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Capecitabine Chemotherapy: Uses, Dosage, Side Effects & Costs
Summary of Key Points
Capecitabine is a chemotherapy medication used to treat various cancers, including breast, colorectal, and gastric cancers. It works by disrupting the growth of cancer cells. Capecitabine is taken orally in tablet form and is often used in combination with other treatments. It is essential to follow your doctor’s instructions closely when taking this medication. Always consult your healthcare provider before making any changes to your dosage.
Names of Medication
US Brand Name: Xeloda
Generic Name: Capecitabine
The generic name refers to the official medical name of the active ingredient in the medication, which is listed in parentheses.
Pharmacologic Category
Antimetabolite
Pyrimidine Analog
Capecitabine Dosage
Capecitabine is prescribed to treat several types of cancer. The dosage and duration of treatment depend on the specific type of cancer being treated. Always follow your doctor’s instructions and consult them before making any adjustments to your dosage. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.
Capecitabine for Breast Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Colorectal Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Gastric Cancer
Dosage: 1,000 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Pancreatic Cancer
Dosage: 1,000 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Esophageal Cancer
Dosage: 1,000 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Head and Neck Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Biliary Tract Cancer
Dosage: 1,000 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Non-Small Cell Lung Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Anal Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Capecitabine for Thymic Cancer
Dosage: 1,250 mg/m² orally twice daily for 14 days, followed by a 7-day rest period. This cycle repeats every 21 days.
Dosage Forms and Strengths
Tablets: 150 mg
Tablets: 500 mg
Administration Instructions for Capecitabine
Capecitabine should be taken with food or within 30 minutes after a meal. Swallow the tablets whole with water; do not crush or chew them. It is important to take the medication exactly as prescribed by your doctor. If you miss a dose, do not take an extra dose to make up for it—simply take your next scheduled dose. Always consult your healthcare provider if you have any questions or concerns about how to take your medication.
Capecitabine Side Effects and Adverse Reactions
Like all medications, Capecitabine can cause side effects. Some are common, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further evaluation.
Common Capecitabine Side Effects
Nausea and Vomiting: Feeling nauseous or vomiting is common. Your doctor may prescribe anti-nausea medication to help manage these symptoms.
Diarrhea: Loose or frequent bowel movements may occur. It’s important to stay hydrated and inform your doctor if the diarrhea becomes severe.
Fatigue: Feeling unusually tired or weak is a common side effect of chemotherapy.
Hand-Foot Syndrome: Redness, swelling, and pain in the hands and feet. This can be managed with moisturizing creams and by avoiding heat or pressure on the affected areas.
Serious Capecitabine Side Effects
Severe Diarrhea: If diarrhea becomes uncontrollable, it can lead to dehydration. Contact your doctor immediately if this occurs.
Heart Problems: Capecitabine can cause chest pain or changes in heart rhythm. Seek medical attention if you experience these symptoms.
Infection Risk: Capecitabine can lower your white blood cell count, increasing your risk of infection. Notify your doctor if you develop a fever or other signs of infection.
Contraindications for Capecitabine
A contraindication is a specific condition where a treatment or medication should not be used because it may be harmful. Several contraindications must be considered when taking Capecitabine.
Severe Renal Impairment: Capecitabine is processed by the kidneys, and individuals with severe kidney disease may not eliminate the drug effectively, leading to toxic levels in the body.
Hypersensitivity to Capecitabine or Fluorouracil: If you’ve had an allergic reaction to Capecitabine or fluorouracil (a related chemotherapy drug), taking Capecitabine again could cause serious allergic reactions, including rash, swelling, or difficulty breathing.
Dihydropyrimidine Dehydrogenase (DPD) Deficiency: Patients with a deficiency in the enzyme DPD cannot break down Capecitabine properly, which can lead to severe and potentially life-threatening side effects, such as severe diarrhea, mouth sores, and low blood cell counts.
Pregnancy: Capecitabine can harm an unborn baby, so it is contraindicated during pregnancy (more details below).
Drug to Drug Interactions with Capecitabine
Capecitabine, an oral chemotherapy drug, can interact with other medications, potentially increasing side effects or reducing the effectiveness of your cancer treatment. It is crucial to inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and supplements. Some medications that can interact with Capecitabine include:
- Warfarin (Coumadin): Capecitabine can enhance the effects of warfarin, a blood thinner, which increases the risk of bleeding.
- Phenytoin (Dilantin): Capecitabine may raise phenytoin levels, a medication used to control seizures, potentially leading to toxicity.
- Leucovorin (Wellcovorin): Leucovorin can intensify Capecitabine’s effects, increasing the likelihood of side effects.
- Allopurinol (Zyloprim): This gout medication can reduce the effectiveness of Capecitabine chemotherapy.
