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Capecitabine, sold under the brand name Xeloda among others, is an anticancer medication used to treat breast cancer, gastric cancer and colorectal cancer. For breast cancer it is often used together with docetaxel.
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Common side effects include abdominal pain, vomiting, diarrhea, weakness, and rashes.
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Capecitabine was patented in 1992 and approved for medical use in 1998. It is on the World Health Organization's List of Essential Medicines.
Medical uses
Capecitabine is indicated for
- adjuvant treatment of people with Stage III colon cancer as a single agent or as a component of a combination chemotherapy regimen;
- perioperative treatment of adults with locally advanced rectal cancer as a component of chemoradiotherapy;
; Very common (>10% frequency):
- Appetite loss
- Diarrhea
- Vomiting
- Nausea
- Stomatitis
- Abdominal pain
- Fatigue
- Weakness
- Hand-foot syndrome
- Oedema
- Fever
- Pain
- Headache
- Hair loss
- Dermatitis
- Indigestion
- Shortness of breath
- Eye irritation
- Myelosuppression
Notes on adverse effects:
Contraindications
Contraindications include: In US, as of 2024, there is no specific contraindication on the package inserts however, there is a cautionary warning: "Patients with certain homozygous or compound
heterozygous variants in the DPYD gene are at increased risk for acute
early-onset toxicity and serious, including fatal, adverse reactions due to
XELODA (e.g., mucositis, diarrhea, neutropenia, and neurotoxicity).
XELODA is not recommended for use in patients known to have certain
homozygous or compound heterozygous DPYD variants that result in
complete absence of DPD activity. Withhold or permanently discontinue
based on clinical assessment. No XELODA dose has been proven safe in
patients with complete absence of DPD activity. "
Within the UK, DPYD testing to check for this contraindication is now routine practice, this is not the case in the US.
Drug interactions
Drugs it is known to interact with include:
Pharmacogenetics
The dihydropyrimidine dehydrogenase (DPD) enzyme is responsible for the detoxifying metabolism of fluoropyrimidines, a class of drugs that includes capecitabine, 5-fluorouracil and tegafur. Those with partial or complete DPD deficiency have a significantly increased risk of severe or even fatal drug toxicities when treated with fluoropyrimidines; examples of toxicities include myelosuppression, neurotoxicity and hand-foot syndrome.
Drug synthesis
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Overdose
Uridine Triacetate is a potential antidote for cases of suspected overdose.
Society and culture
Brand names
One of the brand names is Xeloda, marketed by Genentech.
Others include Xitabin, Capcibin, Kapetral and Pecaset by Eurolab.