disease

Increased risk of severe or fatal adverse reactions in patients with low or absent dihydropyrimidine dehydrogenase (DPD) activity; withhold or permanently discontinue capecitabine in patients with evidence of acute early-onset or unusually severe toxicity, which may indicate near complete or total absence of DPD activity; no capecitabine dose has been proven safe in patients with absent DPD activity

Interrupt capecitabine treatment until dehydration is corrected; potential risk of acute renal failure secondary to dehydration; monitor and correct dehydration

Can cause fetal harm; advise women of the potential risk to the fetus

Based on findings in animal reproduction studies and its mechanism of action, fetal harm may occur when administered to pregnant females; limited available human data are not sufficient to inform drug-associated risk during pregnancy

Data are unavailable regarding presence in human milk, effects on milk production, or effects on breastfed infants

Adults

2,500 mg/m2 PO total daily dose (1,250 mg/m2 PO administered twice daily) on days 1 to 14, every 21 days.

Geriatric

2,500 mg/m2 PO total daily dose (1,250 mg/m2 PO administered twice daily) on days 1 to 14, every 21 days.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Capecitabine 

tablet

  • 150mg
  • 500mg

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