capecitabine (Xeloda)

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.

What brand names are available for capecitabine?

Xeloda

Is capecitabine available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for capecitabine?

Yes

Capecitabine (Xeloda) is a prescription medicine used to treat people with:

• cancer of the colon that has spread to lymph nodes in the area close to the colon (Dukes’ C stage) after surgery.
• cancer of the colon or rectum (colorectal) that has spread to other parts of the body (metastatic).
• breast cancer that has spread to other parts of the body (metastatic) together with another medicine called docetaxel after treatment with certain other anti-cancer medicines have not worked.
• breast cancer that has spread to other parts of the body and has not improved after treatment with paclitaxel and certain other anti-cancer medicines, or who cannot receive any more treatment with certain anti-cancer medicines.

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.

Other important side effects experienced by some patients include:

• heart attacks,
• chest pain, and
• abnormal heart beats.

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.

Capecitabine can interact with blood thinner medicines, such as warfarin (Coumadin). Taking capecitabine with these medicines can cause changes in how fast your blood clots, and can cause life-threatening bleeding. This can occur as soon as a few days after you start taking capecitabine, or later during treatment, and possibly even within 1 month after you stop taking capecitabine. Your risk may be higher because you have cancer, and if you are over 60 years of age.

Before taking capecitabine, tell your doctor if you are taking warfarin or another blood thinner medicine.

If you take warfarin or a similar blood thinner during treatment with capecitabine, your doctor should do blood tests often, to check how fast your blood clots during and after you stop treatment with capecitabine. Your doctor may change your dose of the blood thinner medicine if needed.

These are not all the drugs that could interact with capecitabine. Tell your doctor of all over-the-counter and prescription medications and herbal supplements you are taking.

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

It is not known whether capecitabine is secreted into breast milk.

What preparations of capecitabine are available?

Tablets: 150 and 500 mg.

How should I keep capecitabine stored?

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