Capecitabine (Generic Name)

Other Names: Xeloda

About This Drug

Capecitabine is used to treat cancer. It is taken by mouth.

Possible Side Effects (More Common)

  • Loose bowel movements (diarrhea) that may last for several days
  • Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Swelling in your ankles, feet, arms or hands.
  • Increased total bilirubin in your blood.  This may mean that you have changes in your liver function. Your blood work will be checked by your doctor.
  • Eye irritation.  You may have watery eyes.  Your eyes and eye lids may become red and painful.
  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
  • Decreased appetite (decreased hunger)
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment. Medicines are available to stop or lessen these side effects.
  • Abdominal pain
  • Wheezing and/or feeling short of breath
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Soreness of the mouth and throat. You may have red areas, white patches, and/or sores that hurt.
  • Constipation (not able to move bowels)
  •  Back, joint, or muscle pain

Possible Side Effects (Less Common)

  • Headache
  • xcess water loss from the body (dehydration)
  • Hair loss. You may notice your hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
  • Dizziness
  • Weakness
  • Blood clots.  A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Darkening of your skin or nails
  • Changes in the way food and drinks taste
  • Cough
  • Irregular heartbeat. This drug may cause a rapid or irregular heartbeat.  You may feel your heart beating fast (palpitations).
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Changes in the tissue of the heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.

Treating Side Effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Ask your doctor or nurse about medicines to help you stop or lessen nausea, throwing up, headache, constipation, and/or loose bowel movements (diarrhea).
  • If you have constipation, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • If you are dizzy, get up slowly after sitting or lying down.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.

Important Instructions

  • Take the capecitabine tablets with food or within 30 minutes after the end of a meal.
  • Swallow the tablets whole with water.

Food and Drug Interactions

There are known interactions of capecitabine with food and with some other medicines and products. Ask your doctor what over-the-counter (OTC) medicines you can take for fever, headache and muscle and joint pain. Do not eat grapefruit or drink grapefruit juice.

Talk with your doctor about taking St. John’s Wort, garlic, ginseng, and ginkgo. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Stop taking capecitabine right away and call your doctor if any of these symptoms happen:

  • Loose bowel movements (diarrhea) – if you have an extra 4 bowel movements in a day beyond what is normal for you, or any diarrhea at night
  • Throwing up – if you throw up more than once in a 24-hour period
  • Nausea – if you lose your appetite, and the amount of food you eat each day is much less than normal
  • Mouth sores – if you have pain, redness, swelling, or sores in your mouth
  • Hand-and-foot syndrome – if you have pain, swelling, or redness of hands and/or feet
  • Fever or infection – if you have a temperature of 100.5 F or higher, or other evidence of infection
  • If caught early, most of these side effects start to get better in two to three days after you stop taking capecitabine. If they don’t start to get better within two to three days, call your doctor again. After side effects have resolved, your doctor will tell you whether to start taking capecitabine again or what dose to use.

Call your doctor or nurse right away if you have any of these symptoms:

  • Feeling short of breath or trouble breathing
  • Bleeding or bruising that is not usual
  • Chest pain
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Dizziness

Notify your doctor or nurse as soon as possible if you have any of these symptoms:

  • Headache that does not go away
  • Swelling in your ankles, feet, arms or hands
  • Yellowing of the skin or eyes Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • No bowel movement for three days, or you feel uncomfortable
  • Abdominal pain
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Rash that is not relieved by prescribed medicines

Sexual Problems and Reproductive Concerns

  • Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
  • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
  • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

 Revised June 2014

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