- Folic Acid: Taking folic acid supplements may heighten the risk of Capecitabine-related side effects.
Capecitabine and Pregnancy
Capecitabine is not safe to use during pregnancy. Classified as pregnancy category D, there is evidence that it poses risks to the unborn baby, including birth defects or miscarriage. If you are pregnant or planning to become pregnant, it is important to avoid taking Capecitabine. Effective contraception is necessary during Capecitabine treatment and for at least six months after completing therapy. If you become pregnant while taking Capecitabine, contact your healthcare provider immediately.
Capecitabine while Breastfeeding
Capecitabine is not safe while breastfeeding. The drug can pass into breast milk and may harm a nursing infant. If you are breastfeeding or planning to breastfeed, consult your healthcare provider about alternative treatments. You may need to stop breastfeeding while taking Capecitabine and for a period after treatment ends.
Capecitabine Cost: Estimated Price of Medication
The cost of a 30-day supply of Capecitabine can vary depending on the dosage and the pharmacy. Without insurance, using a GoodRX coupon, the estimated cost ranges from $200 to $500 for a 30-day supply. Prices may fluctuate, so comparing costs at different pharmacies or using discount coupons can help reduce the expense of Capecitabine chemotherapy.
Possible Alternatives to Capecitabine
If Capecitabine is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore your options.
Capecitabine Alternatives for Breast Cancer
Alternatives to Capecitabine for breast cancer include chemotherapy drugs such as doxorubicin (Adriamycin) or paclitaxel (Taxol). Hormonal therapies like tamoxifen or aromatase inhibitors may also be considered. Additionally, lifestyle changes such as maintaining a healthy weight, engaging in regular exercise, and limiting alcohol intake can support breast cancer management.
Capecitabine Alternatives for Colorectal Cancer
For colorectal cancer, alternatives may include chemotherapy drugs like oxaliplatin (Eloxatin) or irinotecan (Camptosar). Targeted therapies such as bevacizumab (Avastin) or cetuximab (Erbitux) may also be options. A diet rich in fruits, vegetables, and whole grains, along with regular physical activity, can support overall health during treatment.
Capecitabine Alternatives for Gastric Cancer
Other chemotherapy options for gastric cancer include cisplatin or docetaxel (Taxotere). Targeted therapies like trastuzumab (Herceptin) may also be used. Eating small, frequent meals and avoiding foods that irritate the stomach can help manage symptoms.
Capecitabine Alternatives for Pancreatic Cancer
For pancreatic cancer, alternatives include gemcitabine (Gemzar) or nab-paclitaxel (Abraxane). Radiation therapy may also be considered. Maintaining a healthy diet and managing blood sugar levels are important for patients with pancreatic cancer.
Capecitabine Alternatives for Esophageal Cancer
Other chemotherapy options for esophageal cancer include carboplatin or paclitaxel (Taxol). Radiation therapy may also be part of the treatment plan. Avoiding tobacco and alcohol, and eating a diet rich in fruits and vegetables, can help improve outcomes.
Capecitabine Alternatives for Head and Neck Cancer
Alternatives for head and neck cancer include cisplatin or cetuximab (Erbitux). Radiation therapy is often used in combination with chemotherapy. Quitting smoking and limiting alcohol consumption are important lifestyle changes for managing head and neck cancer.
Capecitabine Alternatives for Biliary Tract Cancer
For biliary tract cancer, alternatives include gemcitabine (Gemzar) or cisplatin. Surgery may also be an option for some patients. Maintaining a healthy diet and managing symptoms like jaundice can help improve quality of life.
Capecitabine Alternatives for Non-Small Cell Lung Cancer
Alternatives for non-small cell lung cancer include chemotherapy drugs like pemetrexed (Alimta) or targeted therapies like erlotinib (Tarceva). Quitting smoking and staying physically active can help improve lung function and overall health.
Capecitabine Alternatives for Anal Cancer
For anal cancer, alternatives include radiation therapy combined with chemotherapy drugs like mitomycin or fluorouracil. Maintaining a healthy diet and avoiding tobacco can support treatment outcomes.
Capecitabine Alternatives for Thymic Cancer
Alternatives for thymic cancer include chemotherapy drugs like cisplatin or doxorubicin (Adriamycin). Surgery may also be an option. Regular follow-ups with your healthcare provider are important for managing thymic cancer.
Recent Updates on Capecitabine Research
Recent studies on Capecitabine have focused on its use in combination with other therapies to improve cancer treatment outcomes. For example, ongoing research is exploring the effectiveness of Capecitabine when combined with immunotherapy drugs for cancers such as colorectal and gastric cancers. Additionally, researchers are investigating the role of genetic testing to identify patients more likely to experience severe Capecitabine side effects due to DPD deficiency. These advancements may help personalize treatment plans and improve patient outcomes in the future.
