Description: Antineoplastic Agent, Antimetabolite (Pyrimidine Analog)
“ALERT: US Boxed Warning
Patients receiving concomitant capecitabine and oral coumarin-derivative anticoagulant therapy should have their anticoagulant response (INR or PT) monitored frequently in order to adjust the anticoagulant dose accordingly. A clinically important capecitabine-warfarin drug interaction was demonstrated in a clinical pharmacology trial. Altered coagulation parameters and/or bleeding, including death, have been reported in patients taking capecitabine concomitantly with coumarin-derivative anticoagulants such as warfarin and phenprocoumon. Postmarketing reports have shown clinically significant increases in PT and INR in patients who were stabilized on anticoagulants at the time capecitabine was introduced. These events occurred within several days and up to several months after initiating capecitabine therapy and, in a few cases, within 1 month after stopping capecitabine. These events occurred in patients with and without liver metastases. Age >60 years and a diagnosis of cancer independently predispose patients to an increased risk of coagulopathy.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Capecitabine, Xeloda is a prodrug of fluorouracil that is converted by undergoing hydrolysis in the liver and tissues. Fluorouracil, the active moiety is a fluorinated pyrimidine antimetabolite that inhibits thymidylate synthetase, blocking the methylation of deoxyuridylic acid to thymidylic acid, interfering with DNA, and to a lesser degree, RNA synthesis. Fluorouracil appears to be phase-specific for the G1 and S phases of the cell cycle.
Indications For Use
Colorectal cancer, Breast cancer (metastatic)
Before starting Capecitabine, Xeloda sure your physician is aware of any allergies or medications you currently take, if you have kidney disease, liver disease, or are lacking activity of the enzyme dihydropyridine dehydrogenase. Capecitabine, Xeloda use has been associated with rare but serious adverse reactions such as bone marrow suppression, cardiotoxicity, dermatologic toxicity, gastrointestinal toxicity, hand and foot syndrome, and hepatotoxicity.
Oral: 1,250 mg/m2 twice daily for 2 weeks, every 21 days. A lower dosage may be considered to reduce the risk of toxicity.
Pharmacist Tips On Using
How to Take: Usually administered in 2 divided doses (in the morning and evening). Doses should be taken with water within 30 minutes after a meal. Swallow the tablets whole. Avoid cutting or crushing tablets.
Edema, fatigue, paresthesia, pain, palmar-plantar erythrodysesthesia, dermatitis, diarrhea, nausea, vomiting, abdominal pain, decreased appetitively, stomatitis, anorexia, constipation, lymphocytopenia, anemia, neutropenia, thrombocytopenia, hyperbilirubinemia, asthenia, eye irritation, fever
Note this is not a complete list of side effects for Capecitabine, Xeloda only common ones.
Frequently Asked Questions
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions, and many other factors will further complicate or limit which medications are appropriate. This medication is used for certain forms of cancer and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to avoid many of the serious side effects and will keep you on the lowest effective dosage for the shortest amount of time possible.