What is Capecitabine?

The chemotherapy drug capecitabine is taken by mouth and is in the antimetabolite class of drugs.

It is a prodrug of 5-fluorouracil (5-FU), which means that when it is eaten, it is broken down in the body to make 5-FU, which is then sent straight to the tumor site.

This choice increases the efficacy of the medication and reduces its total negative impact on the body.

Overview

Description

Antimetabolite capecitabine is an oral chemotherapy drug. It mostly treats colorectal, breast, and gastric malignancies.

Capecitabine is a prodrug of 5-fluorouracil (5-FU) that becomes active after metabolism, targeting cancer cells.

For advanced or metastatic cancer, it is usually given alone or in combination. Oral Capecitabine is convenient for outpatient treatment.

Uses of Capecitabine Tablets

Capecitabine can be used alone or in combination with other medications to treat:

Colorectal cancer (stage III, metastatic)

Breast cancer

Gastric cancer (combined regimens)

Pancreatic and esophageal cancer

Stage III colon cancer adjuvant therapy

First-line metastatic colorectal cancer monotherapy

Breast cancer resistant to previous treatments

Gastric and esophageal cancers

Benefits

The complications associated with intravenous chemotherapy are circumvented through oral administration.

Systemic toxicity is mitigated by targeted conversion to active drugs in tumors.

Suitable for outpatient treatment Showed comparable efficacy to intravenous 5-fluorouracil

A dosing schedule that is more convenient and requires fewer hospital visits

Side Effects

Gastrointestinal issues: Nausea, vomiting, diarrhea, abdominal pain, stomatitis

Dermatological: Hand-foot syndrome (palmar-plantar erythrodysesthesia), rash

General: Fatigue, loss of appetite, headache

Severe diarrhea and dehydration

Myelosuppression: Neutropenia, thrombocytopenia, anemia

Cardiotoxicity: Arrhythmias, angina (rare)

Liver dysfunction: Elevated bilirubin and liver enzymes

Neurological: Confusion, dizziness

How Does Capecitabine Work?

Capecitabine is a prodrug, which means that it doesn’t work until it is taken and broken down in the body.

When it is eaten, it changes into 5-fluorouracil (5-FU), a strong anticancer drug that stops cancer cells from making DNA and RNA while they divide quickly.

Capecitabine stops the growth of tumors and helps cancer cells die by messing up the replication process.

The fact that it only works on tumor cells helps protect healthy cells, which makes it an effective and focused way to treat some types of cancer, like colorectal and breast cancer.

Dosage Guidelines

The usual amount for an adult is 1,250 mg/m² twice a day, in the morning and at night, for 14 days. Then there is a 7-day break (a 21-day cycle).

For breast cancer (with Docetaxel), 1,250 mg/m² twice a day for 14 days every 21 days

Older people: Start with a smaller dose because they are more likely to become toxic.

Directions for Use

It should be taken 30 minutes after a meal.

Take pills whole with water; don’t chew or crush them.

Follow the plan for taking your medicine.

If you miss a dosage, do not increase the following one.

When Not to Use

If you are allergic to Capecitabine or fluoropyrimidines, you should not take them.

Bad kidney function (CrCl <30 mL/min)

A history of bad responses to 5-FU

Being pregnant and breastfeeding

Drug Interactions

Warfarin: Increased bleeding risk—monitor INR closely

Leucovorin: Enhances 5-FU activity and toxicity

Phenytoin: Increases phenytoin plasma levels

Folic acid: Potentiates toxic effects of Capecitabine

Antacids (Al, Mg): May slightly increase plasma levels of Capecitabine

Safety Advice

For pregnant women, avoid using this product. It is not recommended to breastfeed.

Use of contraception during therapy and for a period of six months after treatment

If you are experiencing dizziness or exhaustion, you should avoid driving.

Avoid alcohol because it may make the symptoms worse.

General Instructions

Check blood counts and liver and kidney function often.

Report signs of infection, such as diarrhea that won’t go away or hand-foot syndrome.

If your WBC is low, stay away from groups and sick people.

As a caregiver, you should wear gloves when handling pills.

Dietary & Lifestyle Recommendations

It is important to eat healthy, well-balanced food while you are on Capecitabine to keep your body strong during treatment.

Protein-, fruit-, and vegetable-rich small meals should be eaten often. Spicy, greasy, or hard-to-digest foods should be avoided, especially if you are feeling sick or having diarrhea.

To avoid getting dehydrated, make sure you drink a lot of water.

Hand-foot syndrome is less likely to happen if you keep your hands and feet moist, stay away from high temperatures, and wear shoes that are easy on your feet.

Because the drug can make you more sensitive to sunlight, stay out of the sun and use sunscreen.

You should stay away from alcohol because it could make side effects worse or hurt the way your liver works.

Comparison with Other Treatments

Capecitabine is an oral chemotherapy drug that offers greater convenience compared to traditional intravenous (IV) chemotherapy, like 5-fluorouracil (5-FU), as it can be taken at home without hospital visits.

It is a prodrug that converts to 5-FU in the body, providing similar effectiveness but with a more targeted release, potentially reducing systemic toxicity.

Unlike some newer targeted therapies or immunotherapies, Capecitabine has a broader cytotoxic effect, which can lead to more general side effects, but is still highly effective for certain cancers like colorectal and breast cancer.

Its oral route and flexible dosing make it a preferred option in many treatment protocols, particularly for patients seeking outpatient care.

Precautions & Warnings

Before beginning treatment, be sure to check for a deficiency in DPD.

Ensure that elderly patients are monitored for toxicity.

Co-administration with other nephrotoxic or hepatotoxic medicines should be avoided by all means.

Watch for signs of cardiac ischemia, especially in people with a history of coronary artery disease (CAD).

Adjustments to the dosage may be required in cases of toxicity, organ impairment, or advanced age.

Use with Other Medications

CAPOX/XELOX: Capecitabine + Oxaliplatin

CAPIRI: Capecitabine + Irinotecan

With Docetaxel in breast cancer

May be combined with Trastuzumab for HER2-positive breast cancer

Storage

Keep below 30°C in a dry environment.

Leave tablets in their original package. Protect against light and moisture.

Keep out of reach of children

Use not past the expiry date.