capecitabine, Xeloda

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GENERIC NAME: capecitabine


DRUG CLASS AND MECHANISM: Capecitabine is an oral medication for treating advanced breast cancer that is resistant to combination therapy with the drugs of choice, paclitaxel (Taxol) and a drug from the anthracycline family of drugs, for example, doxorubicin (Adriamycin). Capecitabine is converted by the body to 5-fluorouracil (5-FU), a drug which has been given intravenously for many years to treat various types of cancer. It is not surprising, therefore, that capecitabine also is effective in the treatment of colorectal cancer, a type of cancer that is treated frequently with 5-FU. 5-FU inhibits the production by the cancerous cells of both DNA and protein that are necessary for the cells to divide and the cancer to grow in size. Capecitabine was approved by the FDA in 1998 for the treatment of breast cancer and in 2005 for the treatment of colorectal cancer.



PREPARATIONS: Tablets: 150 and 500 mg.

STORAGE: Tablets should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Capecitabine is used for treating women with breast cancer that has spread to other tissues and is resistant to other more commonly-used drugs. It also is used following surgery for later stages of colon cancer and colorectal cancer that has spread to other tissues.

DOSING: The recommended dose is 1250 mg/m2 twice daily, with the two doses approximately 12 hours apart. Tablets should be taken 30 minutes after eating. Capecitabine usually is prescribed in repeated cycles of 3-weeks, with the drug taken for two consecutive weeks followed by a week without drug. Some patients may need lower or delayed dosing if there are side effects.

DRUG INTERACTIONS: Capecitabine increases the blood thinning effect of warfarin (Coumadin) and may increase the risk of bleeding. Capecitabine also may increase blood levels of phenytoin (Dilantin, Dilantin-125), and the dose of phenytoin may need to be reduced.

PREGNANCY: Capecitabine can damage the fetus. It should not be taken by pregnant women.

NURSING MOTHERS: It is not known whether capecitabine is secreted into breast milk.

SIDE EFFECTS: The most common side effects with capecitabine are diarrhea, nausea, vomiting, painful swelling of the mouth, fatigue, painful rash and swelling of the hands or feet, low white blood cell count (which can lead to infections), low blood platelet counts (which can lead to bleeding), and anemia. Some patients may experience heart attacks, chest pain, and abnormal heart beats.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 3/12/2013

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