Xeloda

Generic name: Capecitabine

Drug class: Antimetabolites

Dosage form: Tablets (150 mg and 500 mg)

Route of administration: Oral

Dose: Typically, 1,250 mg/m² twice daily for 14 days, followed by a 7-day rest period; dosage may vary based on individual factors and combination therapy

Mechanism of action: Capecitabine is an oral prodrug that is metabolized to 5-fluorouracil (5-FU) in the body. 5-FU inhibits DNA synthesis by interfering with thymidylate synthase, leading to cell death, particularly in rapidly dividing cancer cells.

Drug usage cases:

• Adjuvant treatment of stage III colon cancer
• First-line treatment of metastatic colorectal cancer
• Treatment of advanced or metastatic breast cancer after failure of standard therapy
• Combination therapy with docetaxel for advanced or metastatic breast cancer
• Combination therapy with oxaliplatin for metastatic colorectal cancer following failure of irinotecan-containing chemotherapy

Drug contraindications:

• Hypersensitivity to capecitabine, fluorouracil, or any component of the formulation
• Severe renal impairment (creatinine clearance <30 mL/min)
• History of severe hypersensitivity reactions to fluoropyrimidines
• Known dihydropyrimidine dehydrogenase (DPD) deficiency
• Concurrent use with sorivudine or its analogs
• Pregnancy and lactation

Side effects:

• Hand-foot syndrome (palmar-plantar erythrodysesthesia)
• Diarrhea
• Nausea and vomiting
• Abdominal pain
• Fatigue and weakness
• Decreased appetite
• Mucositis (mouth sores)
• Elevated bilirubin levels
• Skin reactions (rash, pruritus)
• Cardiac events (e.g., chest pain, arrhythmias)
• Hematologic toxicities (e.g., neutropenia, thrombocytopenia)

Warnings:

• Monitor for signs of hand-foot syndrome; dose adjustments may be necessary
• Assess renal function prior to initiation and during treatment
• Regularly monitor complete blood counts due to potential hematologic toxicity
• Evaluate liver function tests periodically
• Discontinue therapy if severe diarrhea or mucositis occurs
• Use caution in patients with a history of cardiac disease
• Ensure adequate hydration to prevent dehydration-related complications
• Advise patients to avoid pregnancy during treatment and for a specified period after completion

Use during pregnancy or breastfeeding:

Capecitabine is contraindicated during pregnancy due to potential teratogenic effects. Women of childbearing potential should use effective contraception during treatment and for a specified period after completion. It is not known whether capecitabine is excreted in human milk; therefore, breastfeeding is not recommended during treatment.